Research Spotlights: March 2023

The use of mobile devices for calming preschool-aged children may interfere with child development

Mobile devices and digital media are increasingly being used by caregivers to keep children calm and occupied. This use has grown in popularity over the past two decades as mobile devices have become ubiquitous. Past research has shown that time spent watching television, other screen time, and playing video/computer games are associated with deficits in executive functioning and poor emotional regulation among children. However, most of this research has been cross-sectional and unable to suggest long-term consequences for child development. Furthermore, few studies have examined the use of mobile devices for the specific purpose of calming young children. Recently published work by NICHD and NCATS aimed to explore the longitudinal associations between the use of mobile devices for calming and executive functioning as well as emotional reactivity among children aged 3 to 5 years.

To investigate this relationship, the researchers conducted a longitudinal cohort study of parents/legal guardians and their children who owned at least one mobile device (n=422; parents: 94% female, mean age = 34 years, 60% college degree or higher; children: 53% male, mean age = 3.8 years). Data collection was conducted via web-based surveys administered at three timepoints (baseline, 3-, and 6-month follow-up) from August 2018 to January 2020, which collected information about child and family media use behaviors and content, parent-reported measures of early childhood executive functioning, behavior reflective of emotional reactivity, and child surgency.

The results of the study indicated that both executive functioning and emotional reactivity in children were associated with device use at baseline, but only the association with emotional reactivity persisted over time. The association between higher emotional reactivity and increased device use for calming was significant bidirectionally among male children, and children with higher surgency between the 3- and 6-month follow-ups. These sex differences have been previously reported and may be related to delayed skills in emotion socialization or emotional immaturity, or differential engagement with digital media.

This study had two primary limitations; first, the reliance of parental self-report to assess the use of mobile devices for calming purposes, rather than objective measures. In addition, the study sample of participants was not generalizable to the United States population due to a high proportion of highly educated parents with children who were predominantly White and non-Hispanic.

This study provided important evidence that providing a young child with a mobile device for the purpose of calming may be harmful to the development of children’s emotion-regulation skills and may become a harmful habit over time among children who are emotionally reactive. Additionally, these results also support recommendations from the American Academy of Pediatrics for parents to avoid reliance on media as a strategy to calm or soothe children.

Radesky JS, Kaciroti N, Weeks HM, Schaller AM, Miller AL. Longitudinal Associations Between Use of Mobile Devices for Calming and Emotional Reactivity and Executive Functioning in Children Aged 3 to 5 Years. JAMA Pediatr. 2023;177(1):62-70. doi: 10.1001/jamapediatrics.2022.4793.

Community-sourced recommendations from Latinx Trans and Non-Binary Individuals to promote cancer prevention

Research shows that trans and non-binary (TNB) individuals are more likely to be diagnosed with late-stage lung cancer and were less likely to receive treatment for kidney and pancreas cancers. Additionally, data published by the American Cancer Society indicates that cancer is the leading cause of mortality within the Latinx community, both within the continental United States as well as its territories. The National Cancer Database published a countrywide cancer study that indicated TNB individuals are at greater risk of suffering from liver, skin, colorectal, and lymphoma cancers, and experience higher rates of mortality after receiving a diagnosis of non-Hodgkin’s, prostrate, or urinary cancers. The same study showed that TNB communities were less likely to receive outreach regarding recommended cervical, breast, and colorectal cancer screenings. There is a broad consensus in the literature that barriers at the individual, provider, organizational, and sociopolitical levels drive cancer inequities experienced by TNB communities and individuals. Given that the gold standard of care is to provide culturally sensitive outreach, communication, and treatment in which are co-developed by members of the prioritized community, researchers with the support of the NCI, NIMHD, and NIMH engaged with TNB individuals residing in Puerto Rico and Florida to develop outreach that supports cancer screening and prevention in these communities.

Researchers conducted a mixed method sequential study examining barriers and facilitators for cervical and breast cancer screening among TNB individuals belonging to Latinx communities (LTNB). Purposive sampling was used to source specific input and experiences regarding the question of barriers and facilitators of cancer screenings impacting these communities, and this qualitative data was collected via synchronous online focus groups facilitated using the secured Zoom platform. The topics explored during these focus groups included: intervention content, outreach strategies to support screening, and the preferred format for intervention.

Participants in the focus groups provided recommendations regarding improvements at the provider level, such as the need for gender-affirming sensitivity in language and behaviors, the importance of inclusive language, and the correct use of a person’s affirmed name and pronouns, to avoid deadnaming an individual. Focus group participants also highlighted the urgency for healthcare providers serving TNB individuals to be trained in perceiving cancer manifestations in trans bodies of all ages. Participants also highlighted the importance of using established LGBTQ+ public gatherings and safe spaces (such as PRIDE events) to provide printed outreach regarding prevention and screening, as well as the usefulness of using established online social platforms to provide public-facing outreach and support to members of the LTNB community.

Results of this study indicate that multi-level approaches co-developed with the LTNB communities are essential to address social, structural, cultural, organizational, and political barriers to adequate cancer screening, prevention, and care impacting these communities.

Rivera-Custodio JJ, Soto-Sanchez AV, Alvarado-Cardona EO, Moreta-Ávila F, Silva-Reteguis J, Velez-Perez E, Jiménez-Ricaurte C, Rivera-Segarra E, Rodríguez-Madera SL, Ramos-Pibernus A. Recommendations from Latinx Trans and Non-Binary Individuals to Promote Cancer Prevention in Puerto Rico and Florida. Int J Environ Res Public Health. 2023 Jan 10;20(2):1213. doi: 10.3390/ijerph20021213. PMID: 36673968; PMCID: PMC9859014.