Work

Associations of digital media use with health, behavioural and developmental outcomes in children and adolescents: an umbrella review and meta-analysis

Year: 2026

Type: article

Abstract: Background Digital media (screen) use is nearly universal among children and adolescents, yet evidence on its associations with health outcomes remains fragmented across exposure types and outcome domains. We aimed to synthesise review-level evidence and quantify associations between digital media use and health, behavioural and developmental outcomes across childhood and adolescence. Methods This systematic umbrella review (PROSPERO-CRD420251175522) includes systematic reviews and/or meta-analyses published from Jan-2021 to Dec-2025 that investigate digital media exposures and their associations with health, behaviour, and development among individuals aged 0–24. Evidence was synthesised narratively and quantitatively, and stratified according to developmental stage (mainly 0–10 & 10–24 years; additionally, subgroups aged 0–5, 5–10, 10–18, 18–24 years and others). Methodological quality and certainty of evidence were assessed using validated tools, and overlap of primary studies was assessed using corrected covered area analysis. Findings We included 121 systematic reviews (52 with meta-analyses), comprising 2790 unique primary studies and over 9 million participants. Quality assessment showed that approximately two-thirds of the available literature was rated as low/critically-low quality, largely reflecting the observational nature of the underlying evidence. Mental health accounted for the largest share of findings (36%), with the direction and magnitude of associations varying according to developmental stage and the type, content, context, and pattern of digital media use. In children aged 0–10 years, overall screen time was associated with poorer socio-emotional and cognitive development and shorter sleep duration, whereas educational content and caregiver co-viewing were associated with improved language and cognitive outcomes. In adolescents aged 10–24 years, problematic digital media use and social media use were associated with higher odds of common mental health problems, lower quality of life, sleep problems, reduced physical activity, self-harm or suicidal ideation, and substance use, while active video games and body-positive content were associated with higher well-being and physical activity. Physical-health outcomes, including obesity, myopia, and cardio-metabolic risk, were reported in samples spanning childhood to adolescence. Interpretation The health implications of digital media use varied across developmental stages and according to the amount, content, context, and patterns of exposure. Given the predominantly observational nature of the evidence, the findings should not be interpreted as causal. Strengthening causal inference through longitudinal and experimental studies, alongside objective exposure assessment and broader outcome evaluation, remains a key research priority. Funding This work was supported by funding from the National University of Singapore under the Academic Health Programme (AHP) through the POPUP project and PANDA Research Programme. The Digital Transformations for Health Lab supported costs associated with project management, coordination, and stipends for Youth Advisory Group members.

Source: EClinicalMedicine

DOI: 10.1016/j.eclinm.2026.104225