Joint association of screen time and physical activity on self-rated health and life satisfaction in children and adolescents: the CASPIAN-IV study

Abstract

Background: Self-rated health and life satisfaction are two subjective measures for assessing overall health status. This study aims to investigate the association of self-rated health and life satisfaction with physical activity and screen time. Methods: As part of the fourth survey of a national surveillance program in Iran (CASPIAN-IV study), 14 880 students aged 6 to 18 years were selected via multi-stage cluster sampling from 30 provinces. Data were obtained from the WHO Global School-Based Student Health Survey questionnaire. Results: A total of 13 486 students with mean age of 12.47 (SD 3.36) completed the study. In crude model both prolonged screen time and physical activity were associated with favorable life satisfaction and selfrated health. However, in multivariate analysis only high physical activity was associated with good self-rated health (OR 1.37) and life satisfaction (OR 1.39), while prolonged screen time was not associated with good self-rated health (OR 1.02) and life satisfaction (OR 0.94). For combined screen time-physical activity variable, low screen time-high physical activity combination had the highest OR for both good self-rated health (OR 1.37) and life satisfaction (OR 1.43) in multivariate analysis. Conclusions: Our findings suggest that increasing physical activity is more crucial than emphasizing reducing screen time in improving the well-being of children and adolescents.