{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:04:07Z","timestamp":1789445047494,"version":"build-2803163510"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>COVID-19 has influenced education systems worldwide, and significantly increased screen time for college students, posing a potential risk of myopia. In China, ninety percent of college students suffer from myopia. Excessive screen time changes college students' lifestyles, imposes potential health risks, and affects opportunities for employment. It is important to identify the potential correlation between screen time use and myopia among college students.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This paper conducted a nationwide experiment using Chinese college students and set a multiple-mediator SEM model to analyze the potential correlation between screen time and myopia. The two mediators were sedentary behavior and physical activity, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We obtained three valuable conclusions as follows: First, there was no significant direct relationship between screen time and myopia among Chinese college students during the COVID-19 pandemic. Second, sedentary behavior and physical activity significantly predicted the increase\/decrease of myopia among Chinese college students, respectively. Third, a serial multiple mediator that encompassed sedentary behavior and physical activity sequentially fully mediated the relationship between screen time and myopia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although there was no directly significant relationship between screen time and myopia, screen time can indirectly influence the risk of suffering myopia by influencing sedentary behavior and physical activity. Our study demonstrates the need to prevent the potential influence of overuse of electronic devices on myopia in college students, especially during the COVID-19 pandemic.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.860098","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T06:00:17Z","timestamp":1665381617000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Screen time and myopia: A serial multiple mediator SEM analysis"],"prefix":"10.3389","volume":"10","author":[{"given":"Jinchen","family":"Xie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuntian","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,10]]},"reference":[{"key":"B1","unstructured":"COVID-19 Impact on Education"},{"key":"B2","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1111\/aos.13316","article-title":"Physical activity in relation to development and progression of myopia\u2013a systematic review","volume":"95","author":"Suhr Thykjaer","year":"2017","journal-title":"Acta Ophthalmol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1739","DOI":"10.1016\/S0140-6736(12)60272-4","article-title":"Myopia","volume":"379","author":"Morgan","year":"2012","journal-title":"Lancet."},{"key":"B4","unstructured":"The Impact of Myopia and High Myopia, Australia2015"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e0211196","DOI":"10.1371\/journal.pone.0211196","article-title":"Myopia is associated with education: results from NHANES 1999-2008","volume":"14","author":"Nickels","year":"2019","journal-title":"PLoS ONE."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1058","DOI":"10.1097\/OPX.0000000000000980","article-title":"What public policies should be developed to deal with the epidemic of myopia?","volume":"93","author":"Morgan","year":"2016","journal-title":"Optomet Vis Sci."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e0215827","DOI":"10.1371\/journal.pone.0215827","article-title":"Impact of various types of near work and time spent outdoors at different times of day on visual acuity and refractive error among Chinese school-going children","volume":"14","author":"Guan","year":"2019","journal-title":"PLoS ONE."},{"key":"B8","doi-asserted-by":"publisher","first-page":"105988","DOI":"10.1016\/j.ypmed.2020.105988","article-title":"The impact of computer use on myopia development in childhood: the Generation R study","volume":"132","author":"Enthoven","year":"2020","journal-title":"Prev Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1841","DOI":"10.1167\/iovs.09-4997","article-title":"Visual activity before and after the onset of juvenile myopia","volume":"52","author":"Jones-Jordan","year":"2011","journal-title":"Investig Ophthalmol Vis Sci."},{"key":"B10","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1111\/opo.12287","article-title":"Myopia among school students in rural China (Yunnan)","volume":"36","author":"Qian","year":"2016","journal-title":"Ophthal Physiol Optics."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1020","DOI":"10.18240\/ijo.2018.06.21","article-title":"Fruit and vegetable consumption and its relation to risk of asthenopia among Chinese college students","volume":"11","author":"Guo","year":"2018","journal-title":"Int J Ophthalmol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.ajo.2020.07.034","article-title":"Digital screen time during the COVID-19 pandemic: risk for a further myopia boom?","volume":"223","author":"Wong","year":"2021","journal-title":"Am J Ophthalmol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.preteyeres.2004.06.004","article-title":"How genetic is school myopia?","volume":"24","author":"Morgan","year":"2005","journal-title":"Progr Retinal Eye Res."},{"key":"B14","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1111\/opo.12657","article-title":"The association between digital screen time and myopia: a systematic review","volume":"40","author":"Lanca","year":"2020","journal-title":"Ophthal Physiol Optics."},{"key":"B15","doi-asserted-by":"publisher","first-page":"e23462","DOI":"10.1097\/MD.0000000000023462","article-title":"Association between time spent outdoors and myopia among junior high school students: A 3-wave panel study in China","volume":"99","author":"Zhang","year":"2020","journal-title":"Medicine."},{"key":"B16","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1136\/bjophthalmol-2019-314675","article-title":"How does spending time outdoors protect against myopia? 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