Comparing the Self-Report and Measured Smartphone Usage of College Students: A Pilot Study

Adolescent smartphone use, sleep, and physical activity: daily associations between sensor-based measures in the adolescent brain cognitive development (ABCD) study

PURPOSE

Potential health consequences of adolescent smartphone use are a growing public concern. Improving upon existing, largely self-report-based research, this study investigated relationships between adolescent smartphone use, sleep, and physical activity using passive sensor measures.

METHODS

Over three weeks, 791 Adolescent Brain Cognitive Development (ABCD) Study participants (Mage=14.12, 53 % female) provided smartphone application and keyboard use data via the Effortless Assessment Research System (EARS) application, and sleep and physical activity data via Fitbit device.

RESULTS

Mixed-effects models found that daytime/evening application use (6:00AM-7:59PM) predicted reduced exercise, more time sedentary, and fewer daily steps (Standardized β=-0.21-0.07, P<.001). Late-evening use (8:00PM-9:59PM) modestly predicted increased sedentary time and reduced steps (Standardized β=-0.05-0.02, P<.001). Late-night use (10:00PM-5:59AM) predicted reduced sleep, delayed sleep onset, delayed waking, increased sedentary time, and fewer daily steps (Standardized β=-0.16-0.27, P<.001). After disaggregating within and between-person smartphone use, within-person relationships remained significant, with associations of similar magnitude to the initial analyses (daytime/evening use: standardized ꞵ=-0.22-0.07, P<.001; late-evening use: standardized ꞵ=-0.05-0.02, P<.001; late-night use: standardized ꞵ=-0.16-0.24, P≤.002), indicating daily-level relationships unattributable to between-subject differences. Examining smartphone use effects by hour relative to sleep onset indicated that only use recorded after initial sleep onset significantly predicted sleep, while use recorded 3-12 hours before sleep onset significantly predicted step counts.

CONCLUSIONS

Using passive sensor data, we found significant associations between adolescent smartphone use, physical activity, and sleep which differed by time of day and remained significant within subjects. Experimental replication is recommended to strengthen tentative causal claims.

Examining measurement discrepancies in adolescent screen media activity with insights from the ABCD study

Concerns about the accuracy of self-reported screen time persist due to discrepancies with objective measures. This study compared passive smartphone tracking via the "Effortless Assessment of Risk States'' (EARS) app with self-reported screen time from 495 adolescents. Based on self-reports, 94.26% of social media use occurred on smartphones. EARS-recorded social media use was higher (1.64 ± 1.93 h) than past-year self-report (1.44 ± 1.97 h; p = 0.037) but similar to post-sensing self-report (1.63 ± 1.93 h; p = 0.835). Higher picture vocabulary scores were associated with lower odds of under-reporting social media use (OR = 0.96, 95% CI: 0.93-0.99). Both self-reported (β = 0.06, 95% CI: 0.01-0.11) and EARS (β = 0.07, 95% CI: 0.03-0.12) measures correlated with externalizing symptoms. They were also correlated with social media addiction (self-reported:β = 0.15, 95% CI: 0.10-0.20; EARS:β = 0.06, 95% CI: 0.01-0.11). However, past-year self-report uniquely correlated with internalizing symptoms (β = 0.05, 95% CI: 0.01-0.09) and video game addiction (β = 0.05, 95% CI: 0.01-0.10). These findings highlight the value of integrating self-report and objective measures in screen media use research.

Race and Anti-Racist Online Coping as Moderators of College Adjustment Associated with Exposure to Social Media Racism among Asian, Black, and Hispanic/Latine Students

With the rise of social media, racism in the digital landscape has become ubiquitous potentially impacting the academic adjustment of college students of color. The role of anti-racist online coping strategies, such as seeking resources, support, and actively managing social networks in mitigating the negative effects of online racism has been understudied. Racial group differences and anti-racist online coping were examined as moderators between online discrimination and college adjustment among Asian, Black and Hispanic/Latine college students. The sample consisted of 772 emerging adults of color (Mage = 20.37, SD = 1.56, 44.8% women; 32.4% Asian, 35% Black, 32.6% Hispanic/Latine). Overall, average and high coping levels moderated the association between discrimination and college adjustment, but the protective effect varied by race and domain of adjustment. Across educational, relational and psychological dimensions of adjustment, protective effects of anti-racist online coping were stronger among Asian students, partially effective for Black students, and least effective for Hispanic/Latine students, and psychological adjustment was most vulnerable. These findings underscore the importance of understanding how students of color experience and take part in the digital landscape and providing institutional supports that help students effectively utilize anti-racist online strategies to mitigate the adverse effects of social media racism on their adjustment to college.

Effect of supplementation with lutein, zeaxanthin, and omega-3 fatty acids on macular pigment and visual function in young adults with long-term use of digital devices: study protocol for a randomized double-blind placebo-controlled study

Background

Growing evidence emphasizes the importance of xanthophyll carotenoids and omega-3 fatty acids in eye health. However, the beneficial effects of such supplementation have not been thoroughly discussed among adults with high screen exposure. Current trial evidence on lutein bioavailability is contradictory, and the interactions of dietary intervention with host-related factors remain elusive. This study aims to investigate the comparative effectiveness of supplementation with macular xanthophylls and omega-3 fatty acids on macular pigment optical density (MPOD) and visual function, access the bioavailability of free lutein and lutein ester, and explore the complex interplay between genetic variations, intestinal microbiota, and the dietary intervention in Chinese adults with long-term exposure to digital devices.

Methods

The Lutein, Zeaxanthin, and Omega-3 (LZO) clinical trial is a 24-week multicenter, randomized, double-blind, placebo-controlled trial of 600 participants recruited from research centers, universities, and communities. Individuals are eligible to participate if they are aged over 18 years and use digital devices for over 8 h daily in the last 2 years, and will be randomized to six arms. A total of three visits will be scheduled at baseline, 12 and 24 weeks. The primary outcome is the change in MPOD over the 24-week intervention. The secondary outcomes are changes in visual function (visual acuity, best-corrected visual acuity, contrast and glare sensitivity, critical flicker fusion, reaction time, visuognosis persistence, symptoms and signs of dry eye, retinal thickness, and optical quality), and changes in serum lutein and zeaxanthin concentrations, and erythrocyte membrane omega-3 fatty acids. Genetic variations will be determined using genome-wide genotyping at baseline. 16S rRNA gene sequencing will be utilized to assess microbiome compositional changes before and after intervention.

Discussion

The trial is anticipated to establish early interventions to prevent photochemical ocular damage and delay the onset of vision impairment in young adults with long-term repeated exposure to screen-based electronic devices, and provide valuable insights for the development of precision nutrition strategies for maintaining eye health.

Clinical trial registration

www.clinicaltrials.in.th, Identifier, TCTR20220904002.

The association between screen time exposure and myopia in children and adolescents: a meta-analysis

OBJECTIVE

This study aimed to systematically review epidemiological evidence on associations between screen time exposure and myopia in children and adolescents, and to quantitatively evaluate summary effect estimates from existing literature.

METHOD

There were three online databases including PubMed, Embase, and Web of Science, for epidemiological studies on screen time exposure and myopia published before June 1, 2023. The risk of bias was assessed by the Newcastle Ottawa Scale (NOS) checklist. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the correlation between screen time exposure and myopia using random or fixed-effect models by exposure type (categorical/continuous). We also performed subgroup analysis by screen device type, study quality, geographic region, and research period.

