Background: Outdoor play and limited screen time are critical for preschoolers’ physical health and socio-emotional development, yet little is known about how caregiver nativity and acculturation shape these behaviors. Methods: We analyzed the 2022-2023 National Survey of Children’s Health data for 10,157 U.S. children 3-5 years old. Generalized linear models estimated associations between caregiver nativity and length of U.S. residence and children’s outdoor play and weekday screen time, adjusting for child, caregiver, and household covariates. Models tested interactions with race/ethnicity. Results: Overall, caregiver length of U.S. residence was not associated with children’s outdoor play. However, screen time differed – children whose caregivers arrived Pre-1997 had lower odds of screen time frequency, whereas those whose caregivers arrived between 1997-2005 had higher odds compared with children of U.S.-born caregivers. Associations for weekday outdoor play and screentime varied significantly by child race/ethnicity. Conclusions: Caregiver length of U.S. residence appears more strongly related to preschoolers’ screen time than outdoor play, with notable differences across racial/ethnic groups. Culturally tailored strategies may be needed to reduce early childhood screen exposure and support healthy movement behaviors among immigrant families.

The authors have declared no competing interest.

First author was supported by the T32 Cancer Health Disparities Training Grant (T32CA128582) from the National Cancer Institute of the National Institutes of Health. The authors declare they have no financial interests.

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