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Internet use has become a widespread reality in daily life, encompassing approximately 67% of the global population in 2023 (International Telecommunication Union, 2023). Consequently, connectivity becomes an activity introduced increasingly early in human development, spanning the stages of childhood and adolescence (Andrade, Lobato et al., 2024). In 2020, one in three children and adolescents between 3 and 17 years old had internet access globally, and in Brazil, this number reached 92% of the population aged 9 to 17 years in 2022 (Comitê Gestor da Internet (CGI), 2023; United Nations Children's Fund (UNICEF), 2020).
Digital technologies and the internet offer this population a wide range of research, entertainment, and communication tools, the leading online activities in this age group (CGI, 2023). However, this facilitation of access to information can expose this population to various risk factors, such as difficulty organizing important tasks in daily life, increased usage time, and even behaviors associated with digital addiction (Andrade, Scatena et al., 2023). Furthermore, some authors point to significant relationships between prolonged screen exposure and negative impacts on the mental health of children and adolescents, such as depression (Fardouly et al., 2018), anxiety (Hsieh et al., 2018), decreased well-being (Milosevic et al., 2022), low self-esteem (Schmuck et al., 2023), and sleep disturbances (Cruz et al., 2024). Internet use without adequate parental supervision, especially among the youngest, can also lead to exposure to aggressive, offensive, and discriminatory content, as well as behaviors such as cyberbullying (Machimbarrena et al., 2018). There are also risks of a pornographic nature, including exposure to explicit videos and materials, the presence of online sexual predators, and the danger of disclosing inappropriate photos or personal information (Agarwal & Dhanasekaran, 2012).
Given these vulnerabilities, monitoring and guiding children and adolescents regarding internet use through parental mediation becomes essential (Andrade, Di Girolamo et al., 2023). This term refers to parental practices and attitudes for regulating and managing their children's use of communication tools, aiming to minimize risks and threats (Ren & Zhu, 2022). There are three mediation strategies: restrictive, active, and participative (Cabello-Hutt et al., 2017). The first involves establishing rules regarding technology use, with defined time and hours of use per day (Jiow et al., 2016). Active mediation is characterized by communication and instruction from parents about risks and safe online practices (Clark, 2011). Lastly, participative mediation is based on the joint and shared use of technology between parents and children (Jiow et al., 2016).
Parental mediation has been identified as an essential tool for healthy development in the face of digital media use. It is a significant preventive factor for negative technology-related consequences (Schwartz & Pacheco, 2021). In general, the absence of parental mediation and lack of knowledge about children's online activities are associated with excessive internet use patterns and even dependency (Wang & Ngai, 2021). On the other hand, parental participation, supervision, and guidance regarding internet use are linked to a healthier and more nurturing family environment (Ren & Zhu, 2022).
Considering the widespread adoption of digital technologies among children and adolescents, concerns arise regarding the risk factors above and excessive internet use. Parental mediation, in turn, can mitigate online dangers and act as a protective measure for the younger population (Andrade, Passos et al., 2024; Milosevic et al., 2022). Significant advancements have been made in understanding the impact of parental mediation on youth's digital media usage, particularly concerning their mental health and behavior (Nielsen et al., 2019). However, many prior reviews have encountered limitations due to their specific cultural or methodological focuses, as well as outdated screening methods.
This current review seeks to address these gaps. By employing a machine learning-assisted selection strategy, we are able to explore a diverse range of parental mediation styles across various cultural contexts. This approach enhances the comprehension of how parental influence shapes the interactions of children and adolescents with digital technology, providing valuable insights for families everywhere.
Therefore, this research aimed to identify the influence of different styles of parental mediation on the use of digital media among children and adolescents and its role as a protective factor against emotional problems through a systematic literature review. As research hypotheses, it would expect that children and adolescents with higher levels of parental mediation will present lower digital media usage time. In addition, we hypothesize that parental mediation will be associated with lower symptomatology of emotional problems.
Method
Study characterization
A systematic literature review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (Page et al., 2021). This approach allows the use of findings from relevant research to contribute to evidence-based health practice.
