# Digital Health in Early Childhood: A Cross-Sectional Study of Pediatricians’ Knowledge, Practices, and Training Needs in Northern Italy

## TL;DR

This study explores how well pediatricians in Northern Italy understand and address digital device use in young children, finding a need for better training and tools.

## Contribution

The study identifies specific knowledge gaps and training needs among pediatricians regarding digital health in early childhood.

## Key findings

- Most pediatricians are aware of guidelines but only half correctly know the screen avoidance age threshold.
- Nearly all pediatricians discuss digital education with parents but nearly all also want more training.
- Pediatricians recognize risks of excessive digital device use but need structured tools to address them.

## Abstract

Background: Digital devices (DDs) are increasingly present in early childhood, with screen exposure beginning as early as infancy. Despite international and national guidelines discouraging digital media use before age two, many children are exposed to screens far earlier, often mediated by parents and caregivers. Excessive or unregulated screen use has been linked to adverse neurodevelopmental, emotional, and physical outcomes. Objective: This study aims to assess the knowledge, attitudes, and educational needs of primary care pediatricians (PCPs) regarding digital education (DE) and DD use in preschool-aged children (0–6 years) in two provinces of Northern Italy. Methods: A cross-sectional survey was distributed to all 165 PCPs in the Modena and Reggio Emilia provinces between December 2024 and January 2025. The 17-item questionnaire explored PCPs’ knowledge of guidelines, awareness of DD-related risks, current counseling practices, and training needs. Results: Of the 165 contacted PCPs, 93 (56%) completed the survey. While 77% were aware of Italian Pediatric Society recommendations, only 56% correctly identified age two as the threshold for total screen avoidance. 87% of PCPs recognized the risks of excessive DD use, particularly its cognitive, behavioral, and physical consequences. Nearly all participants (95%) reported discussing DE during clinical visits, and 96% expressed a desire for further training. Conclusions: PCPs show strong engagement in promoting healthy digital habits but lack specific knowledge of current recommendations. Structured tools such as digital health check-ups and targeted training programs are needed to strengthen pediatricians’ roles in digital health education and support parental guidance.