Risk of using smartphones while walking for digital natives in realistic environments: Effects of cognitive-motor interference

The effect of using smartphones while walking on the cognitive and physical abilities of the "digital native" generation, i.e., individuals who have grown up in a digital media-centric environment, remains poorly understood. This study evaluated the effects of cognitive-motor interference on the use of smartphones while walking in children and young adults. The study involved 50 individuals from the digital age generation, including 24 children and 26 young adults. The study encompassed three experimental conditions, in which participants were instructed to traverse a distance of 60 m. The initial condition functioned as a control, wherein the participants walked without supplementary stimuli. In the second condition, the participants were provided with explicit instructions to grasp the smartphone device and position it in front of their chest by using both hands. This manipulation introduced a postural component into the experimental setup. The third condition required participants to be ambulatory while concurrently engaging in a cognitive task, namely, participating in a game that necessitated focused attention. Gait parameters were obtained by using inertial measurement unit sensors. Subsequently, the acquired gait characteristics were converted into dual-task costs (DTC). In the cognitive condition, children exhibited significantly greater DTC values for gait speed (76%), stride length (79%), stride time (102%), and stride length coefficient of variation (CV) than the young adults (p < 0.025). Moreover, as shown by the increased CV, a significant association exists between poor performance in smartphone games among children and increased variability in stride length. In children, the DTC of stride time CV decreased as smartphone game scores increased (R2 = 16.5%), and the DTC of stride length CV decreased more markedly as smartphone game scores increased (R2 = 28.2%). In conclusion, children are at a higher risk of pedestrian accidents when using smartphones while walking compared to young adults.

Smartphone use as an efficient tool to improve anomia in primary progressive aphasia

Cognitive interventions are helpful in the non-pharmacological management of Primary progressive aphasia (PPA) and other neurodegenerative disorders of cognition, by helping patients to compensate for their cognitive deficits and improve their functional independence. In this study, we examined the effectiveness of cognitive rehabilitation based on the use of mobile device technology in PPA. The aim of this research study was to determine if BL, a patient with semantic variant PPA (svPPA) and severe anomia, was able to learn using specific smartphone functions and an application to reduce her word finding difficulties. She was trained during the intervention sessions on a list of target pictures to measure changes in picture naming performance. Errorless learning was applied during learning. BL quickly learned to use smartphone functions and the application over the course of the intervention. She significantly improved her anomia for trained pictures, and to a lesser extent for untrained semantically related pictures. Picture naming performance was maintained six months after the intervention, and she continued to use her smartphone regularly to communicate with family members and friends. This study confirms that smartphone use can be learned in PPA, which can help reduce the symptoms of anomia and improve communication skills.

Development and psychometric analysis of the smombie scale for adolescents

PURPOSE

Adolescent pedestrian accidents are increasing because of the "smombie" phenomenon, referring to pedestrians who are distracted by their smartphones and become unaware of their surroundings. In the field of nursing, this phenomenon can negatively affect adolescents' health and well-being. We developed the "smombie scale for adolescents" and examined its psychometric properties.

DESIGN AND METHODS

We revised five items and the response scale of an existing smombie scale for adults based on cognitive interviews and content validity test, and included guiding descriptions for adolescents. Using the revised scale, we surveyed 430 adolescents from South Korea to assess construct validity through confirmatory factor analysis. To review group validity, a logistic regression was conducted using responses to the item on whether participants experienced accidents related to smartphone usage on the street or sidewalk.

RESULTS

The 15 items in the four-factor structure, which was validated using confirmatory factor analysis, demonstrated: a chi-square value (p) of 232.63 (< 0.001), root mean square error of approximation of 0.06, goodness of fit index of 0.93, and Tucker-Lewis index of 0.94. The scale's Cronbach's α was 0.85, indicating good internal consistency. Logistic regression results considering actual accident occurrence showed that Factor 1 (perceived risk) and Factor 3 (pending instant message) were significantly correlated with smombie-related accidents.

CONCLUSIONS

The smombie scale for adolescents demonstrated adequate construct and group validity, and good reliability.

PRACTICE IMPLICATIONS

Its application can yield valuable insights into the effectiveness of pediatric nurses' educational and preventative efforts related to the smombie phenomenon in adolescents.

