To examine the longitudinal associations of objectively measured physical activity and modified organized sport participation with executive functions and psychological health in preschoolers. One hundred and eighty-five preschool children, mean age 4.2 ± 7.68; (years:months), 34% girls were followed for one year. Physical activity was measured using accelerometery, examining light, moderate, vigorous, moderate-to-vigorous, and total physical activity. Parents reported children’s participation in modified organized sport. Direct assessment of children’s executive functions (working memory, inhibition and shifting) and educator-reported psychosocial difficulties were also collected. Associations were examined using linear regression adjusting for covariates, baseline developmental outcomes and preschool clustering. Vigorous physical activity at baseline was positively associated with children’s shifting performance (b = 0.245; 95% CI: 0.006, 0.485, p =.045) at follow-up, while the association for moderate-to-vigorous physical activity approached significance (b = 0.119; 95% CI: −0.001, 0.239, p =.051). Children not participating in modified organized sport at baseline demonstrated better inhibition scores 12-months later compared to sports participants (Mdiff 0.06; CI: 0.00, 0.13, p =.046). Increasing time spent in higher intensity physical activity among preschool children may be a viable target for supporting their later cognitive development, although there was no clear benefit of early participation in modified organized sport.

Executive functions and psychosocial health during childhood are positively associated with health and developmental outcomes into adulthood. Electronic media use has been reported to adversely affect health and development in children; however, what remains unclear is whether contemporary media behaviors, such as electronic application (app) use, exerts similar effects on health and development. We investigated the associations of electronic media use (program viewing and app use) with cognitive and psychosocial development in preschoolers. Parents of preschool children (n = 247, 4.2 ± 0.6 years) reported the time their child spent using electronic media. Direct assessment of the children’s executive functions (working memory, inhibition, and shifting) and educator-reported psychosocial difficulties were also collected. Associations were examined using linear regression adjustments for covariates and preschool clustering. Small, but significant, negative associations were observed for total electronic media use (b = −0.001; 95% CI: −0.003, −0.000; p = 0.026) and program viewing (b = −0.002; 95% CI: −0.003, −0.000; p = 0.033) with children’s visual–spatial working memory. However, high-dose app users demonstrated higher phonological working memory scores compared to non-users (MD = 0.31; 95% CI: 0.04, 0.58; p = 0.025). Similarly, compared to non-users, low-dose app users displayed statistically significantly fewer total difficulties (MD = −1.67; 95% CI: −3.31, −0.02; p = 0.047). No associations were evident for high-dose app users and the remaining outcomes. The results may suggest that attempts to reduce program viewing while promoting moderate levels of app use may exert positive influences on children’s executive functions and psychosocial development.

Background: Screen-based devices have become a pervasive feature in the lives of young children. Understanding the ecological influences determining young children’s screen use is imperative for promoting healthy screen habits. While individual studies have examined various factors influencing children’s screen use across the early years, few studies have explored multiple ecological influences simultaneously. This research examines longitudinal associations between children’s home environment, parent management practices and neighbourhood influences on children’s screen time, through 4 to 7 years of age. Methods: Analyses draw on data from 2485 children in the Infant Cohort of a nationally representative sample of children and families participating in the Longitudinal Study of Australian Children (LSAC). Bivariate and multiple linear regression models were developed to assess contributions of child, parenting, home and neighbourhood variables, measured at 4–5 years, in predicting children’s daily screen time at 6–7 years. Results: Girls had lower screen time than boys at 6–7 years of age. Higher household socio-economic status, child participation in home learning activities and out-of-home extra-curricular activities, parenting consistency, and screen management practices including restricted bedroom access, presence and enforcement of screen rules, and parent-reported ease in managing screen time were also all significant predictors of lower daily screen time at age 6–7 years. Neighbourhood factors including liveability, sense of belonging and area-based socio-economic index were not significant predictors of children’s screen time, after child, parenting and home factors were included in the model. Conclusions: Providing guidance to families about building healthy screen practices from an early age should focus on parenting consistency and management of screen time, as well as responsiveness to engage children in other activities. Home routines on screen use, when consistently managed, can provide young children with opportunities to learn to self-regulate their own screen use behaviours from an early age and build healthy screen time habits.

BACKGROUND Digital health solutions have the potential to transform health delivery and health outcomes. However, the process of building acceptable and sustainable digital health interventions (DHIs) proves an ongoing challenge in a local landscape with complex and diffuse clinical informatics systems, siloed governance arrangements, and the safety of the ‘known’ for clinicians used to existing, often antiquated information systems. OBJECTIVE Our paper coalesces existing literature on the development of DHIs in complex environments into three themes to provide a framework to consider lessons learnt in the delivery of an anonymised DHI. We highlight the successes and setbacks involved in the development of a person-centred digital health intervention within a complex health care setting for the benefit of future development of DHIs. METHODS We conducted qualitative interviews both in person and via telephone with 22 stakeholders involved in the development of the DHI. Three researchers used a thematic analysis to iteratively code interview transcripts and considered the emerging themes within the context of wider literature. RESULTS We considered the development of a DHIs around three core themes: creating and sustaining aspirational, yet feasible vision; the engagement of decision-makers, service users, and service providers; and the use of data and flexibility to solve emerging challenges. Our case example underscores the importance of these themes. Specifically, the case example demonstrated that the engagement of stakeholders and end-users is important, however equally vital is the alignment between ‘co-design’ and ‘build’ phases of technology development. proved a challenging negotiation for the organisation responsible for the intervention. Additionally, the case example showed the necessity of balancing novelty and feasibility of vision, which could have been aided by greater technological competence during co-design phases. CONCLUSIONS Our paper provides an empirical consideration of the complexity of designing and developing digital health interventions, with some practical guidance for mitigating this complexity for future DHI development.