Research question identification
The central question of this study is: "What is the impact of different parental mediation strategies on online behavior and the mental health of children and adolescents, considering the risks associated with screen use?" This question was based on the FINER criteria (Feasible, Interesting, New, Ethical, Relevant) proposed by (Cummings et al., 2013). The question is feasible because there is a wide range of available data for analysis in the literature. Given the increasing digital interaction of youth and its potential implications for well-being, the topic is interesting for parents, educators, and researchers. It is an innovative question as it explores the variable effect of mediation practices, addressing underexplored dimensions of parental mediation practices in diverse cultural and methodological contexts. Additionally, it is ethical to investigate how these practices can protect against online risks, contributing to creating a safe digital environment. Finally, the study is relevant as it addresses urgent concerns about the influence of technology on child development, guiding effective parental mediation strategies.
Inclusion and exclusion criteria
The PECOS strategy (Population, Exposure, Comparison, Outcomes, Study design) was used to define and direct inclusion and exclusion criteria (Morgan et al., 2018). The population was delimited to parents whose children have internet and digital media access, and the exposure was parental mediation of this usage. The comparison included different types of parental mediation and their outcomes. Regarding outcomes, it was considered that parental mediation is related to less frequent usage and decreased emotional problems resulting from internet use.
Strategy search
The literature search was conducted using the Scopus and PSYCNET databases. Other platforms were excluded due to the difficulty of exporting data on a large scale. The search strategy was defined through descriptors previously consulted in the Medical Subject Headings (MESH) and Health Sciences Descriptors (DeCS) indexers. The descriptors were combined using boolean operators, forming strings for each database.
The search algorithm consisted of the following descriptors: “parenting” OR “digital parenting” OR “parental control” OR “parental warmth” OR “parental mediation” OR “parenting style” OR “parental regulation” OR “parental monitoring” OR “parental involvement” OR “family communication” AND smartphone addiction OR social media OR digital media OR internet addiction OR dysfunctional internet use OR problematic internet use OR gaming OR game OR depression OR anxiety OR stress OR emotional OR psychological distress OR isolation OR suicide OR aggression OR hostility OR emotional regulation.
Article selection and data extraction
The data were extracted and exported in “.ris format” to the reference management software Zotero to unify the articles from the two research databases. Subsequently, all data were exported to ASreview, an Artificial Intelligence (AI) and machine learning tool used to select and screen textual data on a large scale. The platform was trained by labeling a sample of 5% of articles as relevant or irrelevant according to the research objective, and based on this process, the AI can identify articles similar to those indicated by the programmer (Van de Schoot et al., 2021).
A total of 28,964 articles were found in the databases, and the titles and abstracts of 5% of the articles (n = 1,448) were read, as suggested by ASreview. After the preliminary analysis, 342 articles were classified as relevant, and the AI suggested an additional 17. Next, titles and abstracts were reviewed, resulting in the selection of 60 studies. After full-text reading and eligibility criteria analysis, the final number of articles was 27. Figure 1 describes the PRISMA flowchart of the selection process.
Finally, the data from each article was extracted and organized in the Airtable software, with a numerical identifier ordered by publication date and alphabetical order. The following categories were created: authors, country, objectives, methodological design, central theme, instruments used, and sample characteristics (profile, age, size, and gender distribution), as well as results and limitations. The central theme relates to the different subjects investigated in the realm of parental mediation, which were mental health, parental attitudes, problematic internet use, digital gaming disorder, parenting styles, bullying/cyberbullying, smartphone use, risk factors, and apps.
Study evaluation and bias risk
The quality assessment of the manuscripts was conducted using the Critical Appraisal Checklist for Analytical Cross-Sectional Studies (Moola et al., 2020). This method comprises nine questions, with a Yes/No response format, totaling a final score from 1 to 9. The cutoff point for article inclusion was 5, considered on a scale of 5 to 6 as moderate methodological quality and moderate risk of bias. Articles scoring 7 or 8 were classified as having good methodological quality and a low risk of bias (Aromataris et al., 2024). The evaluation and final score for each study is shown in Table 1.
