The association between children's and parents' co-TV viewing and their total screen time in six european countries: Cross-sectional data from the Feel4diabetes-study

In many European children, high levels of screen time can be found, which is associated with several adverse health outcomes. Therefore, there is a need for identifying effective intervention strategies that reduce screen time in children. A factor that may contribute to excessive screen time in children may be "co-TV viewing" (i.e., the time that parents and children spend on watching TV together), as parents often recognize the importance of limiting children's (individual) screen time, but often encourage TV viewing as a family because of its perceived benefits (e.g., educational purposes). The primary aim of this study was to investigate the (sex-specific) association between co-TV viewing and both children's and parents' screen time, and these associations were investigated across and within six European countries. In total, 10,969 parents (Mean age = 40.7 ± 5.3 years, Mean BMI = 24.4 ± 4.6) of primary school children (Mean age = 8.2 ± 1.0 years, 49.0% boys, Mean BMI = 17.3 ± 2.8) completed a questionnaire assessing co-TV viewing and screen time. Multilevel regression analyses were conducted. Across countries, positive associations were found between co-TV viewing and both children's (ß = 11.85, SE = 3.69, p < 0.001) and parents' screen time (ß = 14.47, SE = 4.43, p = 0.001). Similar associations were found in most (but not all) countries. The results suggest that targeting co-TV viewing might be a promising intervention strategy because of its potential to limit screen time of both children and parents.