RESULTS

We searched 7,571 records from three databases and identified 19 eligible studies, including 14 high-quality studies and 5 moderate-quality studies. Meta-analyses suggested that there was a statistically significant correlation between screen time (high vs. low) and myopia. The pooled ORs with 95%CIs were respectively 2.24 (1.47-3.42) for cross-sectional studies, and 2.39 (2.07-2.76) for cohort studies. We also found a significant association between continuous exposure to screen time (per 1 h/d increase) and myopia in cohort studies. The pooled ORs with 95%CIs were 1.07 (1.01-1.13). In subgroup analysis stratified by screen device type in cross-sectional studies, screen time exposures from computers (categorical: OR = 8.19, 95%CI: 4.78-14.04; continuous: OR = 1.22, 95%CI: 1.10-1.35) and televisions (categorical: OR = 1.46, 95%CI: 1.02-2.10) were associated with myopia, while smartphones were not. Although publication bias was detected, the pooled results did not show significant changes after adjustment using the trim and fill method.

CONCLUSION

Our findings support that screen time exposure was significantly associated with myopia in children and adolescents. Notably, screen time exposure from computers may have the most significant impact on myopia.

No evidence for adult smartphone use affecting attribution of communicative intention in toddlers: Online imitation study using the Sock Ball Task

Adults infer others' communicative intentions, or lack thereof, from various types of information. Young children may be initially limited to attributions based on a small set of ostensive signals. It is unknown when richer pragmatic inferences about communicative intentions emerge in development. We sought novel type of evidence for such inferences in 17-to-19-month-olds. We hypothesized that toddlers recognize adults' smartphone use in face-to-face interactions as incongruous with ostension and would rely on this interpretation when inferring the communicative intention of a model in a new imitation task conducted entirely online, dubbed the Sock Ball Task. In Experiment 1 with a between-subject design, we tested the hypothesis by assessing toddlers' (N = 48) imitation of sub-efficient means and the goal-outcome presented by a model, who interrupted her ostensive demonstration either by using a smartphone or by fiddling with her wristwatch, depending on the condition. We expected toddlers to imitate the sub-efficient means more faithfully in the wristwatch condition than in the smartphone condition. But there was no significant effect of condition on imitation of neither means nor goal. Thus, our hypothesis was not borne out by the results. In Experiment 2, using a within-subject design, we first assessed toddlers' (N = 24) performance in a no-demonstration baseline and then again after a no-disruption ostensive demonstration. In all three conditions with ostensive demonstration (Experiment 1: smartphone, wristwatch; Experiment 2: no-disruption), toddlers produced the demonstrated sub-efficient means significantly above the baseline level. In the no-disruption condition, goals were also imitated significantly above the baseline level. We conclude that the Sock Ball Task is a valid research tool for studying toddler imitation of novel means actions with objects. We end by discussing suggestions for improving the task in future studies.

Managing Screen Use in the Under-Fives: Recommendations for Parenting Intervention Development

The impact of excessive screen use on children's health and development is a public health concern and many countries have published recommendations to limit and guide the use of screen media in childhood. Despite this, international studies report that the majority of parents and children do not adhere to screen use recommendations. Existing research aiming to understand children' screen use has largely focused on older children, and on demographic and structural aspects of the child's environment. Parents play a central role in determining young children's screen use and identify numerous barriers to developing healthy screen use practices with their children. However, no clear models exist that incorporate key parenting factors in understanding children's screen use, which presents an impediment to intervention development. Likewise, while some evidence exists for interventions to improve children's screen use behaviours, most are focused on older children and parental involvement has generally been limited. In this paper, we overview key factors associated with screen use in young children (< 5 years) and summarise the existing evidence base for interventions designed to support healthy screen use. This paper proposes a conceptual model linking aspects of parenting and the socio-ecological environment to young children's screen use. Our proposed model could be used to design longitudinal studies of screen use predictors and outcomes, and inform intervention development. Finally, the paper provides key recommendations for future research, intervention development and testing.

A Preliminary Evaluation of the Effects of a Contingency Management + Deposit Contract Intervention on Problematic Smartphone Use With College Students

Problematic smartphone use (PSU) is smartphone usage that is, in some way, damaging to the user. PSU represents a growing public health concern that could be addressed via behavioral intervention. We recruited six college students who reported negative side effects of smartphone use and sought to decrease their PSU. The effects of a contingency management (CM) + deposit contract intervention on PSU was evaluated. During the CM + deposit contract condition, participants deposited $40 and had the opportunity to earn back their entire deposit by meeting daily smartphone usage goals. To promote adherence to study protocols, participants also had the opportunity to earn a $20 cooperation bonus. For all participants, lower levels of PSU were observed during intervention relative to baseline. The CM + deposit contract intervention produced consistent decreases in PSU for four participants (mean reduction percentages above 40% were obtained) and had inconsistent effects on PSU for two participants (mean reduction percentages below 20%). Maintenance of intervention effects was limited for all participants. Although preliminary, results suggest that CM + deposit contract interventions could be a viable, low-cost approach to addressing PSU. Potential explanations for our findings and avenues for future research are discussed.

The problematic use of smartphones in public: the development and validation of a measure of smartphone “zombie” behaviour

Purpose

We have witnessed an evolution in the use of smartphones in recent years. We have been aware for some time of the potentially deleterious impact of smartphones on users' lives and their propensity for user addiction, as reflected in the large and growing body of work on this topic. One modern phenomenon – the distracted mobile phone user in public, or “smartphone zombie” – has received limited research attention. The purpose of the present study is to develop a robust measure of smartphone zombie behaviour.

Design/methodology/approach

The research deign comprises three studies: A round of focus groups (n = 5) and two online surveys (survey one n = 373, survey two n = 386), in order to develop and validate a three-factor, 15-item measure named the Smartphone Zombie Scale (SZS).

Findings

Following the round of focus groups conducted, Exploratory Factor Analysis and a Confirmatory Factor Analysis, the SZS measure (Cronbach's α = .932) is demonstrated to be robust and comprises three factors: Attention Deficit (Cronbach's α = .922), Jeopardy (Cronbach's α = .817) and Preoccupation (Cronbach's α = .835), that is shown to be distinct to existing closely related measures (Smartphone Addiction scale and Obsessive Compulsive Use).

Originality/value

The present study represents the first extant attempt to produce a measure of smartphone zombie behaviour, and provides us with a reliable and valid measure with which we can study this growing phenomenon.

Systematic Bias in Self-Reported Social Media Use in the Age of Platform Swinging: Implications for Studying Social Media Use in Relation to Adolescent Health Behavior

Public health researchers are increasingly interested in the potential relationships between social media (SM) use, well-being, and health behavior among adolescents. However, most research has assessed daily SM time via self-report survey questions, despite a lack of clarity around the accuracy of such reports given the current tendency of youth to access SM on multiple electronic devices and cycle between multiple SM platforms on a daily basis (i.e., platform swinging). The current study investigates the potential for systematic reporting biases to skew findings. Three hundred and twenty incoming college students downloaded software on their computers, tablets, and smartphones to track their active use of Facebook, Twitter, Instagram, and Snapchat over a 2-week surveillance period and then self-reported their average daily minutes on each platform immediately after. Larger proportions of students over-estimated than under-estimated their use, with the largest overestimations found on the most heavily used platforms. Females logged significantly more SM time and were less accurate in reporting than were males and, independently, the likelihood of substantial inaccuracies in reporting total SM time and time on most individual platforms increased with each additional SM platform participants reported using. Findings demonstrate that self-reported estimates of SM time among adolescents in the age of SM platform swinging are prone to substantial error and may lead to biased conclusions about relationships between variables. Alternative measurement approaches are suggested to improve the validity of future research in this area.

