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5C Screen Time |
Description | Specific Indicators | Ontario Public Health Standards (OPHS) | Corresponding Health Indicator(s) from Statistics Canada and CIHI | Data Sources | Survey Questions | Analysis Check List | Method of Calculation | Basic Categories | Indicator Comments | Cross-References to Other Indicators | Cited Reference(s) | Changes Made | Acknowledgements Description | - Proportion of population, aged 12 and over, who are frequent television or video viewers during their leisure time
- Proportion of population, aged 12 and over, who are frequent computer users during their leisure time
- Proportion of population, aged 12 and over, who are frequent television or video viewers, computer users, and video game players during their leisure time
| Specific Indicators | - Prevalence of frequent leisure-time television or video viewing (15 or more hours per week)
- Prevalence of frequent leisure-time computer use (11 or more hours per week)
- Prevalence of frequent leisure-time television or video viewing, computer use, and video games playing (15 or more hours per week)
Ontario Public Health Standards (OPHS) - The Ontario Public Health Standards (OPHS) establish requirements for the fundamental public health programs and services carried out by boards of health, which include assessment and surveillance, health promotion and policy development, disease and injury prevention, and health protection. The OPHS consist of one Foundational Standard and 13 Program Standards that articulate broad societal goals that result from the activities undertaken by boards of health and many others, including community partners, non-governmental organizations, and governmental bodies. These results have been expressed in terms of two levels of outcomes: societal outcomes and board of health outcomes. Societal outcomes entail changes in health status, organizations, systems, norms, policies, environments, and practices and result from the work of many sectors of society, including boards of health, for the improvement of the overall health of the population. Board of health outcomes are the results of endeavors by boards of health and often focus on changes in awareness, knowledge, attitudes, skills, practices, environments, and policies. Boards of health are accountable for these outcomes. The standards also outline the requirements that boards of health must implement to achieve the stated results.
Outcomes Related to this Indicator - Societal Outcome (Chronic Disease Prevention): An increased proportion of the population lives, works, plays, and learns in healthy environments that contribute to chronic disease prevention.
- Societal Outcome (Chronic Disease Prevention): There is increased adoption of behaviours and skills associated with reducing the risk of chronic diseases of public health importance.
Assessment and/or Surveillance Requirements Related to this Indicator - The board of health shall conduct epidemiological analysis of surveillance data...in the area of physical activity (Chronic Disease Prevention).
http://www.ontario.ca/publichealthstandards | Corresponding Indicators from Statistics Canada and CIHI | Data Sources
Numerator & Denominator: Canadian Community Health Survey (CCHS) Original source: Statistics Canada Distributed by: 1. Ontario Ministry of Health and Long-Term Care 2. Statistics Canada Suggested citation (see Data Citation Notes): 1. Canadian Community Health Survey [year], Statistics Canada, Share File, Ontario Ministry of Health and Long-Term Care 2. Canadian Community Health Survey [year], Statistics Canada, Public Use Microdata File, Statistics Canada |
Survey Questions The Canadian Community Health Survey (CCHS) has a Sedentary Activities module (optional content) that includes questions related to typical sedentary activities during leisure-time over the past three months, including computer use, video games, television viewing and reading. The module was selected by some health units in 2001 and 2003 and was theme content in 2007-2008. Two derived variables are also available for total number of leisure-time hours per week spent in sedentary activities, including or excluding reading. Data Source | Module | Question/Description | Response Categories | Year | Variable | CCHS | Sedentary Activities | Now, a few additional questions about activities you do in your leisure time, that is, activities not at work or at school. In a typical week in the past 3 months, how much time did you usually spend on a computer, including playing computer games and using the Internet? | None Less than 1 hour, From 1 to 2 hours, From 3 to 5 hours, From 6 to 10 hours, From 11 to 14 hours, From 15 to 20 hours, More than 20 hours, Don’t Know, Refused
| 2001 | SACA_1 | 2003 | SACC_1 | 2007-2008 | SAC_1 | Now, a few additional questions about activities you do in your leisure time, that is, activities not at work or at school. In a typical week in the past 3 months, how much time did you usually spend watching television or videos?