Association between screen time, including that for smartphones, and overweight/obesity among children in Japan: NICE EVIDENCE Study 4

The association between screen time (ST), including that for smartphones, and overweight/obesity in children was examined separately for boys and girls, considering the influence of lifestyle factors. A cross-sectional study was conducted in 2,242 Japanese children (1,278 girls) aged 10-14 years. Overweight/obesity was defined by the International Obesity Task Force. Logistic regression analysis showed that only for girls, total ST (≥4 h), smartphone ST (≥3 h), and non-smartphone ST (≥2 h) were all independently and significantly associated with overweight/obesity compared to <2 h total ST, non-use of smartphones, and <1 h non-smartphone ST. Thus, smartphone ST ≥3 h and non-smartphone ST ≥2 h were additively associated with overweight/obesity in girls only. Girls having smartphone ST ≥3 h and non-smartphone ST ≥2 h were 6.79 times (95% CI: 3.11-14.81) more likely to have overweight/obesity than girls with less usage of both. In girls, when total ST was ≥4 < 5 h or smartphone ST was ≥2 h, the significant association with overweight/obesity disappeared when physical activity was ≥60 min/day and sleep time was ≥8.5 h. In addition, none of these associations was significant in boys. In Japanese girls, smartphone ST, non-smartphone ST, and total ST were all significantly associated with overweight/obesity. To avoid overweight/obesity, it is suggested to keep smartphone ST, non-smartphone ST, and total ST to <3 h, <2 h, and <4 h, respectively, and to engage in sufficient physical activity and sleep time.

Watch your step: A pilot study of smartphone use effect on young females' gait performance while walking up and down stairs and escalators

The increasingly ubiquitous use of smartphones has made distracted walking common, not only on flat ground, but also on stairs. Available information regarding changes in gait performance while walking and using a smartphone in different environments is still lacking. We aimed to investigate the differences in gait behavior and subjective walking confidence while walking up and down stairs and escalators, with and without smartphone use. A field experiment involving 32 female adults was conducted at a subway station. Gait parameters collected included step frequency, acceleration root mean square, step variability, step regularity, and step symmetry. The results showed that walking task, walking environment, and walking direction significantly affected gait performance and walking confidence. Overall, playing games or texting while walking down escalators resulted in the lowest walking confidence and the largest gait performance decrement: slower step frequency; reduced root mean square; decreased step regularity and step symmetry; and increased step variability. Step frequency, step variability, and step regularity significantly correlated with walking confidence. Smartphone use while walking on stairs and escalators significantly affects gait behavior and might increase the risk of falls. Interventions and prevention are needed to increase safety education and hazard warnings for the general population.

Balancing media selections over time: Emotional valence, informational content, and time intervals of use

The sequencing of information in media can influence processing of content via mechanisms like framing, mood management, and emotion regulation. This study examined three kinds of media sequences on smartphones: (1) balancing positive and negative emotional content; (2) balancing emotional content with informational content; and (3) balancing time spent on and off the media device. Actual media use was measured in natural settings using the Screenomics framework which gathers screenshots from smartphones every 5 s when devices are on. Time-series analyses of 223,531 smartphone sessions recorded from 94 participants showed that emotionally positive content was more likely to follow negative content, and that emotionally negative content was more likely to follow positive content; emotional content was more likely to follow informational content, and informational content was more likely to follow emotional content; and longer smartphone sessions were more likely to follow longer periods of non-use.

Excessive Smartphone Use is Associated with Depression, Anxiety, Stress, and Sleep Quality of Australian Adults

Problematic smartphone use has been associated with poorer mental health in different population groups; however, little is known about how levels of smartphone use were associated with mental health outcomes of adults in Australia. Using data from a cross-sectional survey among Australian adults aged 18-59 years (n = 655, Mean = 24.55 [SD = 5.59] years; 66% female), the current study aimed to examine association between problematic smartphone use and different psychological outcomes. Participants completed measures of problematic smartphone use with Mobile Phone Problem Use Scale (MPPUS), mental health outcomes with Depression, Anxiety, and Stress Scale (DASS-21), and Pittsburgh Sleep Quality Index (PSQI), in addition to some socio-demographics. Smartphone use was categorised into three groups: low-moderate, moderate-high, and high-severe. A total of 160 adults (24.4%) reported high-severe smartphone use. Multivariable linear regression analyses showed that smartphone use was inversely associated with psychological outcomes in a dose-dependent manner with high-severe smartphone uses having the most adverse effects. Compared to low-moderate use, average depression score was 3.5 points higher for moderate-high smartphone use (β = 3.51, 95% CI: 1.63-5.40) and 6.9 points higher for high-severe smartphone use (β = 6.91, 95% CI: 4.74-9.07). Similarly, average stress score was 3.4 points higher for moderate-high smartphone use (β = 3.40, 95% CI: 1.75-5.06) and 7.0 points higher for high-severe smartphone use (β = 7.02, 95% CI: 5.11-8.93). Similar association estimates were found for anxiety and sleep quality. Reducing smartphone use has the potential to optimise depression, anxiety, stress, and sleep quality; however, longitudinal research is warranted to establish directionality of the association.