Problematic Smartphone Use Leads to Behavioral and Cognitive Self-Control Deficits

Excessive use of smartphones has been associated with a number of negative consequences for individuals. Some of these consequences relate to many symptoms of behavioral addiction. The present study aims to investigate whether participants with high levels of smartphone usage may have difficulty with their ability to wield the self-control that is needed to restrict smartphone usage compared to participants with lower levels of smartphone addiction. Specifically, we expect that people with high levels of smartphone usage may have problems in refraining from using a smartphone. In addition, we expect people with a high level of smartphone use may show deficiencies in cognitive tasks such as memory, executive control, and visual and auditory attention. An ABA design was applied to analyze the effects of smartphone withdrawal. The first A refers to baseline measurements: Visual RT, Auditory RT, Go/No-Go RT and N-Back RT and Eriksen flanker RT. The B refers to 3 days of smartphone withdrawal, whereas the second A refers to the same measurements used in the baseline. In addition, several standardized scales were administered, among them: Smartphone addiction scale-short version (SAS-SV), Fear of missing out scale (FoMOs), Procrastination scale, and Psychological General Well-Being Index. One hundred and eleven participants took part in the study. Based on median split they were divided into two groups: high level and low level smartphone users. Moreover, thanks to an app installed on the participants' smartphones, it was possible to measure levels of compliance with the task. Results indicate that participants with low levels of smartphone usage show less difficulty in their ability to wield the self-control needed to withdraw smartphone use and faster reaction times on cognitive tests than participants with high levels of smartphone usage. Moreover, the profile of participants with high levels of smartphone usage shows higher scores on the FoMOs and Procrastination scale, and lower scores in the Psychological General Well-Being Index. The results are discussed in light of self-regulation theory.

The Effects of Playing Video Games on Stress, Anxiety, Depression, Loneliness, and Gaming Disorder During the Early Stages of the COVID-19 Pandemic: PRISMA Systematic Review

During the initial phases of the COVID-19 pandemic, playing video games has been much more than just a pastime. Studies suggested that video games for many individuals have helped to cope with such difficult life experience. However, other research indicates that gaming may have had harmful effects. Within this context, this systematic review aimed to describe the literature on the effects of video games during the early stages of the COVID-19 crisis on stress, anxiety, depression, loneliness, and gaming disorder (GD), examining the study characteristics and outcomes. A systematic search of the literature was made following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. It was preregistered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY)-INPLASY202180053. The search databases were PsycINFO, Web of Science, and Medline. The search string was: [("video game*") OR ("computer game*") OR ("gaming")] AND [("COVID-19")]. Twenty-four studies met the inclusion criteria. Four research explored the effects of playing video games during the COVID-19 pandemic on stress, anxiety, and depression. Four studies investigated loneliness, while 18 research investigated game disorder. Video games, especially augmented reality and online multiplayer ones, mitigated stress, anxiety, depression, and loneliness among adolescents and young adults during stay-at-home restrictions. However, in the case of at-risk individuals (i.e., particularly male youths), playing video games had detrimental effects.

The Association Between Temperament and Characteristics, Smartphone App Use Patterns and Academic Performance of University Students

BACKGROUND

Smartphone use patterns may predict daily life efficacy and performance improvements in sports. Additionally, personal characteristics may be associated with smartphone overuse.

METHODS

We investigated the correlation between the temperament and character inventory (TCI) and academic performance using smartphone log data. We hypothesized that the elite and general groups, divided based on academic performance, differed according to the TCI and downloadable smartphone apps (applications). Additionally, we hypothesized a correlation between smartphone app usage patterns and TCI. A total of 151 students provided smartphone log data of the previous four weeks. They also completed the TCI and provided academic records of the previous year.

RESULTS

The first and second most frequently used apps by both groups of students were social networking and entertainment, respectively. Elite students scored higher on novelty seeking, reward dependence, persistence, self-directedness, and self-transcendence than general students. In all participants, the usage time of serious apps was correlated with the scores for novelty seeking (r = 0.32, P < 0.007), reward dependence (r = 0.32, P < 0.007), and self-transcendence (r = 0.35, P < 0.006). In the elite group, the usage time of serious apps was correlated with the scores for novelty seeking (r = 0.45, P < 0.001), reward dependence (r = 0.39, P = 0.022), and self-transcendence (r = 0.35, P = 0.031). In the general group, the usage time of serious apps was correlated only with self-transcendence (r = 0.32, P < 0.007).

CONCLUSION

High usage time of serious apps can help sports majors to excel academically. Particularly among sports majors, serious apps are related to activity, the desire for rewards and recognition, and the tendency to transcend themselves.

Raising Awareness of Smartphone Overuse among University Students: A Persuasive Systems Approach

Smartphone overuse can lead to a series of physical, mental and social disturbances. This problem is more prevalent among young adults as compared to other demographic groups. Additionally, university students are already undergoing high cognitive loads and stress conditions; therefore, they are more susceptible to smartphone addiction and its derived problems. In this paper, we present a novel approach where a conversational mobile agent uses persuasive messages exploring the reflective mind to raise users’ awareness of their usage and consequently induce reduction behaviors. We conducted a four-week study with 16 university students undergoing stressful conditions—a global lockdown during their semester—and evaluated the impact of the agent on smartphone usage reduction and the perceived usefulness of such an approach. Results show the efficacy of self-tracking in the behavior change process: 81% of the users reduced their usage time, and all of them mentioned that having a conversational agent alerting them about their usage was useful. Before this experiment, only 68% of them considered such an approach could be useful. In conclusion, users deemed it essential to have an engaging conversational agent on their smartphones, in terms of helping them become more aware of usage times.

Utilizing grid search cross-validation with adaptive boosting for augmenting performance of machine learning models

Corona Virus Disease 2019 (COVID-19) pandemic has increased the importance of Virtual Learning Environments (VLEs) instigating students to study from their homes. Every day a tremendous amount of data is generated when students interact with VLEs to perform different activities and access learning material. To make the generated data useful, it must be processed and managed by the proper machine learning (ML) algorithm. ML algorithms' applications are many folds with Education Data Mining (EDM) and Learning Analytics (LA) as their major fields. ML algorithms are commonly used to process raw data to discover hidden patterns and construct a model to make future predictions, such as predicting students' performance, dropouts, engagement, etc. However, in VLE, it is important to select the right and most applicable ML algorithm to give the best performance results. In this study, we aim to improve those ML and DL algorithms' performance that give an inferior performance in terms of performance, accuracy, precision, recall, and F1 score. Several ML algorithms were applied on Open University Learning Analytics (OULA) dataset to reveal which one offers the best results in terms of performance, accuracy, precision, recall, and F1 score. Two popular ML algorithms called Decision Tree (DT) and Feed-Forward Neural Network (FFNN) provided unsatisfactory results. They were selected and experimented with various techniques such as grid search cross-validation, adaptive boosting, extreme gradient boosting, early stopping, feature engineering, and dropping inactive neurons to improve their performance scores. Moreover, we also determined the feature weights/importance in predicting the students' study performance, leading to the design and development of the adaptive learning system. The ML techniques and the methods used in this research study can be used by instructors/administrators to optimize learning content and provide informed guidance to students, thus improving their learning experience and making it exciting and adaptive.

A Smarter Way to Use Your Smartphone: An Intervention to Limit Smartphone-Related Distractions Reduces Hyperactivity but Not Inattention Symptoms

INTRODUCTION

Smartphones are often helpful in our everyday lives. Yet, they also tend to interrupt us during other activities. It has been argued that such distractions contribute to attention-deficit/hyperactivity disorder-like symptoms. However, since there are mostly correlational studies, the causal nature of this relationship is unclear. Our aim was to test whether reducing smartphone-related distractions might have a beneficial effect on inattention and hyperactive symptoms.

