Date of Award

Spring 5-24-2020

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Dr. Semira Asaro, PhD, PMHNP-BC



Background:Excessive media use is an emerging health concern amongst the pediatric population. The American Academy of Pediatrics (AAP) recommends less than 2 hours per day of recreational screen time, yet the national average is between 7 to 9 hours per day for adolescents. A media-saturated lifestyle has consequences on a child’s mental, physical, and emotional health. Despite guidelines stating media use should be assessed at annual well-visits, only 16% of providers are following this recommendation. This gap in care leaves many families with a limited understanding of the impact of media on their child's health and represents a missed opportunity to provide education on how to manage screen time at home.

Aims of Service Change:This project utilizes the Family Media Plan at the 13 to 18 year-old well-child visits to reduce daily recreational screen time, cultivate media awareness, and reduce lifetime risk of depression.

Details of Innovation: An educational presentation was held to review pertinent information and reinforce provider adherence to assess adolescent recreational screen time at all 13 to 18 year well-visits, educate on guidelines regarding healthy media habits, review risks and benefits associated with screen time, and assess readiness to change media related behavior. The Family Media Plan, an evidence-based toolkit created by the AAP to create sustainable media-related behavior changes, was offered to families at the well-visit in either a printed or online access card version. The provider reviewed the intent of this project with the family, added the pre-formatted template to the patient’s chart, and received verbal consent for a follow-up phone call in 30 days to determine if the intervention was meaningful via a survey. Additionally, posters highlighting healthy behaviors were placed around the office to further support provider-led education.

Outcomes:The average baseline recreational screen time was 3.7 hours and the average post-intervention time was 3.0 hours for the 33 patients that responded at the 30 day follow-up. This demonstrates an 18% reduction in screen time correlated with implementing well-visit discussions on media use and utilizing the Family Media Plan. After conducting the follow-up survey, there was 93% family satisfaction with utilizing the Family Media Plan. Two providers agreed to participate in this project, and by October 30, 2019 both were assessing adolescent screen time and incorporating the Family Media Plan at all well-child visits as demonstrated through charting audits. Only 21 patients responded with post-intervention Patient Health Questionnaire-2 scores, which did not allow for a correlation between reduction in screen time and reduction in depression scores to be determined due to a small sample size. Notably, it was also found that there was an average of 1.3 less hours spent on media devices during the week than on weekends.

Implications to Practice: This reproducible and cost-effective intervention can help health care professionals, patients, and families respond to the growing problem of unhealthy media use. By assessing screen time, providers can connect families with resources, encourage open discussions, and gain a better understanding of their patients’ health. Empowering youth to positively engage media can mitigate negative sequalae as patients grow into adulthood and reduce the burden of healthcare related costs.