Nuances of balance; parental perspectives around screen use and nature exposure in middle childhood.

BACKGROUND: Limitations of existing screen guidelines combined with the prevalence of parental concerns around children's screen use necessitate the need for novel approaches to screen use management that are family-centred and focus on health-positive rather than restrictive messaging. A health-promoting activity that is inversely associated with excessive child screen use across numerous psychosocial outcomes and may lead to greater improvements in family functioning compared to other activities, is nature exposure. However, the joint and reciprocal relationships between child screen use and nature exposure have not been investigated in the relational family context. METHODS: Qualitative data was collected from 20 primary caregivers of children aged 5-8 who participated in semi-structured online interviews. A template thematic analysis comprising both deductive (conceptual and definitional scope for coding was determined through an a priori template) and inductive processes guided theme generation. RESULTS: Three main themes were generated, representing commonalities across parent accounts and intersections between key research areas: (1) 'fixation, obsession and displacement', (2) 'is screen use facilitating opportunities or driving disconnection?' and (3) 'parental self-efficacy is fluid'. The findings reveal meaningful interactions between children's screen use and outdoor time, that map onto the interactional theory of childhood problematic media use. We propose family-based nature activities as an additional protective factor for the etiology of problematic child media use. CONCLUSION: Findings provide a more integrated and nuanced understanding of how children's screen use and engagement with nature interact within the family paradigm. This research may help generate evidence-based alternatives and practical approaches to help parents navigate some of the challenges associated with childhood screen use.