METHODS

We conducted a 1-week field experiment with 37 healthy undergraduates and quasi-randomly assigned them to an intervention or control group (CG). The intervention group was given theory-based specific instructions that aimed at reducing smartphone-related distractions, whereas the CG received no intervention. The outcomes of interest were inattention level, hyperactive symptoms, and working memory accuracy.

RESULTS

Compared to those in the control condition, participants who limited their smartphone use showed considerable reductions in hyperactive symptoms after 1 week - particularly those who displayed high problematic smartphone use. However, there were no group differences regarding inattention symptoms and working memory accuracy.

DISCUSSION

The results give a first hint that strategically reducing smartphone-related distractions via specific but simple use modifications can mitigate hyperactive symptoms. Especially people with problematic smartphone use seem to profit from such an intervention. Remaining questions and directions are discussed.

Commentary: The real (?) effect of smartphone use on parenting - a commentary on Modecki et al. (2020)

A recent publication by Modecki and colleagues asserts that 'more [smart]phone use was associated with higher parenting quality'. Modecki and colleagues make their generalistic concluding statement in contradiction to an increasingly conflicting research corpus, and we suggest that a more cautious interpretation of their data would be beneficial. This study used a cross-sectional convenience sample; however elsewhere, research questions the ability of participants to accurately estimate their own smartphone use. Further, one-sided reports of two-sided attachment relationships may be unreliable. A useful addition to the paper would have been the inclusion and stratification of demographic information about the children whose parents were surveyed. With Modecki and colleagues seeking to describe the 'real effect' of smartphones on parenting, the age, stage and needs of the children studied remained largely silent. Modecki and colleagues wisely encourage us to ask more nuanced questions in our research. We wholly agree, but also urge researchers to be more nuanced in our research designs and understanding of its implications for all within the parent:child relationship.

Virtual Reality Applications in Medicine During the COVID-19 Pandemic: Systematic Review (Preprint)

Background

Virtual reality can play an important role during the COVID-19 pandemic in the health care sector. This technology has the potential to supplement the traditional in-hospital medical training and treatment, and may increase access to training and therapies in various health care settings.

Objective

This systematic review aimed to describe the literature on health care–targeted virtual reality applications during the COVID-19 crisis.

Methods

We conducted a systematic search of the literature on the PsycINFO, Web of Science, and MEDLINE databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The search string was as follows: “[(virtual reality)] AND [(COVID-19) OR (coronavirus) OR (SARS-CoV-2) OR (healthcare)].” Papers published in English after December 2019 in peer-reviewed journals were selected and subjected to the inclusion and exclusion criteria. We used the Mixed Methods Appraisal Tool to assess the quality of studies and the risk of bias.

Results

Thirty-nine studies met the inclusion criteria. Seventeen studies showed the usefulness of virtual reality during the COVID-19 crisis for reducing stress, anxiety, depression, and pain, and promoting physical activity. Twenty-two studies revealed that virtual reality was a helpful learning and training tool during the COVID-19 crisis in several areas, including emergency medicine, nursing, and pediatrics. This technology was also used as an educational tool for increasing public understanding of the COVID-19 pandemic. Different levels of immersion (ie, immersive and desktop virtual reality), types of head-mounted displays (ie, PC-based, mobile, and standalone), and content (ie, 360° videos and photos, virtual environments, virtual reality video games, and embodied virtual agents) have been successfully used. Virtual reality was helpful in both face-to-face and remote trials.

Conclusions

Virtual reality has been applied frequently in medicine during the COVID-19 pandemic, with positive effects for treating several health conditions and for medical education and training. Some barriers need to be overcome for the broader adoption of virtual reality in the health care panorama.

Trial Registration

International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) INPLASY202190108; https://inplasy.com/inplasy-2021-9-0108/

A systematic review and meta-analysis of discrepancies between logged and self-reported digital media use

There is widespread public and academic interest in understanding the uses and effects of digital media. Scholars primarily use self-report measures of the quantity or duration of media use as proxies for more objective measures, but the validity of these self-reports remains unclear. Advancements in data collection techniques have produced a collection of studies indexing both self-reported and log-based measures. To assess the alignment between these measures, we conducted a pre-registered meta-analysis of this research. Based on 106 effect sizes, we found that self-reported media use correlates only moderately with logged measurements, that self-reports were rarely an accurate reflection of logged media use and that measures of problematic media use show an even weaker association with usage logs. These findings raise concerns about the validity of findings relying solely on self-reported measures of media use.

Association between digital smart device use and myopia: a systematic review and meta-analysis

BACKGROUND

Excessive use of digital smart devices, including smartphones and tablet computers, could be a risk factor for myopia. We aimed to review the literature on the association between digital smart device use and myopia.

METHODS

In this systematic review and meta-analysis we searched MEDLINE and Embase, and manually searched reference lists for primary research articles investigating smart device (ie, smartphones and tablets) exposure and myopia in children and young adults (aged 3 months to 33 years) from database inception to June 2 (MEDLINE) and June 3 (Embase), 2020. We included studies that investigated myopia-related outcomes of prevalent or incident myopia, myopia progression rate, axial length, or spherical equivalent. Studies were excluded if they were reviews or case reports, did not investigate myopia-related outcomes, or did not investigate risk factors for myopia. Bias was assessed with the Joanna Briggs Institute Critical Appraisal Checklists for analytical cross-sectional and cohort studies. We categorised studies as follows: category one studies investigated smart device use independently; category two studies investigated smart device use in combination with computer use; and category three studies investigated smart device use with other near-vision tasks that were not screen-based. We extracted unadjusted and adjusted odds ratios (ORs), β coefficients, prevalence ratios, Spearman's correlation coefficients, and p values for associations between screen time and incident or prevalent myopia. We did a meta-analysis of the association between screen time and prevalent or incident myopia for category one articles alone and for category one and two articles combined. Random-effects models were used when study heterogeneity was high (I²>50%) and fixed-effects models were used when heterogeneity was low (I²≤50%).

FINDINGS

3325 articles were identified, of which 33 were included in the systematic review and 11 were included in the meta-analysis. Four (40%) of ten category one articles, eight (80%) of ten category two articles, and all 13 category three articles used objective measures to identify myopia (refraction), whereas the remaining studies used questionnaires to identify myopia. Screen exposure was measured by use of questionnaires in all studies, with one also measuring device-recorded network data consumption. Associations between screen exposure and prevalent or incident myopia, an increased myopic spherical equivalent, and longer axial length were reported in five (50%) category one and six (60%) category two articles. Smart device screen time alone (OR 1·26 [95% CI 1·00-1·60]; I²=77%) or in combination with computer use (1·77 [1·28-2·45]; I²=87%) was significantly associated with myopia. The most common sources of risk of bias were that all 33 studies did not include reliable measures of screen time, seven (21%) did not objectively measure myopia, and nine (27%) did not identify or adjust for confounders in the analysis. The high heterogeneity between studies included in the meta-analysis resulted from variability in sample size (range 155-19 934 participants), the mean age of participants (3-16 years), the standard error of the estimated odds of prevalent or incident myopia (0·02-2·21), and the use of continuous (six [55%] of 11) versus categorical (five [46%]) screen time variables INTERPRETATION: Smart device exposure might be associated with an increased risk of myopia. Research with objective measures of screen time and myopia-related outcomes that investigates smart device exposure as an independent risk factor is required.

FUNDING

None.

Smartphone use as a possible risk factor for myopia

CLINICAL RELEVANCE

This study demonstrates an association between myopia and smartphone data usage. Youths now spend more time participating in near tasks as a result of smartphone usage. This poses an additional risk factor for myopia development/progression and is an important research question in relation to potential myopia management strategies.

BACKGROUND

Children are now exposed to another possible environmental risk factor for myopia - smartphones. This study investigates the amount of time students spend on their smartphones and their patterns of smartphone usage from a myopia perspective.