Total number of hours per week spent on leisure time television or video viewing, computer use, and video games playing (only ask those aged 19 and under for video games playing)
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None Less than 1 hour, From 1 to 2 hours, From 3 to 5 hours, From 6 to 10 hours, From 11 to 14 hours, From 15 to 20 hours, More than 20 hours, Don’t Know, Refused
None Less than 1 hour, From 1 to 2 hours, From 3 to 5 hours, From 6 to 10 hours, From 11 to 14 hours, From 15 to 20 hours, More than 20 hours, Don’t Know, Refused
| 2001 | SACA_3 | 2003 | SACC_3 | 2007-2008 | SAC_3 | 2001 | SACDTER (syntax) | 2003 | SACDTER (syntax) | 2007-2008 | SACDTER |
Analysis Check List
| CCHS - It is recommended that public health units use the Share File provided by the Ministry of Health and Long-Term Care rather than Public Use Microdata File (PUMF) provided by Statistics Canada. The Share File has a slightly smaller sample size because respondents must agree to share their information with the province to be included; however, the share file has more variables and fewer grouped categories within variables. The Share File is a cleaner dataset for Ontario analysis because all variables that were not common content, theme content or optional content for Ontario have been removed.
- There may be slight differences between results from the share file and data published on the Statistics Canada website for the Health Indicators because rates calculated for Health Indicators use the master CCHS data file.
- Not applicable respondents should be excluded; however, it is important to understand who these respondents are from the questionnaire skip patterns to be able to describe the relevant population.
- Users need to consider whether or not to exclude the ‘Refusal, 'Don't Know' and ‘Not Stated' response categories in the denominator. Rates published in most reports, including Statistics Canada's publication Health Reports generally exclude these response categories. In removing not stated responses from the denominator, the assumption is that the missing values are random, and this is not always the case. This is particularly important when the proportion in these response categories is high.
- Estimates must be appropriately weighted (generally the share weight for the CCHS) and rounded.
- Users of the CCHS Ontario Share File must adhere to Statistics Canada's release guidelines for the CCHS data when publishing or releasing data derived from the file in any form. Refer to the appropriate user guide for guidelines for tabulation, analysis and release of data from the CCHS. In general, when calculating the CV from the share file using the bootstrap weights, users should not use or release weighted estimates when the unweighted cell count is below 10. For ratios or proportions, this rule should be applied to the numerator of the ratio. Statistics Canada uses this approach for the tabular data on their website. When using only the Approximate Sampling Variability (Coefficient of Variation, CV) lookup tables for the share file, data may not be released when the unweighted cell count is below 30. This rule should be applied to the numerator for ratios or proportions. This provides a margin of safety in terms of data quality, given the CV being utilized is only approximate.
- Before releasing and/or publishing data, users should determine the CV of the rounded weighted estimate and follow the guidelines below:
- Acceptable (CV of 0.0 - 16.5%) Estimates can be considered for general unrestricted release. Requires no special notation.
- Marginal (CV of 16.6 - 33.3%) Estimates can be considered for general unrestricted release but should be accompanied by a warning cautioning subsequent users of the high sampling variability associated with the estimates. Such estimates should be identified by the letter E (or in some other similar fashion).
- Unacceptable (CV greater than 33.3%) Statistics Canada recommends not to release estimates of unacceptable quality. However, if the user chooses to do so then estimates should be flagged with the letter F (or in some other fashion) and the following warning should accompany the estimates: "The user is advised that...(specify the data)...do not meet Statistics Canada's quality standards for this statistical program. Conclusions based on these data will be unreliable and most likely invalid". These data and any consequent findings should not be published. If the user chooses to publish these data or findings, then this disclaimer must be published with the data.
Method of Calculation Prevalence of frequent leisure-time television or video viewing:
Weighted population aged 12+ that spend 15 or more hours per week watching television or videos during leisure time | |
| X 100 | Weighted total population aged 12+ | |
Prevalence of frequent leisure-time computer use:
Weighted population aged 12+ that spend 11 or more hours per week on a computer during leisure time | |
| X 100 | Weighted total population aged 12+ | | Prevalence of frequent leisure-time television or video viewing, computer use, and/or video games playing:
Weighted population aged 12+ that spend 15 or more hours per week watching television or videos, using a computer, and playing video games during leisure time
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| X 100 | Weighted total population aged 12+ | |
Basic Categories | - Age groups for age-specific rates: 12-19, 20-44, 45-64, 65+.
- Sex: male, female, total.
- Geographic areas for: CCHS – Ontario, and all 36 Public Health Units.
Indicator Comments | Cross-References to Other Indicators | Cited Reference(s) - Boyce WF, King MA, Roche J. Healthy settings for young people in Canada. Ottawa, ON: Public Health Agency of Canada, 2008. Available online at: http://www.phac-aspc.gc.ca/dca-dea/yjc/ch3_51_54-eng.php (Accessed October 2009).
