Association of Sedentary Leisure Time with School Performance in Children and Adolescents: the CASPIAN-V Study

Background: Leisure time activities might be associated with school performance. This study aimed to investigate the association between leisure time variables, including television and computer using time, homework time and cell phone using time, with children’s school performance in a nationally representative sample of Iranian children and adolescents. Materials and Methods: In this analytical cross-sectional study as the fifth survey of a national school-based surveillance program in Iran, participants were selected by multi-stage sampling approach among 7-18-year-old students from urban and rural areas. In addition to filling questionnaires obtained from World Health Organization Global School Health Survey and conducting physical examinations, the averages of school grades were categorized into "very good" (grade 17-20 out of 20), and "not very good" (under 17 out of 20) as school performance according to qualitative evaluation scales established recently in Iranian schools. Results: The participation rate was 99%, 14,274 students completed the study. Urban students spent more time doing homework and using screen media, and they had better school performance than rural students (P < 0.001). Girls had higher homework time and better school performance than boys (P < 0.001). Prolonged screen time, including watching television and computer use increased the odds of lower school performance (Odds ratio = 1.11). No other media type times or homework time had a significant association with school performance. Conclusion: In this study, prolonged screen time represents an inverse association with school performance. Television viewing time, computer and cell phone using time and homework time might have no separate significant effects on school performance.