The relationship between self-concept clarity, athletic identity, athlete engagement and the mediating roles of quality of life and smartphone use in Chinese youth athletes

Background

Youth athletes represent the future of competitive sports, so examining their commitment to sport is critical. This study investigated the impacts of self-concept clarity and athletic identity on athlete engagement among Chinese youth athletes, and the mediating roles of quality of life and smartphone use.

Methods

410 youth athletes from sports schools completed an online cross-sectional survey measuring self-concept clarity, athletic identity, quality of life, smartphone use, and athlete engagement. We used convenience sampling. Instruments included validated scales like the Self-Concept Clarity Scale.

Results

The direct effect of self-concept clarity and athlete engagement in youth athletes was not significant (β = 0.04, p = 0.344), but there was a direct effect of athletic identity and athlete engagement (β = 0.61, p < 0.05). Quality of life mediated the relationships between self-concept clarity(indirect effect = -0.054, 95 % CI = -0.114, -0.019), athletic identity(indirect effect = 0.202, 95 % CI = 0.114, 0.349) and athlete engagement.

Conclusions

This study helps address gaps in understanding athlete engagement in youth athletes. The mediation model provides insights to improve self-concept clarity, athletic identity and quality of life to motivate greater engagement in youth athletes.

Impacts of problematic smartphone use on children: Perspectives from main caregivers

PURPOSE

This study examines the impact of problematic smartphone use (PSU) on children aged six years and younger, as perceived by their main caregivers.

METHOD

Overall, 15 mothers who identified that their children used smartphones excessively were recruited and interviewed. Data were analyzed using summative content analysis.

FINDINGS

Participants reported various impacts of PSU that were categorized into developmental, behavioral, health, quality of life, and parent-child relational perspectives.

PRACTICAL IMPLICATIONS

Efforts to prevent PSU in children are needed. Nurses' roles in the early assessment of PSU are essential.

The smartphone as a "significant other": interpersonal dependency and attachment in maladaptive smartphone and social networks use

Smartphones are increasingly widespread throughout the world and, although smartphones provide various benefits, excessive and maladaptive use is often reported. Given the penetration of smartphones in the individual's daily life, it is relevant to identify the mechanisms sustaining their use, including the affective bond that the owner may develop with the device. The aim of the current study is to test a novel model to explain smartphone and Social Network Sites (SNS) use from an interpersonal perspective. We hypothesized that adult attachment style and interpersonal patterns (i.e., features of interpersonal dependency) generalize to the emotional bond with the mobile device, interacting with psychological correlates and background factors to predict smartphone and SNS consumption. 341 nonclinical adults (57.2% females; age M = 35.5, SD = 14.6) completed a battery consisting of the Attachment Style Questionnaire, the Relationship Profile Test, the Rosenberg Self-Esteem Scale, the Toronto Alexithymia Scale, the Young Adult Attachment to Phone Scale, and the Social Network Intensity and Social Network Access via Mobile phone Applications. A multi-mediation model supported the hypothesis regarding the influence of interpersonal style in the relationship of the individual with their smartphone and use of SNS. A parallel between attachment style and the emotional bond with the smartphone emerged, with anxious attachment style and destructive overdependence being potential risk factors for maladaptive smartphone use especially in individuals involved in a romantic relationship. Findings are discussed in terms of theoretical implications and intervention strategies towards smartphone dependency.

Smartphone and Instagram use, body dissatisfaction, and eating disorders: investigating the associations using self-report and tracked data

BACKGROUND

Previous research has linked smartphone and Instagram use to higher body dissatisfaction (BD) as well as eating disorder (ED) symptomatology. However, these studies have typically been limited to using self-report measures for technology use which, as shown by scientific literature, might not be reliable. In the present work, we combine self-reported assessments as well as tracked smartphone and Instagram use.