- Wong, SL, Leatherdale, S. Association between sedentary behavior, physical activity, and obesity: inactivity among active kids. Preventing Chronic Disease. 2009:6(1):1-13.
- Mutz DC, Roberts DF, Vanvuuren DP. Reconsidering the displacement hypothesis: television's influence on children's time use. Communication Research. 1993;20(1):51-75.
- Engelberg E, Sjöberg L. Internet use, social skills, and adjustment. CyberPsychology Behavior. 2004;7(1):41-47.
- VERB Youth Media Campaign, print advertorial. Interrupt your child’s regularly scheduled programming to give them a healthier start on life. Centers for Disease Control and Prevention. Running date 2002 Aug 19-Oct 2 Available online at: http://www.cdc.gov/youthcampaign/pressroom/article/decreasing-screen.htm (Accessed March 2010).
- Crespo CJ, Smit E, Troiano RP, Bartlett SJ, Macera CA, Andersen RE. Television watching, energy intake, and obesity in US children: results from the Third NHANES. Arch Pediatr Adolesc Med. 2001 Mar;155(3):360-365.
- Andersen RE, Crespo CJ, Bartlett SJ, Cheskin LJ, Pratt M. Relationship of physical activity and television watching with body weight and level of fitness among children. The Journal of the American Medical Association, 1998 Mar 25;279(12):938-942. Available online at: http://jama.ama-assn.org/cgi/content/full/279/12/938 (Accessed April 2010).
- Shields M, Tremblay MS. Sedentary behaviour and obesity. Health Reports (Statistics Canada, Catalogue 82-003-X) 2008 Jun;19(2):19-30. Available online at: http://www.statcan.gc.ca/pub/82-003-x/2008002/article/10599-eng.htm (Accessed November 2009).
- Aires L, Andersen LB, Mendonça D. Changes in fitness, physical activity, fitness, and screen time: a longitudinal study in children and adolescents. Nature Precedings: hdl:10101/npre.2009.3004.1 : Posted 30 Mar 2009. Available online at: http://precedings.nature.com/documents/3004/version/1 (Accessed March 2010).
- Whitehead, Margaret. A typology of actions to tackle social inequalities in health. J Epidemiol Community Health. 2007 Jun;61(6):473-478.
- Canadian Paediatric Society, Psychosocial Paediatrics Committee. Position statement: impact of media use on children and youth. Paediatrics & Child Health. 2003;8:301-6. Available online at: http://www.cps.ca/english/statements/CP/pp03-01.htm (Accessed November 2009).
- Canadian Society for Exercise Physiology. Canadian Sedentary Behaviour Guidelines for Children and Youth. 2011 Feb. Available online at: http://www.csep.ca/english/view.asp?x=804 (Accessed June 2011)
- Shields M, Tremblay MS. Screen time among Canadian adults: a profile. Health Report (Statistics Canada). 2008 Jun;19(2):31-43. Available online at: http://www.statcan.gc.ca/pub/82-003-x/2008002/article/10600-eng.htm (Accessed November 2009).
- Foehr, EG. Media multitasking among American youth: prevalence, predictors and pairings. December 2006. The Kaiser Family Foundation. www.kff.org. Washington, DC.
- Rideout, VJ, Foehr, UG, Roberts, DF. Generation M²: Media in the lives of 8- to 18-year-olds. January 2010. Henry J. Kaiser Family Foundation, Menlo Park, California.
| Changes Made Date | Type of Review (Formal Review or Ad Hoc?) | Changes made by | Changes | January 4, 2011 | Development | Healthy Eating and Active Living subgroup of Core Indicators | - Screen Time indicator created.
| June, 14, 2011 | Ad hoc | Healthy Eating and Active Living subgroup of Core Indicators | - Add a specific indicator " Prevalence of frequent leisure-time television or video viewing, computer use, or video games playing (15 or more hours per week)”
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Acknowledgements Lead Author(s) | Fangli Xie, Durham Region Health Department Elsa Ho, Ontario Ministry of Health and Long-Term Care Jennifer Skinner, Haliburton, Kawartha, Pine Ridge District Health Unit
| Contributing Author(s) | | Reviewers | John Barbaro, Simcoe Muskoka District Health Unit Mary-Anne Pietrusiak, Durham Region Health Department Rachel Colley, Children's Hospital of Eastern Ontario Research Institute Art Salmon, Ontario Ministry of Health Promotion and Sport Beth Theis, Cancer Care Ontario
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