{
  "abstract": "The ‘myopia epidemic’ has become a significant public health concern. Studies in school-aged children have shown at least 13-hours outdoors per week is protective against myopia, while increased screen-time is a risk-factor. However, little is known about these associations in pre-school children. The COSMIC study aims to explore these phenomena in children aged 1–4 years.This Leicester-based mixed-methods study comprised a focus group and survey. We recruited four parents to a semi-structured focus group exploring pre-schoolers’ outdoor time, screen-time, driving factors and barriers. The focus group helped advertise and construct our online survey, including demographic questions, Likert scales and free-text responses.Twenty-seven parents completed the survey over fourteen days. The mean age of children was 3 years; 52% were female. Whilst 85% of parents believe it is very important for their child to be outdoors regularly, only 15% of children achieved 2-hours per day outdoors. Consistent with focus group thematic analysis, main barriers to outdoor time were adverse weather (81%) and household responsibilities (67%). 15% of children own a device and 67% primarily use far-distance screens. Most parents (67%) believe hand-held screens to negatively affect children’s eye health and most (74%) agree or strongly agree that ‘screen-time reduces the amount of time my child spends outdoors.’ Screen-time motivations were education (48%) and occupying children (48%).Our study has begun to shed light on the driving factors and barriers to outdoor time and screen-time in pre-school children. Further research and interventions are needed to protect pre-school children against myopia.",
  "authors": [
    {
      "affiliations": [
        "University of Leicester Ulverscroft Eye Unit, Leicester Royal Infirmary, Leicester, UK"
      ],
      "name": "Simran Khutan"
    },
    {
      "affiliations": [
        "University of Leicester Ulverscroft Eye Unit, Leicester Royal Infirmary, Leicester, UK"
      ],
      "name": "Rebecca McLean"
    },
    {
      "affiliations": [
        "University of Leicester Ulverscroft Eye Unit, Leicester Royal Infirmary, Leicester, UK"
      ],
      "name": "Mervyn Thomas"
    },
    {
      "affiliations": [
        "University of Leicester Ulverscroft Eye Unit, Leicester Royal Infirmary, Leicester, UK"
      ],
      "name": "Sohaib Rufai"
    }
  ],
  "title": "125943 Correlating outdoor time, screen-time and myopia in pre-school children: the COSMIC study",
  "uid": "551c2f07-9746-56c9-9d63-4e1c5d107950"
}