• Dylan B Jackson, Alexander Testa, and Bryanna Fox.
• Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland. Electronic address: dylan.jackson@jhu.edu.
• Am J Prev Med. 2021 Apr 1; 60 (4): 462-470.

IntroductionIncreasing amounts of time using digital media (i.e., texting, social media, electronic gaming, and general smartphone and computer use) among children and adolescents is becoming a growing concern given its potentially deleterious effects on health. However, little is known about the social and developmental underpinnings of digital media use among children and youth. This study examines the link between adverse childhood experiences and digital media use among a recent, nationally representative sample of children and adolescents.MethodsData pertaining to children/youth aged 6-17 years from the 2018 National Survey of Children's Health were analyzed in 2020 (N=21,954). The association between 9 distinct forms of childhood adversity and time spent on digital media among youth was assessed using multinomial logistic regression. The mediating roles of family-, parent-, and child-level factors were determined using the Karlson-Holm-Breen method.ResultsNet of covariates, the relative risk of heavy digital media use was 3 times higher among youth experiencing ≥4 adverse childhood experiences than among those experiencing none. Both family resilience and connection as well as parenting stress emerged as significant mediators of the association between adverse childhood experiences and heavy digital media use, collectively accounting for approximately 39% of the association.ConclusionsIn an effort to mitigate heavy digital media use, providers and practitioners who consistently interact with youth should consider screening for adverse childhood experiences and referring high-risk youth and their families for various prevention and treatment programs poised to address these risk factors.Copyright © 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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