Using Wearable Video Cameras to Assess Screen Use Contexts in Preschool-Aged Children: Pilot Observational Study.

Background: Wearable video cameras may offer a feasible approach to assess the contexts of screen use (eg, screen content and co-use) among preschool-aged children. Objective: The objective of this study was to assess the contexts of screen use among preschool-aged children using wearable video cameras. Methods: Children aged 2 to 5 years from Melbourne, Australia, wore a video camera for 1 day in the home environment during May 2023. One researcher manually coded video footage second by second; 15% was double coded for reliability. Coding included device type, screen activity, screen content classified using Common Sense Media ratings, streaming service, setting, social interaction, screen multitasking, and concurrent behaviors. Results: A total of 37,944 seconds (10.5 hours) of video camera footage from 8 children were identified and coded as screen use, equating to 21.8% (37,944/174,290) of total camera wear time (range 0.3%-74.0%). Screen use was predominately characterized by program viewing (n=37,461, 98.7% seconds) on televisions (n=34,192, 90.1% seconds) in the lounge room (n=33,710, 88.8% seconds). Programs scored low for educational value (mean 1.7, SD 1.4 of 5 stars), and approximately one-third (3/9, 33.3%) of programs were classified as appropriate for an age older than that of the children in this sample. Screen multitasking was rare (n=46, 0.1% of seconds), and coviewing occurred in approximately one-third of all screen use (n=11,010, 29%). Conclusions: Contexts considered beneficial for development (eg, educational and age-appropriate content) were infrequently observed. This suggests that interventions to equip parents with practical strategies to identify genuine educational content and recognize and avoid age-inappropriate content are warranted. However, our small sample size limits generalizability.