METHODS

The effective sample comprised N = 119 women (34 with ED diagnosis history) who were queried about BD and ED symptomatology, and who provided the data about their smartphone and Instagram use duration for each day of the previous week.

RESULTS

The study results show that women with an ED diagnosis history scored higher on both BD as well as ED scales. Although women with an ED diagnosis history had higher smartphone screen time, there were no statistically significant differences in Instagram screen time. Tracked smartphone use duration was positively correlated with both BD and ED symptomatology, but the role of Instagram use needs to be further elucidated.

CONCLUSIONS

The results of this study show that while BD and ED symptomatology are correlated with smartphone use, it may be that Instagram use is not the main contributor to that relationship.

Smartphones and rightward collisions

People tend to deviate to the right when walking through a narrow aperture (e.g., a doorway), resulting in a rightward bias in collisions. This study examines the effects of smartphone use on rightward collisions while walking. When pedestrians walk through a narrow aperture, they usually head straight to the perceived centre of the aperture, which is shifted slightly to the right, without updating the estimates. The rightward shift of the perceived centre is attributable to the rightward attentional shift in the extrapersonal space. Pedestrians using smartphones tend to fixate on the phone most of the time and thus tend not to look at their surroundings (i.e., extrapersonal space). Therefore, we predict that smartphone use will reduce rightward collisions. To test this prediction, we used a narrow-doorway task in which participants walked through a narrow doorway either with or without a smartphone. The participants with smartphones used them to perform either verbal or spatial tasks. The number of rightward collisions decreased when the participants used smartphones. The type of task had no effect on the lateral collision biases. These results were interpreted in terms of lateral attentional bias in peripersonal and extrapersonal spaces.

A Positive View of Excessive Smartphone Utilization and Its Relationship With Other Academic-Related Variables Within the Online Course Setting

The continual use of smartphones is a global problem that requires scholars' attention. This study investigates the impact of excessive smartphone use, self-regulation, and procrastination on students' online academic performance. A total of n = 238 university students participated in the study. Mean comparisons unveiled clear discrepancy scores on procrastination, self-regulation, and daily hours spent on smartphones between the smartphone-addicted and non-addicted students. Structural Equation Modeling helps us to answer our hypothesis. Unusually, smartphone use had a significant and positive effect on online students' academic performance. Also, the study provides a better understanding of the procrastination factor that significantly impacts students' smartphone use and online academic performance. Results are discussed considering possible interventions at the academic level.

A cross-sectional study on smartphone uses among pregnant women attending childbirth classes in the Metropolitan Area of Palermo, Italy: The Stop-Phone study

Background

Prevalence of mobile device addiction has increased over the years; both women and men have assimilated the mobile phone as a central component of their personal existence: integrating it into their lifestyle or becoming so dependent on it that life without it has become unimaginable. Smartphones generate radio-frequency electromagnetic fields. While short-term exposure in adults was considered quite safe, effects of long-term exposure or exposure during pregnancy on fetuses or during breastfeeding on newborns are not well studied yet. The objective of the present study was to investigate the prevalence and usage characteristics of smartphones among a sample of pregnant women, and promote the correct and conscious use of the smartphone.

Methods

A cross-sectional study was conducted, with a questionnaire administered during childbirth classes and - after the questionnaire administration - an educational intervention focused on promoting the correct and conscious use of smartphones was carried out by psychologists and psychotherapists.

Results

The findings of our study suggest that a significant number of the participants suffered addiction to mobile phone usage, but were not aware of it. More than two third of the sample (67.2%) have not changed their smartphone use habits since the beginning of their pregnancy and even more significant data shows that almost all future moms (98.3%) never speak with their doctor about smartphone use during pregnancy.

Conclusions

Data collected suggest a lack of attention to the proposed topic, especially in relation to pregnancy. It seems necessary to sensitize future mothers on this topic. The promotion of a more conscious and controlled use of electronic devices can help reduce the radiation to which the unborn child may be exposed, but has a fundamental role even after birth, to ensure an adequate psychomotor and relational development of the child and do not affect, due to uncontrolled use of smartphones, the mother-child relationship.

Does parental media mediation make a difference for adolescents? Evidence from an empirical cohort study of parent-adolescent dyads

Background and aims

Adolescents, who are undergoing brain changes, are vulnerable to many online risks in their use or overuse of digital technology. Parental media mediation (a set of practices parents use to guide children's media use and to reduce potential negative consequences of children from media) is considered an important way to help regulate and reduce adolescents' use or problematic use of digital media and protect them from online risks. However, previous studies have shown controversial results. These controversial results reflect a reproducibility crisis in psychological science due to selective reporting, selective analysis, and inadequate description of the conditions necessary to obtain results.