Table 1: Results of methodological quality assessment
Note: Q1: Were the sample inclusion criteria clearly defined? Q2: Have the study subjects and environment been described in detail? Q3: Was the exposure measured validly and reliably? Q4: Were objective and standardized criteria used to measure the condition? Q5: Were confounding factors identified? Q6: Were strategies for dealing with confounding factors stated? Q7: Were the outcomes measured validly and reliably? Q8: Was appropriate statistical analysis used?
Results
To Table 2 . . . presents data on the selected articles, including information such as authors, year, country of origin of the study, objectives, method used, central theme, instruments, and sample characteristics. The results reveal a predominance of studies from the United States, Taiwan, China, Turkey, and other European, Asian, African, and Oceanian countries. No studies of Latin American origin were found. All research adopted an exploratory approach, highlighting the scarcity of experimental studies.
The total number of participants was 70,298. Some samples were composed exclusively of children or adolescents, while others combined these groups. Additionally, three studies included data from more than one report, collected through pairs of children or adolescents and their caregivers. Several variables related to parental mediation were identified, emphasizing the importance of this practice for healthy development. Among these variables, mental health stands out, particularly in relation to depression, anxiety, self-esteem, technological use disorders, suicidal ideation, and
well-being. Furthermore, there were studies related to parental mediation and social media, cyberbullying, parenting styles, and interpersonal relationships of children and adolescents.
Table 2: This section provides data on article identifiers, authors, year, country, objectives, methodological design, central theme, and instruments used
Table 3 . . . summarizes the main findings and limitations of each study. Overall, parental mediation emerges as a protective factor against cyberbullying and mental health problems in children and adolescents. In addition, the quality of the parent-child relationship was also identified as an important aspect for healthy development and reduced use of digital media. As for the limitations, the cultural specificity of the samples stands out, which compromises the generalizability of the data, the self-report data, which are subject to bias, and the cross-sectional design of the studies.
Discussion
The excessive use of digital media by children and adolescents is linked to a variety of negative phenomena, such as problematic internet use, exposure to inappropriate content, organizational difficulties, and emotional problems (Reichert et al., 2021; Spritzer et al., 2023). In this sense, parental mediation plays an essential role in preventing risk factors and promoting healthy development. In the context of mental health, adolescents with low or no parental mediation have higher levels of anxiety, depression, low self-esteem, aggressiveness, and suicidal ideation, as well as reduced academic performance (Lee et al., 2023; Meeus et al., 2019; Singer et al., 2004). Thus, practices such as setting limits, monitoring, and communication, common in parental mediation, play a crucial role in preventing excessive use and its negative consequences for well-being.
Regarding online risk behaviors, such as cyberbullying, problematic internet use, and exposure to online violence, these phenomena represent threats to the integrity of children and adolescents in the digital age (Ramos et al., 2023; Romualdo et al., 2025). Through unsupervised use, users can protect themselves behind fake profiles and corroborate the practice of cyberbullying and the dissemination of hate speech, in addition to increasing the risk of victimization (Swider-Cios et al. 2023). In this context, parental mediation emerges as an essential shield to prevent these risk behaviors, since in addition to supervising content, it promotes autonomy and the internalization of guidelines, rules, and values established by parents in relation to the proper use of the internet (Meeus et al., 2019; Schmuck et al., 2023). In addition, studies indicate that excessive use of digital technologies, especially when not mediated by parents, is associated not only with greater exposure to violent and sexual content, but also with negative implications for the mental health of individuals (Barry & Kim, 2023; Neophytou et al. 2021; Singer et al., 2004).