METHODS

Primary, secondary and tertiary level students completed a questionnaire exploring patterns of smartphone usage and assessing their attitudes toward potential myopia risk factors. Device-recorded data usage over an extended period was quantified as the primary and objective indicator of phone use. Average daily time spent using a smartphone was also quantified by self-reported estimates. Refractive status was verified by an optometrist.

RESULTS

Smartphone ownership among the 418 students invited to participate was over 99-per cent. Average daily smartphone data and time usage was 800.37 ± 1,299.88-MB and 265.16 ± 168.02-minutes respectively. Myopic students used almost double the amount of smartphone data at 1,130.71 ± 1,748.14-MB per day compared to non-myopes at 613.63 ± 902.15-MB (p = 0.001). Smartphone time usage was not significantly different (p = 0.09, 12-per cent higher among myopes). Multinomial logistic regression revealed that myopic refractive error was statistically significantly associated with increasing daily smartphone data usage (odds ratio 1.08, 95% CI 1.03-1.14) as well as increasing age (odds ratio 1.09, 95% CI 1.02-1.17) and number of myopic parents (odds ratio 1.55, 95% CI 1.06-2.3). Seventy-three per cent of students believed that digital technology may adversely affect their eyes.

CONCLUSION

This study demonstrates an association between myopia and smartphone data usage. Given the serious nature of the ocular health risks associated with myopia, our findings indicate that this relationship merits more detailed investigation.

A Smartphone App to Support Adherence to Inhaled Corticosteroids in Young Adults With Asthma: Multi-Methods Feasibility Study

Background

Young adults with asthma often report low adherence to inhaled corticosteroids (ICS), leading to uncontrolled symptoms and poor disease outcomes. Technology-enabled digital supports such as mobile health (mHealth) asthma smartphone apps have the potential to support adherence to ICS and asthma self-management. There is a need for feasibility studies to determine the usability, acceptability, and feasibility of these interventions. In addition, it is essential to determine the feasibility of recruiting and retaining young adults to plan future efficacy and effectiveness trials and therefore, establish evidence-based asthma apps.

Objective

This study aimed to determine (1) the feasibility of recruiting and retaining young adults to a trial and (2) the usability, acceptability, and feasibility of using the AsthmaMD app to support adherence to ICS in a population of young adults living with asthma.

Methods

A multi-methods feasibility study was conducted. Young adults aged 18-30 years with asthma and current prescription for ICS were eligible and invited to take part through a university circular email, social media, and general practice sites. Participation involved completing a baseline self-report questionnaire, downloading and using the AsthmaMD app for 2 weeks, and completing the follow-up assessment, including self-report and open-ended questions about participants’ experience of using the app. Primary outcomes included participant recruitment and retention and the usability, acceptability, and feasibility of using AsthmaMD. Quantitative self-report data were analyzed using descriptive statistics, and qualitative open-ended data were analyzed using inductive reflexive thematic analysis.

Results

A total of 122 young adults (females, n=101, 82.8%) with a mean age of 24.4 (SD 3.8) years were recruited and they completed baseline measures. Of the 122 young adults, 59 (48.4%) completed the study. The AsthmaMD app received a mean score of 63.1/100 (SD 20.1) on the System Usability Scale (ie, a standardized measure of usability for technology-based apps), and an overall user satisfaction score of 5.8/10 (SD 2.2). Of the 59 participants who completed the study, 49 (83%) participants used the app ≥1 day per week. Two main themes were identified in the qualitative analysis of user experiences: (1) learning how to use the app to suit the individual and (2) benefits and relevance of using the app.

Conclusions

The findings from this study indicate that it is feasible to recruit and retain young adults to examine efficacy and effectiveness in a future trial and that young adults living with asthma may find AsthmaMD to be usable, acceptable, and feasible to support adherence to ICS. Our findings also identified opportunities to further optimize the usability of AsthmaMD and similar apps. Based on our findings, we recommend providing more accessible information on how to use the app and replacing medical terminology with simplified language within the app to improve usability.

Trial Registration

ISRCTN Registry ISRCTN11295269; https://www.isrctn.com/ISRCTN11295269

Smartphone Use Among University Students During COVID-19 Quarantine: An Ethical Trigger

To reduce the spread of COVID-19, Jordan enforced 10 weeks of home quarantine in the spring of 2020. A cross-sectional study was designed to assess this extended quarantine's effect on smartphone addiction levels among undergraduates. A random sample of 6,157 undergraduates completed an online questionnaire (mean age 19.79 ± 1.67 years; males 28.7%). The questionnaire contains different sections to collect socio-demographic, socio-economic, academic, quarantine-related information, and smartphone usage. The smartphone addiction scale-short version was used to assess the degree of addiction during the quarantine. The mean addiction score across the whole sample was 35.66 ± 12.08, while the prevalence of addiction among participants was 62.4% (63.5% in males and 61.9% in females). The majority of the participants (85%) reported that their smartphone usage during the quarantine increased or greatly increased (27.6 and 57.2%, respectively), with some 42% using their smartphones for more than 6 h a day. Nevertheless, three-quarters of the students wished to reduce their smartphone usage. Several demographic and quarantine factors have been assessed, and students' gender, the field of study, parental education, household income in addition to the location of quarantine (urban, rural) and the house specifications (apartment, independent house, with/without a garden) showed statistically significant associations with smartphone addiction during the quarantine. Female students, students studying scientific- and medical-related majors compared to those studying humanity majors, those with higher incomes, those who had been quarantined in an apartment without a garden, and those who lived in urban areas showed significantly higher addiction scores.

Fear of Missing Out Predicts Distraction by Social Reward Signals Displayed on a Smartphone in Difficult Driving Situations

Smartphones are particularly likely to elicit driver distraction with obvious negative repercussions on road safety. Recent selective attention models lead to expect that smartphones might be very effective in capturing attention due to their social reward history. Hence, individual differences in terms of Fear of Missing Out (FoMO) – i.e., of the apprehension of missing out on socially rewarding experiences – should play an important role in driver distraction. This factor has already been associated with self-reported estimations of greater attention paid to smartphones while driving, but the potential link between FoMO and smartphone-induced distraction has never been tested empirically. Therefore, we conducted a preliminary study to investigate whether FoMO would modulate attentional capture by reward distractors displayed on a smartphone. First, participants performed a classical visual search task in which neutral stimuli (colored circles) were associated with high or low social reward outcomes. Then, they had to detect a pedestrian or a roe deer in driving scenes with various levels of fog density. The social reward stimuli were displayed as distractors on the screen of a smartphone embedded in the pictures. The results showed a significant three-way interaction between FoMO, social reward distraction, and task difficulty. More precisely, under attention-demanding conditions (i.e., high-fog density), individual FoMO scores predicted attentional capture by social reward distractors, with longer reaction times (RTs) for high rather than low social reward distractors. These results highlight the importance to consider reward history and FoMO when investigating smartphone-based distraction. Limitations are discussed, notably regarding our sample characteristics (i.e., mainly young females) that might hamper the generalization of our findings to the overall population. Future research directions are provided.

Factors influencing US speech and language therapists' use of technology for clinical practice

BACKGROUND

There is an increasing number of technological resources available to speech and language therapists (SLTs) for use in clinical practice, but the factors that influence SLTs' selection and use of such resources are not well understood. In related fields, technology acceptance models have been employed to explain users' adoption of technology and to inform the advancement of empirically supported technological resources.

AIMS

To determine the factors that influence SLTs' use of technology for clinical practice by testing a model of their technology acceptance and use.

