BACKGROUND: Modern children have significant exposure to technology, with gadgets like TVs and smartphones becoming integral to daily life. As a result, young people are spending more time on screen-based activities, leading to potential technology addiction, especially during adolescence. Screen time includes activities such as playing video games, watching TV, and using computers. The Indian Academy of Paediatrics and the American Academy of Paediatrics recommend balancing screen time with physical activity and social interactions, advising limits on entertainment screen time to under 1-2 hours a day. It can also affect sleep quality, with exposure to screens before bed reducing melatonin levels, which the AAP recommends avoiding at least one hour before bedtime. Prolonged screen usage has been associated with mental health issues like anxiety and depression [1], and in rural India, where access to smartphones is expanding, screen time is increasing, potentially affecting educational outcomes. Studies globally show that a large percentage of children exceed recommended screen time limits, with higher averages in urban areas compared to rural ones[1]. The pandemic further contributed to the rise in screen time, but there is limited research on post-pandemic screen time trends. OBJECTIVES 1) To determine the association between duration of screen time and behavioral health problems among rural and urban school going school going children aged between 14 to 16 years and 2) to compare behavioral health problems between rural and urban school going children. .METHODOLOGY: Schools from Mandya district were divided into rural and urban based on location. A cross-sectional analytical study was done on 3600 students who were selected as per simple random sampling. After taking the informed consent for 14 to 16 years of the school going children teachers and parents , the school children were included under study and the children, parents and teachers were given separate strength and difficulty questionnaires which contained 5 scales for measuring conduct problems, hyperactivity/inattention, peer relationship problems, emotional symptoms and pro-social behavior. The duration of screen time was assessed after comparison of all the three proforma given by parent’s teachers and students. RESULTS : Participants spend an average of 27.4 hours per week on TV/ video games/ chat/mail/computer and 12 hours on social media, with considerably less time on physical activity (1.95hours), homework (1hour) and reading books (1.48 hours). The self-reported data from the Strengths and Difficulties Questionnaire (SDQ) provides the mean score for total emotional symptoms (ES) is 2.26±0.93, indicating generally low emotional issues were reported emotional issues among the participants. Conduct problems (CPS) have a mean score of 1.43±0.81, reflecting a similar trend of low self-reported conduct issues. The hyperactivity scale (HAS) scores were also low, with a mean of 1.24±1.04, suggesting minimal hyperactivity concerns. Peer problems (PPS) had a mean score of 1.49±1.10, indicating few issues in peer relationships. Interestingly, the prosocial scale (PSS) had a relatively higher mean score of 6.98±1.58, demonstrating a strong tendency towards prosocial behaviors among the participants. Overall, the total SDQ score averages at 6.42±2.08, reflected a balanced profile with low levels of difficulties and high levels of positive social behaviors. School performance ratings indicated that the largest group of participants was rated as average (22.4%), with very poor and poor ratings constituting 11.1% and 11%, respectively. CONCLUSION: The present study concludes that school-going children aged 14 - 16 years spend an average of 27.4 hours per week on screen activities. It highlights a significant link between excessive screen time and behavioral health issues in these children. The study indicates that both rural and urban children are similarly impacted by high screen time, with no significant differences in SDQ scores between residential areas. The findings show that increased screen time is associated with a higher likelihood of emotional, conduct, and hyperactivity problems, regardless of where the children live. This emphasizes the need to monitor and manage screen time to improve behavioral health outcomes in children.

Screen time, Strength and Difficulty Questionnaires, Effect of screen time