Regarding parental mediation strategies, the most investigated were active and restrictive mediation, especially in relation to their moderating role in the relationship between smartphone use and children’s health (Chang et al., 2019; Fardouly et al., 2018; Meeus et al., 2019). Active mediation was associated with lower internet addiction among adolescents and was negatively related to smartphone addiction (Hsieh et al., 2018; Stevic & Matthes, 2021), demonstrating its potential in promoting healthy internet use through guidance, modeling, and encouragement of online self-regulation. On the other hand, restrictive parental mediation was related to lower smartphone use. However, restrictive mediation was not shown to be a protective factor against online victimization, as it focuses more on limiting the time and frequency of use without directly interfering with the quality of the content consumed (Stevic & Matthes, 2021; Wright, 2016).
The results indicate a gender difference in the online activities carried out by children and adolescents. Boys showed a greater tendency to addiction to games, exposure to violent content, and the development of social anxiety and externalizing problems, such as aggressiveness, disobedience, and impulsivity (Rozgonjuk et al., 2023; Zandi Payam & Mirzaeidoostan, 2019). On the other hand, girls showed a greater propensity for Instagram addiction, self-esteem problems due to high social media consumption, higher levels of anxiety, and vulnerability to cyberbullying victimization (Lee et al., 2023; Stevic & Matthes, 2021). In addition, girls also demonstrate a greater benefit from parental mediation, as they tend to seek more parental help than boys (Yao et al., 2022).
Studies that included parental reports indicate a discrepancy in parents’ perception of their effectiveness in parental mediation compared to their children’s perception. Parents tend to report higher levels of mediation than adolescents, suggesting possible communication failures or an overestimation of the strategies adopted by parents (Barry & Kim, 2023; Schmuck et al., 2023). In addition, parenting styles were identified as a crucial aspect for the effectiveness of parental mediation. For example, more authoritarian parenting styles are correlated with emotional regulation difficulties. In this context, children are likely to seek the internet as a space for acceptance and escape from reality for self-regulation, increasing the risk of problematic and excessive use (Hsieh et al., 2018; Martínez-Ferrer et al., 2018). On the other hand, parents who adopt a more democratic parenting style and consistently practice parental mediation tend to have greater self-efficacy in the parental role and, consequently, a better perception of support and protection from their children (Schmuck et al., 2023).
Parental mediation stands out as an important aspect for the healthy development of children and adolescents. However, it is important to emphasize that, beyond this strategy, the quality of family relationships is also an essential factor for well-being, since parents’ emotional involvement with their children promotes autonomy, self-regulation, and the creation of interests beyond the virtual environment (Chang et al., 2015; Eo & Lee, 2022; Hsieh et al., 2018). Thus, functional family bonds, combined with parental mediation, are associated with greater internalization of values and rules by children, which favor protection against the risks posed by the internet (Meeus et al., 2019). It’s important to recognize a limitation in the selection of articles for this review. The criteria primarily focused on studies that examine the negative outcomes associated with internet use, which may have caused us to overlook research showcasing the potential benefits of digital media, particularly when supported by parental involvement. Recent literature suggests that digital engagement can enhance cognitive, emotional, and social development in children and adolescents, especially when parents are actively and positively involved. This omission may have led to a skewed representation of the overall picture, emphasizing the need for caution when generalizing the results.
Conclusion
A general widespread use of the internet by children and adolescents brings along exposure to various risks such as cyberbullying, dependency, and emotional issues like depression, anxiety, and low self-esteem. In this context, parental mediation is crucial in supervising, guiding, and controlling access to certain content and excessive use frequency. Despite providing a comprehensive overview of scientific production in this area, this study highlights the need for more comprehensive research that includes longitudinal aspects, cultural diversity, and the use of standardized instruments.
It is important to acknowledge the limitations of this article. The research was limited to studies from only two databases, which may have excluded relevant works from other sources due to limitations in the number of articles processed by the ASReview software. Additionally, the article was selected through artificial intelligence software, which may introduce bias depending on the data quality and algorithm used. Most of the analyzed studies adopt a cross-sectional design, making it difficult to establish causal relationships between parental mediation and its impacts on children and adolescents’ behavior and mental health. Finally, the diversity in methodologies and assessment instruments makes direct comparison and generalization of results challenging.