Methods

To address this issue and reveal the authentic effect of parental media mediation strategies, this study presented the results of a specification curve analysis of 1176 combinations indicating the longitudinal effect of parental media mediation on adolescent smartphone use or problematic use. A total of 2154 parent-adolescent dyads (adolescents' ages ranged from 9 to 18, the average age was 12.13 ± 2.20, and 817 of the adolescents were male) participated in two waves of measurements.

Results

The results showed that of the 12 parental media mediations, joint parental use for learning had the greatest effect in reducing future smartphone use or problematic use among adolescents. Overall, none of the parental media mediations had a substantial effect in reducing future smartphone use or problematic use among adolescents.

Discussion and conclusions

The ineffectiveness of parental media mediation poses a challenge for researchers, the public, and policy-makers. More exploration is needed in the search of effective parental media mediations for adolescents.

Is excessive smartphone use associated with weight status and self-rated health among youth? A smart platform study

BACKGROUND

In Canada, it is recommended that youth limit screen time to less than two hours per day, yet, the majority of youth are reportedly spending a significantly higher amount of time in front of a screen. This is particularly concerning given that these recommendations do not take into account smartphone devices, which is the most common screen time technology of choice for the younger generations. This study implements an innovative approach to understanding screen time behavior and aims to investigate the unique relationship between smartphone specific screen time and physical health outcomes.

METHODS

This cross-sectional study is part of the Smart Platform, a digital epidemiological and citizen science initiative. 436 youth citizen scientists, aged 13-21 years, provided all data via their own smartphones using a custom-built smartphone application. Participants completed a 124-item baseline questionnaire which included validated self-report surveys adapted to collect data specifically on smartphone use (internet use, gaming, and texting), demographic characteristics, and physical health outcomes such as weight status and self-rated health. Binary regression models determined the relationship between smartphone use and physical health outcomes.

RESULTS

Overall participants reported excessive smartphone use in all categories. 11.4% and 12% of the 436 youth participants reported using their smartphone excessively (greater than 2 h per day) during the week and weekend respectively for gaming and were over 2 times more likely than their peers to fall within an overweight/obese BMI status. Excessive weekend gaming was also associated with self-rated health where participants were over 2 times more likely than their peers to report poor self-rated health.

CONCLUSIONS

The results indicate that excessive screen time on smartphones does have complex associations with youth health. Further investigation with more robust study designs is needed to inform smartphone-specific screen time guidelines for youth.

PROBLEMATIC USE OF SMARTPHONE AND NOMOPHOBIA AMONG MEDICAL AND NURSING UNDERGRADUATE STUDENTS OF A TERTIARY CARE REFERRAL HOSPITAL IN INDIA AND ITS ASSOCIATION WITH QUALITY OF LIFE: A CROSS-SECTIONAL OBSERVATIONAL STUDY

BACKGROUND

Overuse of smartphone amongst today's young generation has assumed an epidemic proportion. Assessment of severity of Nomophobia and Smartphone use related problems is important as it can help to ascertain the current adverse consequences of Smartphone problematic use. The study aims to assess the association between smartphone dependence, nomophobia and quality of life in undergraduate medical and nursing students in a tertiary care referral hospital cum medical institution in India.

SUBJECTS AND METHODS

This cross-sectional study involved 437 medical and nursing undergraduate students, which involved assessing their dependence for smartphone and nomophobia using the Test for Mobile Phone dependence (TMD) questionnaire brief version and Nomophobia Questionnaire (NMP-Q) respectively.

RESULTS

The average hours spent on smartphone per day for the study population was 3.2 hours. Smartphone dependence was found in 12% of study participants. Nearly 50% in each batch had moderate degree of nomophobia and around 13-15% had severe nomophobia. Both smartphone dependence and nomophobia were significantly associated with each other and had significant associations with poorer quality of life in the medical and nursing students. Preclinical medical students scored higher in all the domains of Smartphone dependence and nomophobia questionnaire and were associated with poor quality of life compared to other batches.

CONCLUSION

Excessive smartphone use is associated with poorer quality of life in medical and nursing students. More studies in future are required that will involve various age groups and other educational streams which willadd up to the existing knowledge on technology addiction.

