Author Type

Faculty

Publication Date

2026

Document Type

Article

Abstract

Objective

This study aimed to examine the independent and combined effects of screen time and physical activity on flourishing among US children and adolescents in the postpandemic era.

Methods

This cross-sectional study used existing data from the 2022 to 2023 National Survey of Children’s Health, a nationally representative survey of US children. A total of 47,673 children and adolescents aged 6 to 17 years were included. Multivariate logistic regression models were applied to examine the main effects and interactions between screen time and physical activity on flourishing, adjusting for sociodemographic covariates.

Results

Lower screen time and higher physical activity were each significantly associated with increased odds of flourishing. The interaction analysis revealed a dose-response pattern, where the combination of high physical activity and low screen time yielded the highest odds of flourishing (OR = 4.00, P< .001). Even among youths with high screen time, high physical activity remained a strong predictor of flourishing.

Conclusion

This study highlights the association between lifestyle behaviors and the well-being of children and adolescents. Encouraging regular physical activity and managing screen time may help promote flourishing. Because physical activity appears to buffer the negative effects of excessive screen use, fostering an active and balanced routine could support healthy development, even in high-screen-use environments.

DOI

https://doi.org/10.1016/j.acap.2026.103227

Journal Title

Academic Pediatrics

Volume (Issue)

Volume 26, Issue 4

Journal ISSN

1876-2859

Document Version

Publisher's PDF

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