Article Text

Original research
From screen time to the digital level of analysis: a scoping review of measures for digital media use in children and adolescents
  1. Dillon Thomas Browne1,
  2. Shealyn S May1,
  3. Laura Colucci1,
  4. Pamela Hurst-Della Pietra2,
  5. Dimitri Christakis3,
  6. Tracy Asamoah4,
  7. Lauren Hale2,
  8. Katia Delrahim-Howlett5,
  9. Jennifer A Emond6,
  10. Alexander G Fiks7,
  11. Sheri Madigan8,
  12. Greg Perlman2,
  13. Hans-Jürgen Rumpf9,
  14. Darcy Thompson10,
  15. Stephen Uzzo11,
  16. Jackie Stapleton12,
  17. Ross Neville13,
  18. Heather Prime14
  19. The MIST Working Group
    1. 1Psychology, University of Waterloo, Waterloo, Ontario, Canada
    2. 2Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
    3. 3School of Medicine, University of Washington, Seattle, Washington, USA
    4. 4Media Committee, American Academy of Child and Adolescent Psychiatry, Washington, District of Columbia, USA
    5. 5Division of Extramural Research, National Institute on Drug Abuse, North Bethesda, Maryland, USA
    6. 6The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Geisel School of Medicine Global Health Tanzania DarDar Programs, Hanover, New Hampshire, USA
    7. 7Department of Pediatrics, Children’s Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    8. 8Psychology, University of Calgary, Calgary, Alberta, Canada
    9. 9Psychiatry and Psychotherapy, Translational Psychiatry Unit, Research Group S:TEP, University of Luebeck, Lubeck, Germany
    10. 10School of Medicine, University of Colorado, Denver, Colorado, USA
    11. 11New York Hall of Science, Flushing, New York, USA
    12. 12Information Services and Resources, University of Waterloo, Waterloo, Ontario, Canada
    13. 13School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
    14. 14Psychology, York University, Toronto, Ontario, Canada
    1. Correspondence to Dr Dillon Thomas Browne; dillon.browne{at}


    Objectives This scoping review aims to facilitate psychometric developments in the field of digital media usage and well-being in young people by (1) identifying core concepts in the area of “screen time” and digital media use in children, adolescents, and young adults, (2) synthesising existing research paradigms and measurement tools that quantify these dimensions, and (3) highlighting important areas of need to guide future measure development.

    Design A scoping review of 140 sources (126 database, 14 grey literature) published between 2014 and 2019 yielded 162 measurement tools across a range of domains, users, and cultures. Database sources from Ovid MEDLINE, PsycINFO and Scopus were extracted, in addition to grey literature obtained from knowledge experts and organisations relevant to digital media use in children. To be included, the source had to: (1) be an empirical investigation or present original research, (2) investigate a sample/target population that included children or young persons between the ages of 0 and 25 years of age, and (3) include at least one assessment method for measuring digital media use. Reviews, editorials, letters, comments and animal model studies were all excluded.

    Measures Basic information, level of risk of bias, study setting, paradigm, data type, digital media type, device, usage characteristics, applications or websites, sample characteristics, recruitment methods, measurement tool information, reliability and validity.

    Results Significant variability in nomenclature surrounding problematic use and criteria for identifying clinical impairment was discovered. Moreover, there was a paucity of measures in key domains, including tools for young children, whole families, disadvantaged groups, and for certain patterns and types of usage.

    Conclusion This knowledge synthesis exercise highlights the need for the widespread development and implementation of comprehensive, multi-method, multilevel, and multi-informant measurement suites.

    • mental health
    • paediatrics
    • community child health
    • child & adolescent psychiatry
    • public health

    Data availability statement

    Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplemental information. Relevant data are included as online supplemental information. Extended data available by request.

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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    Data availability statement

    Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplemental information. Relevant data are included as online supplemental information. Extended data available by request.

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    Supplementary materials


    • SSM and LC are joint senior authors.

    • Collaborators The MIST Working Group: Daphne Bavelier, University of Geneva, Geneva, Switzerland; Florence Breslin, Laureate Institute for Brain Research, Tulsa, USA; Joanne Broder, Saint Joseph’s University, Philadelphia, USA; Zsolt Demetrovics, Eötvös Loránd University, Budapest, Hungary; John Hutton, Cincinnati Children’s Hospital, Cincinnati, USA; Jessica Mendoza, University of Alabama, Tuscaloosa, USA; Jaysree Roberts, NYC Health + Hospitals, Kings County, New York, USA; Thomas Robinson, Stanford University, Stanford, USA; Cris Rowan, Zone'in Programs Inc., Sechelt, Canada; Oren Shefet, Suny Old Westbury, Old Westbury, New York; Tim Smith, Birkbeck University of London, Birkbeck, London; Rachel Waxman, NYC Health + Hospitals/ Kings County, New York, USA; Paul Weigle AACAP/Natchaug Hospital, Mansfield, USA.

    • Contributors DTB obtained funding, conceptualised the research, oversaw data collection and analyses, and edited the manuscript. SSMay conceptualised the research, conducted data collection and analyses, drafted and edited the manuscript. LC conducted data collection and analyses, drafted and edited the manuscript. PH-DP obtained funding, conceptualised the research, and edited the manuscript. DC, TA, LH, KD-H, JAE, AGF, SMad, GP, H-JR, DT, SU, JS, RN, HP conceptualised the research and edited the manuscript. The MIST Working Group conceptualised the research and edited the manuscript. All authors were involved in the decision to submit the manuscript for publication and approved the final manuscript.

    • Funding Funding for this research project was provided by Children and Screens: Institute of Digital Media and Child Development (grant/award number: not applicable). The project was conceptualized, stewarded, and funded by Children and Screens as part of an effort to develop a Media Impact Screening Toolkit for clinicians and researchers; as such, Dr. PHDP (fourth author) represents the organization as an active member of the article authorship team.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.