METHODS & PROCEDURES

We surveyed 209 practising SLTs in the United States representative of the speech and language membership of the American Speech-Language-Hearing Association (ASHA). Participants completed a 38-item electronic survey representing four categories: (1) technology use, (2) technology attitudes and factors influencing technology use, (3) employment information and (4) demographics. Items measuring technology attitudes served as indicators of the research model, which mapped the primary relationships of a technology acceptance model. Survey data were collected before the Covid-19 pandemic.

OUTCOMES & RESULTS

The research model accounted for 66% of the variance in SLTs' behavioural intention to use technology, which significantly and positively predicted the amount of time they reportedly spent using technology in the workplace. Subjective norms and attitudes towards technology use directly predicted the intention to use technology. Perceived usefulness and ease of use indirectly predicted intention to use technology. Survey respondents reported using technology during 48% (SD = 24%) of their overall weekly work hours on average, with a large majority reporting using technology at least once per week for planning (89% of respondents), assessment (66% of respondents) or intervention (90% of respondents).

CONCLUSIONS & IMPLICATIONS

These findings statistically explain the relationships between SLTs' attitudes and their intention to use technology for clinical practice, contributing to our understanding of why SLTs adopt certain technologies. We also detail the nature and frequency of technology use in the clinical practice of SLTs. Future directions for this work include further exploring use categories, employing direct measurements of technology use and exploring the impact of recent changes in SLT service delivery due to the Covid-19 pandemic on SLTs' technology attitudes. What this paper adds What is already known on the subject Existing research about the adoption and use of technological resources by SLTs indicates that they select tools based on convenience, cost and recommendations by others. What this paper adds to existing knowledge This study is the first to develop and test a research model of SLTs' technology attitudes. The findings from model testing demonstrate the significant predictors of SLTs' behavioural intention to use technology for clinical purposes. Intent of use is related to how much SLTs use technology in the workplace. What are the potential or actual clinical implications of this work? The present findings can inform interventions targeting the design and adoption of electronic SLT resources that are empirically supported.

Predictors of Habitual and Addictive Smartphone Behavior in Problematic Smartphone Use

OBJECTIVE

Smartphones have become common, and problematic smartphone use (PSU) is increasing. Predictors of PSU should be identified to prevent it. Little is known about the role of content types of smartphone use as predictors of PSU. Therefore, we aimed to evaluate the predictors of two proposed concepts of PSU, namely habitual smartphone behavior (SB) and addictive SB, within the context of the application (app) categories.

METHODS

We studied 1,039 smartphone users using online surveys conducted between January 2 and 31, 2019. We employed multiple regression analysis to identify the predictors of habitual and addictive SB. We controlled for sex and age (mean=39.20).

RESULTS

Common predictors of habitual and addictive SB were the use of social networking services, games, entertainment apps, and average weekend smartphone usage time. The predictors of habitual SB were the use of web and lifestyle apps, weekly usage frequency, and sex (female) and the predictors of addictive SB were the use of shopping apps and sleep duration.

CONCLUSION

This study revealed the need to consider habitual and addictive SB in evaluating PSU. The predictors in terms of the content types of smartphone usage can be used to develop monitoring and prevention services for PSU.

Validation of Self-Reported Smartphone Usage Against Objectively-Measured Smartphone Usage in Hong Kong Chinese Adolescents and Young Adults

OBJECTIVE

This study evaluated the validity of self-reported smartphone usage data against objectively-measured smartphone usage data by directly tracking the activities in the participants' smartphone among Chinese adolescents and young adults in Hong Kong.

METHODS

A total of 187 participants were recruited (mean age 19.4, 71.7% female) between 2017 and 2018. A smartphone usage tracking app was installed on all participants' smartphone for 7 consecutive days. After the 7-day monitoring period, they completed a selfadministered questionnaire on smartphone usage habits.

RESULTS

Although the correlation between self-reported and objectively-measured total smartphone usage time was insignificant (ρ=-0.10, p=0.18), in three out of the four usage domains were positively and significantly correlated, namely social network (ρ=0.21, p=0.005), instant messaging (ρ=0.27, p<0.001), and games (ρ=0.64, p<0.001). Participants' self-report of the total time spent on smartphones exceeded the objective data by around 760 min per week (self-reported 1,930.3 min/wk vs. objectively-measured 1,170.7 min/wk, p<0.001). Most of the over-reporting was contributed by the web browsing domain (self-reported 447.8 min/wk vs. objectively-measured 33.3 min/wk, p<0.001).

CONCLUSION

Our results showed large discrepancies between self-reported smartphone and objectively-measured smartphone usage except for self-reported usage on game apps.

Investigating the effect of social networking site use on mental health in an 18-34 year-old general population; a cross-sectional study using the 2016 Scania Public Health Survey

BACKGROUND

Social Networking Sites (SNS) are commonly used, especially by young adults. Their impact on mental health is unclear. Moreover, little is known about how social factors, e.g. Perceived Emotional Support (PES), may affect this association. Mental health issues are increasingly burdening the young generation and society as a whole. This study aims to investigate the association between frequency of SNS use and number of SNS contacts with the mental health of a young, Swedish population. Additionally, the potential effect modification of PES will be analysed in regard to these relationships.

METHOD

This cross-sectional study applied logistic regression analyses to data on 1341 participants (aged 18-34), retrieved from the Scania Public Health Survey (2016). Analyses were stratified by gender and the GHQ-12 scale assessed poor mental health. A 2-way interaction model was used to test for effect modification by PES regarding the association between SNS use and mental health.

RESULTS

Increased risk for poor mental health was found in women only. Using SNS almost hourly vs. less often resulted in an odds ratio (OR) of 1.66 (95% confidence interval (CI) = 1.16-2.38). The corresponding figures for having ≥600 contacts vs. ≤599 were (1.89; 1.21-2.97). Having low PES and using SNS almost hourly was associated with an OR of 3.12 (CI = 1.69-5.76; synergy index (SI) = 1.25). Low PES and ≥ 600 contacts resulted in an OR of 6.07 (CI = 1.73-21.33), whereby interaction was detected (SI = 2.88).

CONCLUSION

Women, but not men, with frequent SNS use and a high number of SNS contacts were more likely to have poor mental health, which was exacerbated in women with low PES. Facilitating PES could be an approach for improving mental health among young adults. Future studies on the use of SNS should focus more on gender analyses.

Together Apart: The Mitigating Role of Digital Communication Technologies on Negative Affect During the COVID-19 Outbreak in Italy

The ongoing pandemic of COVID-19 has forced governments to impose a lockdown, and many people have suddenly found themselves having to reduce their social relations drastically. Given the exceptional nature of similar situations, only a few studies have investigated the negative psychological effects of forced social isolation and how they can be mitigated in a real context. In the present study, we investigated whether the amount of digital communication technology use for virtual meetings (i.e., voice and video calls, online board games and multiplayer video games, or watching movies in party mode) during the lockdown promoted the perception of social support, which in itself mitigated the psychological effects of the lockdown in Italy. Data were collected in March 2020 (N = 465), during the lockdown imposed to reduce the COVID-19 spread. The results indicated that the amount of digital technology use reduced feelings of loneliness, anger/irritability, and boredom and increased belongingness via the perception of social support. The present study supported the positive role of digital technologies in maintaining meaningful social relationships even during an extreme situation such as a lockdown. Implications such as the need to reduce the digital divide and possible consequences of the ongoing pandemic are discussed.

