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Digital Media and the Pediatric Provider: Provider Perceptions of the Impact of Child Digital Media Use

Natalie Arthur*, Neha Malhotra*, Jaime Brown MD, James Roberts MD, and Christine Turley MD.
* = coequal first authors

Digital Media (DM) and screen use is a pervasive presence in the lives of children. While the American Academy of Pediatrics (AAP) provides recommendations for children’s DM usage, there is no standardized management plan for families and physicians to follow. Unhealthy use of DM has been linked to poor sleep, obesity, and language delays. Conversely, positive outcomes of DM include exposure to prosocial messaging, language improvement, etc. It is pivotal that well child care (WCC) providers have the proper tools to counsel their patients about DM. Creating a better implementation strategy first requires understanding population concerns and needs surrounding DM. 
This study examines perceptions of primary care providers regarding differences in negative and positive effects of DM use on children. These perceptions were then analyzed with regards to population characteristics (Spanish-speaking/bilingual, African-American, Medicaid, and rural).
A REDCap survey was provided electronically to WCC providers across South Carolina and distributed in paper format at the SC-AAP Annual meeting in August 2019. Providers were asked to answer only once and select up to three of their own perceived negative and positive outcomes of DM in children. They were also asked to estimate the percentage of their patients belonging to the previously mentioned demographic subsets. 
72/306 providers responded to the survey (response rate 24%). Results showed that providers with predominantly rural populations were more likely to select “sleep problems” as a negative effect of DM. Providers serving African American populations were more likely to choose ‘increased communication with distant relatives and friends’ as a positive outcome of DM use, and ‘bullying’ as a negative outcome. 
These results showed important differences in perceptions of DM use from providers serving diverse populations. Research shows that children’s DM use depends on social determinants such as familial income, parental education and status, sedentary behavior, and neighborhood safety. This, when combined with our data, suggests that healthy DM intervention is a multifactorial consideration. 
Future Directions: 
Knowledge about the needs of various demographics will contribute to the creation of a more tailored DM intervention and enable more effective counseling by primary care providers.

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