Joint associations of sports participation and smartphone screen time with anxiety among school adolescents

To investigate the joint association of sports participation and smartphone screen time (ST) with anxiety symptoms in school adolescents. This cross-sectional study included 142 Brazilian high school adolescents from a federal public school. Anxiety symptoms were assessed using the Screen for Child Anxiety Related Disorders, with a cutoff point of ≥ 30. Sports participation was measured using the Habitual Physical Activity Questionnaire for Adolescents, classifying participants as sports participation or non-sports participation. ST was measured using the digital well-being function of the smartphone, categorizing participants into low ST and high ST based on the median. Participants were distributed into four groups: sports participation + low ST, sports participation + high ST, non-sports participation + low ST, and non-sports participation + high ST (reference group). Analysis was performed using Poisson regression with robust variance to calculate prevalence ratio (PR) and 95% confidence intervals (CI) for anxiety among groups. The prevalence of anxiety was 41.5% (95% CI 33.6, 50.0). The sports participation + low ST group exhibited a lower prevalence of anxiety compared to the reference group (PR 0.52; 95% CI 0.28, 0.94; p = 0.031). The other groups showed no significant association with the reference group (p > 0.05). In conclusion, sports participation associated with low smartphone ST is related to a lower prevalence of anxiety symptoms in school adolescents. Keywords: Sports. Exercise. Sedentary time. Mental health. Adolescence.