Development of the Smartphone Addiction Risk Rating Score for a Smartphone Addiction Management Application

Smartphone usage characteristics are useful for identification of the risk factors for smartphone addiction. Risk rating scores can be developed based on smartphone usage characteristics. This study aimed to investigate the smartphone addiction risk rating (SARR) score using smartphone usage characteristics. We evaluated 593 smartphone users using online surveys conducted between January 2 and January 31, 2019. We identified 102 smartphone users who were addicted to smartphones and 491 normal users based on the Korean Smartphone Addiction Proneness Scale for Adults. A multivariate logistic regression analysis was used to identify significant risk factors for smartphone addiction. The SARR score was calculated using a nomogram based on the significant risk factors. Weekend average usage time, habitual smartphone behavior, addictive smartphone behavior, social usage, and process usage were the significant risk factors associated with smartphone addiction. Furthermore, we developed the SARR score based on these factors. The SARR score ranged between 0 and 221 points, with the cut-off being 116.5 points. We developed a smartphone addiction management application using the SARR score. The SARR score provided insights for the development of monitoring, prevention, and prompt intervention services for smartphone addiction.

Factors associated with smartphone addiction: A comparative study between Japanese and Thai high school students

BACKGROUND

Smartphone addiction is a growing social problem with adverse health outcomes. There are few comparative studies in Asia that examine factors associated with smartphone addiction. The current study aimed to address this research gap by presenting a comparative analysis of factors associated with smartphone addiction in Japan and Thailand, two countries heterogeneous in both their level of economic development and culture.

METHODS

Participant data were collected using two population-based surveys. Participants were high school students in grade 11, aged 16-17 years old, and were selected using quota sampling in Japan in 2014 and random sampling in Thailand in 2016. The outcome of interest was smartphone addiction, measured using a modified version of the Young Diagnostic Questionnaire for Internet Addiction. Multiple logistic regression analysis was performed to determine factors associated with smartphone addiction (gender; nationality; family connectedness; and average time spent on smartphone per day).

RESULTS

This study included a total of 7694 students, 6585 students from Japan and 1109 students from Thailand. The prevalence of smartphone addiction was 35.9% among Thai students and 12% among Japanese students. Thai students were more likely to have smartphone addiction than Japanese students (AOR 2.76; 95% CI: 2.37-3.30). Being female was associated with increased odds of smartphone addiction in both Japanese (AOR 1.53; 95% CI: 1.32-1.78) and Thai students (AOR 1.34; 95% CI: 1.01-1.78). The parental connectedness variables "my parents noticed when I was unhappy" (AOR 0.77; 95% CI: 0.62-0.96) and "my parents noticed when I did something good" (AOR 0.78, 95% CI: 0.61-0.99) were associated with lower odds of smartphone addiction among Japanese students.

CONCLUSION

Smartphone addiction was more prevalent among Thai adolescents than Japanese adolescents, and more prevalent among females than males in both countries. Interventions for reducing smartphone addiction should take into account both context and gender, and should leverage the protective effect of parental connectedness.

Hypnotised by Your Phone? Smartphone Addiction Correlates With Hypnotisability

Hypnosis and heavy smartphone use are both characterised by absorbed states in which one loses track of time and responds automatically to stimuli. In this pre-registered study, we tested whether there was a relationship between smartphone addiction and hypnotisability: one's tendency to follow suggestions under hypnosis. Over 11 public lectures, we hypnotised 641 student-aged participants; after the hypnosis session, participants completed the Smartphone Addiction Scale (Short Version). There was a positive correlation between hypnotisability and smartphone addiction (r = .17, 95% CI [.09, .24], p < .001) with a magnitude similar to standard predictors of hypnotisability. This correlation was small but unlikely spurious: it was positive in 10 of the 11 samples (including two from psychology courses) and persisted in a follow-up several months later. The addiction scores in this Canadian sample were unexpectedly high (M = 31.41) compared to other countries. We hypothesise that targeting the absorbed, time-distorted, and automatic use of smartphones may promote healthier phone habits.

Fear of Missing Out, Mental Wellbeing, and Social Connectedness: A Seven-Day Social Media Abstinence Trial

Smartphones aid the constant accessibility of social media (SM) applications, and these devices and platforms have become a key part of our everyday lives and needs. Previous research has focused on the psychological impact of social media use (SMU) and SM abstinence has only received limited attention. Therefore, employing a combination of an experimental within-subjects mixed methodology using surveys to obtain both quantitative and qualitative data, this study aimed to compare psychosocial factors of fear of missing out (FoMO), mental wellbeing (MWB), and social connectedness (SC) before and after seven days of SM abstinence. Results revealed that participants (N = 61) experienced a significant increase in MWB and SC, and a significant decrease in FoMO and smartphone use following SM abstinence. There was a significant positive relationship between MWB and SC change scores and a significant negative relationship between SC and FoMO change scores. There were no significant differences in levels of SMU before abstinence or across genders in FoMO, MWB, and SC change scores. Thematic analysis revealed coping, habit, and boredom as motivations for SMU, and notification distractions presenting a challenge for successful abstinence from SM. Participants indicated that abstinence resulted in the perceived need to fill their time with non-SM applications. Finally, thematic analysis revealed mixed experiences of perceived connectivity in the absence of SMU. Findings present implications for the importance of unplugging from SM for temporary periods because scrolling through SM to fill time is a key motivator of SMU, and notifications encourage SMU and trigger FoMO.

Factor structure and measurement invariance of the problematic mobile phone use questionnaire-short version across gender in Chinese adolescents and young adults

BACKGROUND

Problematic mobile phone use (PMPU) has become a public health issue in China, particularly in adolescents and young adults. The Problematic Mobile Phone Use Questionnaire-Short Version (PMPUQ-SV) is a validated instrument that measures multiple aspects of PMPU. The current study aimed to test the psychometric characteristics of a Chinese adaption of the PMPUQ-SV and examine its measurement invariance across gender.

METHODS

A total of 2086 participants were recruited form nine schools (six undergraduate colleges and three vocational colleges) through an online platform. Measures included socio-demographic variables, patterns of mobile phone use, the Chinese version of the PMPUQ-SV (C-PMPUQ-SV), the Chinese version of the Smartphone Addiction Proneness Scale (C-SAPS), and the Depression Anxiety Stress Scales (DASS-21).

RESULTS

Exploratory and confirmatory factor analyses conducted in two independent subsamples confirmed that the postulated dimensions fit the data well. Four items, judged as either outdated or not adapted to the Chinese context, performed poorly and were removed, resulting in a shorter 11-item scale. Convergent validity was established through correlations between emotional symptoms and the C-PMPUQ-SV and addictive smartphone use. Additional measurement invariance analyses showed that the scale performed largely similarly in male and female participants.

CONCLUSIONS

The present study demonstrated that the C-PMPUQ-SV is an adequate instrument to study various types of PMPU in Chinese adolescents and young adults. The updated 11-item scale shortens the evaluation time and is adapted to assess contemporary smartphone use.

Passive objective measures in the assessment of problematic smartphone use: A systematic review

Research focussing on problematic smartphone use has predominantly employed psychometric tests which cannot capture the automatic processes and behaviours associated with problematic use. The present review aimed to identify passive objective measures that have been used or developed to assess problematic smartphone use. A systematic search was conducted using Web of Science, Scopus, PsychInfo and PubMed databases to identify passive objective measures that have been employed to assess problematic smartphone use, resulting in 18 studies meeting the inclusion criteria. Objective data that were monitored predominantly focussed on general screen usage time and checking patterns. Findings demonstrate that passive monitoring can enable smartphone usage patterns to be inferred within a relatively short timeframe and provide ecologically valid data on smartphone behaviour. Challenges and recommendations of employing passive objective measures in smartphone-based research are discussed.

