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Early exposure to screens puts children at risk of later neurodevelopmental delay. This exposure is particularly prevalent among the underprivileged populations in our study area, and we don't yet know the motivations, factors and constraints that need to be put in place to remedy the situation.
Our approach is a bottom-up study, based on the experience of parents who stopped their child's exposure to screens before age 3, to develop a program to reduce early exposure to screens. This will then be tested on a larger scale via a randomized trial
The research will be performed in 2 phases:
Phase 1: No intervention, an qualitative and observational phase.
We will identify participants through parents' reports during standard pediatric follow-up consultations. Those who report the cessation of screen exposure will be interviewed using the SCREEN survey, both before and at least 3 months after cessation. Our study's objectives will be presented along with an oral agreement. These "expert parents" will be contacted by phone to gather necessary data for sampling before any qualitative interview. Our aim is to have a carefully selected, homogeneous sample, rather than a representative one. Eligible parents may differ based on certain criteria, leading to potential bias : child's age, presence of older siblings, parents' socio-professional category, childcare arrangements for children <3 years of age, screen-free period (lockdown or not). Inclusion will occur after this stage.
The objectives of this interview are as follows:
The results of this survey will form the basis for the EPURE program. Working sessions with a multi-professional working group should define :
Final implementation will depend on the results of phase 1 and should not be anticipated
PHASE 2 : described as a prospective multicenter interventional study, which falls within the scope of the JARDE law.
The inappropriate use of screens will be identified by completing the SCREEN survey with all families of children under 3 years of age who attend the centers participating in the study. This identification will take place during consultations or "all-inclusive" interviews for children under 3, or during a consultation for a family member who has raised a suspicion of a high-risk situation (for example, a baby being calmed down with a cell phone during a consultation for an older child or a parent for example).
The program will involve the random selection of volunteer families in the cohort. Beforehand, a randomization list will be prepared and provided to the centers in sealed envelopes, each containing an encrypted code corresponding to the inclusion arm. This method was chosen for its minimal disruption to daily consultation practice. Neither the investigator nor the family will have access to the meaning of the code, ensuring unbiased selection.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EPURE + | Active Comparator | In this phase, a tool will be tested aimed to reduce screen time. A screen will be conducted at 2 and 6 months to measure the program's effectiveness. |
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| EPURE - | Active Comparator | In this arm, no tool will be used. This arm will require only advices. Depending on the result of the screen at 2 months, adjustement will be made.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| EPURE + : EPURE program | Behavioral | EPURE program will be tested. |
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| Measure | Description | Time Frame |
|---|---|---|
| Demographic informationns (child) | First and last name, age | [Day 1] |
| Results of SCREEN survey | SCREEN Survey's results. | [Day 1] |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hopitalier de Saint-Denis | Saint-Denis | Seine Saint Denis | 93200 | France |
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| EPURE - : Standard practices |
| Behavioral |
This group will receive standard practices to prevent the use of screens in child under 3 |
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