Are play and screen time associated with British preschoolers’ mental health? Cross-sectional findings from the British Preschool Children’s Play Survey

OBJECTIVES: To investigate associations between adventurous play, outdoor play and screen time and mental health (MH) in British preschool-aged children. DESIGN: Cross-sectional. SETTING: A nationally representative sample of caregivers of 2-4 years old (n=1066) in England, Scotland and Wales (Britain), recruited through an online research data and analytics group (YouGov UK). PARTICIPANTS: Caregivers of 1018 children provided valid complete-case data (age 2: n=298 (29%), age 3: n=365 (36%), age 4: n=355 (35%); female n=481 (47%); white: n=878 (81%)). OUTCOME MEASURES: Four outcomes, derived from parent-report questionnaires: internalising and externalising scores (using the Strengths and Difficulties Questionnaire) and positive and negative affect scores (using the Positive and Negative Affect Schedule for Children-P). Linear regression was used to explore associations between the three exposures (time (in hours per week) a child spent: (1) playing adventurously; and engaging in (2) educational screen time and (3) recreational screen time) and the four outcomes; interactions between play and screen time variables were also tested. Models were adjusted for child and parental demographic variables. RESULTS: For each additional hour per week a child engaged in adventurous play, they had lower internalising scores (-0.02 (-0.03 to -0.01)) and higher positive affect scores (0.04 (0.02 to 0.05)). More hours per day (vs