Prevalence of problematic smartphone usage and associated mental health outcomes amongst children and young people: a systematic review, meta-analysis and GRADE of the evidence

BACKGROUND

Over the past decade, smartphone use has become widespread amongst today's children and young people (CYP) which parallels increases in poor mental health in this group. Simultaneously, media concern abounds about the existence of 'smartphone addiction' or problematic smartphone use. There has been much recent research concerning the prevalence of problematic smartphone use is in children and young people who use smartphones, and how this syndrome relates to mental health outcomes, but this has not been synthesized and critically evaluated.

AIMS

To conduct a systematic review and meta-analysis to examine the prevalence of PSU and quantify the association with mental health harms.

METHODS

A search strategy using Medical Subject Headings was developed and adapted for eight databases between January 1, 1st 2011 to October 15th 2017. No language restriction was applied. Of 924 studies identified, 41 were included in this review, three of which were cohort studies and 38 were cross sectional studies. The mental health outcomes were self-reported: depression; anxiety; stress; poor sleep quality; and decreased educational attainment, which were synthesized according to an a priori protocol.

RESULTS

The studies included 41,871 CYP, and 55% were female. The median prevalence of PSU amongst CYP was 23.3% (14.0-31.2%). PSU was associated with an increased odds of depression (OR = 3.17;95%CI 2.30-4.37;I2 = 78%); increased anxiety (OR = 3.05 95%CI 2.64-3.53;I2 = 0%); higher perceived stress (OR = 1.86;95%CI 1.24-2.77;I2 = 65%); and poorer sleep quality (OR = 2.60; 95%CI; 1.39-4.85, I2 = 78%).

CONCLUSIONS

PSU was reported in approximately one in every four CYP and accompanied by an increased odds of poorer mental health. PSU is an evolving public health concern that requires greater study to determine the boundary between helpful and harmful technology use. Policy guidance is needed to outline harm reduction strategies.

Smartphone use and study behavior: A Korean and Australian comparison

Smartphone use amongst university students is widespread and a common practice while studying. However, this usage can lead to academic performance costs. This study examined the relationship between smartphone use during study, problematic smartphone use and academic performance in Korean and Australian university students. 119 Korean and 270 Australian students aged between 18 and 26 years completed a survey comprised of a smartphone usage questionnaire, smartphone addiction scale and self-report of their current GPA score. Average smartphone use and problematic smartphone use were found to be significantly higher for Korean compared to Australian students. A positive relationship was found between smartphone use and problematic smartphone use. For Australian students, a negative relationship was found between smartphone use and GPA. Results indicate that smartphone use and smartphone addiction proneness are currently higher for Korean students compared to Australian students. Furthermore, the more time a student spends using their smartphone, the more at risk they are for problematic smartphone use and possible academic performance costs.

Fear of missing out (FoMO) and rumination mediate relations between social anxiety and problematic Facebook use

Introduction

Prior research has found that psychopathology constructs such as depression and anxiety are associated with problematic use of Facebook (PFU). In the present study, we examined a structural equation model whereby depression, social anxiety and lower life satisfaction predicted PFU severity, while analyzing mediating variables including rumination, fear of missing out (FoMO), and frequency of Facebook use, as well as age and gender as covariates.

Method

Participants were 296 college students administered a web survey of instruments measuring these constructs.

Results

Modeling results demonstrate that FoMO and rumination were significantly related to PFU severity. Facebook use frequency was related to PFU severity. FoMO and rumination each mediated relations between social anxiety and PFU severity.

Conclusions

Results are discussed in the context of prior work on FoMO and excessive technology use, as well as several relevant theoretical frameworks.

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Fear of missing out (FoMO) was related to problematic Facebook use (PFU) severity.

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Facebook use frequency related to PFU severity.

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Rumination was associated with PFU severity.

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Rumination mediated relations between social anxiety and PFU severity.

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FoMO mediated relations between social anxiety and PFU severity.

Evening electronic device use and sleep patterns in athletes

The present study aimed to investigate pre-sleep behaviours (including evening electronic device use) and sleep quantity in well-trained athletes. Seventy well-trained athletes (44 females, 26 males) aged 21 ± 4 y from a range of team and individual sports were asked to complete an online sleep diary for 7 days. The sleep diary included questions about pre-sleep behaviours (e.g. napping, caffeine intake), electronic device use in the 2 h prior to bedtime (e.g. type of device and duration of use) and sleep (e.g. time in bed, sleep onset latency). On average, athletes spent 8:20 ± 1:21 h in bed each night. Associations between age, time in bed and sleepiness suggested that younger athletes spent more time in bed (B = -0.05, p = 0.001) but felt sleepier (r = -0.32, p < 0.01) than older athletes. On average, athletes mostly used electronic devices for 0-30 min prior to sleep. The use of multiple devices in the evening was associated with more perceived difficulty in falling asleep (B = 0.22, p = 0.03), but no associations existed with other sleep variables. In summary, younger athletes may require later start times or improved sleep quality to resolve excessive sleepiness.

Correlation among smartphone addiction, craniovertebral angle, scapular dyskinesis, and selected anthropometric variables in physiotherapy undergraduates

Objectives

Smartphone addiction has been indicated to reduce the craniovertebral angle, thereby causing a forward head posture and increasing scapular dyskinesis. This study determined the correlation among smartphone addiction level, craniovertebral angle, scapular dyskinesis, and selected anthropometric variables in physiotherapy undergraduates.

Methods

Seventy-seven participants were recruited from the Department of Physiotherapy, College of Medicine, University of Lagos, through a purposive sampling technique. The smartphone addiction level was assessed with the short version Smartphone Addiction Scale (English version). Craniovertebral and scapular dyskinesis were assessed using the photographic method. Descriptive and inferential statistics were used to analyse the data at an alpha level of 0.05.

Results

The analysis in this study revealed that many undergraduates are addicted to using smartphones. There was no significant difference in the addiction level (p = 0.367) and in scapular dyskinesis (p = 0.129) between male and female participants. However, there was a significant difference in craniovertebral angle (p = 0.032) between male and female participants. There was a significant relationship among smartphone addiction, craniovertebral angle (r = 0.306, p = 0.007), and scapular dyskinesis (r = 0.363, p = 0.007) in male and female participants.

Conclusion

A high level of smartphone addiction reduces the craniovertebral angle and increases scapular dyskinesis. Therefore, the smartphone addiction level should be assessed in all patients with neck and shoulder pain to plan appropriate management.

Smartphone addiction risk and daytime sleepiness in Korean adolescents

AIM

Smartphone overuse can cause not only mobility problems in the wrists, fingers and neck but also interference with sleep habits. However, research on smartphone addiction and sleep disturbances is scarce. Therefore, we aimed to investigate daytime sleepiness in association with smartphone addiction risk in Korean adolescents.

METHODS

A cross-sectional survey method was used in this study. The Pediatric Daytime Sleepiness Scale was used to assess daytime sleepiness, and the Korean Smartphone Addiction Proneness Scale index was used to evaluate the degree of risk for smartphone addiction.

RESULTS

The analyses were performed in 1796 adolescents using smartphones, including 820 boys and 976 girls. The at-risk smartphone users made up 15.1% of boys and 23.9% of girls. Our multivariate analyses demonstrated that students who were female, consumed alcohol, had lower academic performance, did not feel refreshed in the morning and initiated sleep after 12 am were at a significantly higher risk of smartphone addiction. The at-risk smartphone user group was independently associated with the upper quartile Pediatric Daytime Sleepiness Scale score in students with the following factors: Female gender, alcohol consumption, poor self-perceived health level, initiating sleep after 12 am, longer time taken to fall asleep and duration of night sleep less than 6 h.

CONCLUSIONS

The quality of sleep in adolescence affects growth, emotional stability and learning skills. Therefore, the management of smartphone addiction seems to be essential for proper sleeping habits. There is a critical need to develop a means of preventing smartphone addiction on a social level.