Determinants of High Screen Time Use and Physical Inactivity Among High School Students in Texas: A 2001-2023 Cross-Sectional Study.

Abstract

PurposeTo examine demographic, socioeconomic, and health related correlates of the combined behavioral pattern of high screen time and physical inactivity among Texas high school students.DesignCross-sectional study using Youth Risk Behavior Survey data.SettingTexas high schools.Sample32 227 students in grades 9-12 from 2001-2023.MeasuresScreen time was dichotomized as high (≥3 hours/day) vs low (<3 hours/day). Physical activity was categorized as low (0-3 days/week) vs high (>3 days/week of ≥60 minutes/day). Demographic, body mass index, mental health, substance use, and dietary variables were assessed.AnalysisWeighted prevalence estimates and multivariable logistic regression models were used, adjusting for potential confounders.ResultsApproximately 25% of students exhibited both high screen time and low physical activity. Female students had 75% higher odds (95% CI: 1.54-2.00) of this behavioral combination compared to males. Black, Hispanic, and Other/Multiracial students had 2-3 times higher odds compared to White students. Students perceiving themselves as very overweight had 2.5 times higher odds of both high screen time and low physical activity (95% CI: 1.82-3.50) compared to those who perceived themselves as having about the right weight. Depression and drug use were associated with increased odds, while fruit and vegetable consumption showed protective effects.ConclusionComprehensive, culturally tailored interventions targeting both behaviors simultaneously are needed, particularly among underrepresented racial/ethnic groups and students with mental health challenges.