A general practice thesis to raise GPs’ awareness of their role in preventing the dangers of screens, defended at the Grenoble Faculty of Medicine
Doctors are beginning to realise the major role they have to play in preventing the dangers of screens. Charlotte Michon and Camille Fouilland, both medical residents, made it the subject of their doctoral thesis, defended on 6 July 2018 at the Grenoble Faculty of Medicine. This study, supervised by Badis Hadrouf, a general practitioner, set out to determine GPs’ practices regarding screen prevention for children under three. Ways of improving practice were then proposed. It is titled: REPRÉSENTATIONS ET PRATIQUES DES MÉDECINS GÉNÉRALISTES D’ISÈRE ET DE SAVOIE SUR LA PRÉVENTION DE L’EXPOSITION AUX ÉCRANS CHEZ LES ENFANTS DE MOINS DE TROIS ANS, ET PISTES POUR L’AMÉLIORATION DES PRATIQUES (GPs’ perceptions and practices in Isère and Savoie regarding the prevention of screen exposure in children under three, and ways to improve practice).
This thesis first notes that screens are omnipresent in homes. From their earliest age, children are exposed to images without limit. Yet the negative effects of screens no longer need to be proved: delays in psychomotor development, sleep disorders, reduced school performance, antisocial behaviour or overweight. Despite this, GPs rarely raise the subject during consultations. Why? And how can this be remedied?
PREVENTION HELD BACK
In total, 39 GPs were interviewed through 7 interviews.
This study confirms that doctors are aware of the negative impacts of screens. Yet prevention on the subject remains marginal. GPs only do it when faced with a trigger (a child on a screen during the consultation, or with a condition that may be linked to screens).
OBSTACLES TO PREVENTION
Several obstacles are cited to justify the absence of prevention. The lack of time during consultations and doctors’ lack of knowledge are obvious barriers. Parents’ lack of awareness and the benefit they get from screens (calming and occupying the child) also seem to be notable obstacles. This special position of the screen within family habits makes doctors uncomfortable, all the more so as they know how convenient screens can be. They identify with the parent and therefore limit the criticism they make of screens.
Yet doctors have an educational role in other behavioural areas (tobacco, nutrition…). They could therefore take on this role with regard to screens.
TOWARDS BETTER PRACTICE
Despite these obstacles, the doctors interviewed in this study feel they have a role to play. Systematic prevention from the first year of life seemed essential to them, accompanied by precise advice on limiting use.
To improve this prevention, doctors need training in order to increase their knowledge. Many tools already exist to help them in their practice, such as questionnaires, posters, or brochures containing precise advice. They are easily accessible, like the 3-6-9-12 posters created by Professor Serge Tisseron. Using them would make communication with parents easier and help doctors to raise this subject in consultations.
Obviously, the issue of screens goes beyond general practice. More broadly, a national campaign launched by the public authorities would alert the whole population.
Charlotte Michon and Camille Fouilland
