Document Type

DNP Project

Publication Date


Degree Name

Doctor of Nursing Practice

Faculty Advisor

Rosemary Johnson, DNP, APRN, FNP-BC

Practice Mentor

Josanne Hussain, M.D.

Second Practice Mentor

Rachel Leigh, MS, RDN


Background: Children in the US spend an average of 7.5 hours a day in front of a screen, well above the recommended 2 hours per day for entertainment. Screen time of greater than 3 hours per day is associated with higher body mass indices and insulin resistance that can lead to type 2 diabetes. Providers should review and reinforce age-appropriate screen time guidelines at well-child visits. Screen time education and behavior contracts can be used to facilitate age-appropriate screen time.

Project Goals:

  1. To implement screen time education and behavior contracts in a pediatric population in a federally qualified health center (FQHC) from November 2022 to February 2023.
  2. To reduce individual screen time to meet the recommended ≤2 hours per day except for homework in a pediatric population from November 2022 to February 2023.

Methods: Screen time education and agreement were available in English and Spanish and were included in 4 visits. Participants set their own weekly screen time goal. Weekly follow-up calls on average weekly screen time were conducted from December 28, 2022 to March 1, 2023. Participants could opt out of the weekly calls.

Results: A total of 35 participants (66.03%) completed the screen time education and agreement and agreed to be contacted. At least 1-week of follow-up data was available for 29 (82.86%) participants. Overall, 16 (55.17%) participants met the guidelines of ≤2 hours per day. There were 14 participants who set a screen time goal of >2 hours per day and by the end of the pilot period, 7 (46.67%) met the goal of ≤2 hours per day. Of the 15 participants that set their screen time goal at <2 hours per day, 6 (40%) reported weekly average screen times greater than their goal. Two school vacations occurred during the pilot period with parents reporting higher screen times for entertainment. On average, it took about 10 minutes at each visit to complete the intervention.

Conclusion: Screen time education and agreements with annual physicals and follow up visits helped children meet the guidelines of ≤2 hours per day with little additional visit time. The practice change should be adopted extended and changes to improve the process efficiency like having the nurse or medical assistant give the screentime education and contract during rooming in should be tested. (e.g., having the nurse or medical assistant give the screentime education and contract during rooming in).


A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

Available for download on Wednesday, June 26, 2024