The impact of smartphone use on learning effectiveness: A case study of primary school students

This study investigated the effects of smartphone use on the perceived academic performance of elementary school students. Following the derivation of four hypotheses from the literature, descriptive analysis, t testing, one-way analysis of variance (ANOVA), Pearson correlation analysis, and one-way multivariate ANOVA (MANOVA) were performed to characterize the relationship between smartphone behavior and academic performance with regard to learning effectiveness. All coefficients were positive and significant, supporting all four hypotheses. We also used structural equation modeling (SEM) to determine whether smartphone behavior is a mediator of academic performance. The MANOVA results revealed that the students in the high smartphone use group academically outperformed those in the low smartphone use group. The results indicate that smartphone use constitutes a potential inequality in learning opportunities among elementary school students. Finally, in a discussion of whether smartphone behavior is a mediator of academic performance, it is proved that smartphone behavior is the mediating variable impacting academic performance. Fewer smartphone access opportunities may adversely affect learning effectiveness and academic performance. Elementary school teachers must be aware of this issue, especially during the ongoing COVID-19 pandemic. The findings serve as a reference for policymakers and educators on how smartphone use in learning activities affects academic performance.

The new role of nursing in digital inclusion: Reflections on smartphone use and willingness to increase digital skills among Chinese older adults

OBJECTIVE

This study explores the willingness of older adults to use smartphones and improve their digital skills and encourages nursing to actively participate in bridging the digital divide.

METHODS

Subject analysis was used to conduct qualitative research, and 23 older adults were interviewed.

RESULTS

We identified four themes: (1) the current situation of smartphone use; (2) the digital dilemma of smartphone use; (3) social support for digital skills; and (4) the willingness to learn digital skills. Older adults in China are willing to accept and use smartphones for simple operations, and peer learning may be an effective way to improve their digital skills.

CONCLUSION

Community support is necessary to develop the digital skills of older adults with smartphones and reduce the digital divide to the greatest extent possible. Nursing may play a role in promoting digital inclusion for older adults.

Impacts of parental technoference on parent-child relationships and child health and developmental outcomes: a scoping review protocol

BACKGROUND

With increases in the use of technological devices worldwide, parental technoference is a potential threat to the quality of parent-child relationships and children's health and development. Parental technoference refers to disrupted interactions between a parent and child due to a parent's use of a technological device. The aims of this scoping review are to map, describe, and summarize the existing evidence from published research studies on the impacts of parental technoference on parent-child relationships and children's health and development and to identify the limitations in the studies and gaps in the literature.

METHODS

This scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology. A search for relevant research studies will be undertaken in APA PsycInfo, MEDLINE, Central, Cochrane Database for Systematic Reviews, JBI EBP, and Embase (OVID). CINAHL (Ebsco) and Scopus will also be searched. Grey and popular literature will be excluded. This review will include primary research studies and review papers published in English with no time limit that identify the impacts of technoference on parent-child relationships and child health and developmental outcomes. Parent participants include primary caregivers, either biological, adopted, or foster parents, of children under the age of 18 who engage in technoference. Two reviewers will independently screen the titles, abstracts, and full texts of studies according to the inclusion and exclusion criteria. Disagreements will be resolved through discussion with a third researcher. Data will be extracted into a data charting table including author(s), year of publication, country, research aim, methodology/design, population and sample size, variables/concepts, and corresponding measures and main results. Data will be presented in tables and figures accompanied by a narrative summary.

DISCUSSION

The goal of this scoping review is to present an overview of the evidence on the impacts of parental technoference on parent-child relationships and child and health developmental outcomes, highlighting the current risk of children of today. It will identify gaps in the literature, inform future research, advise recommendations for parents on technological device use, and possibly guide the development of interventions aimed at addressing parental technoference.

TRIAL REGISTRATION

Open Science Framework https://doi.org/10.17605/OSF.IO/QNTS5.

Smartphone non-users experience disproportionately higher psychological distress than their counterparts: Mediations via psychosocial resources in a large sample of college students in China

BACKGROUND

Despite growing adoption of digital technologies, the gap between users and non-users (aka digital divide) persists. It is imperative to determine whether and how such a gap can lead to disparities in mental health outcomes among populations. However, few empirical studies have explored the effect of smartphone non-use on psychological well-being.

METHODS

A large-scale cross-sectional survey was conducted among 26,951 college students in Shaanxi Province, China. Levels of depression and loneliness were first compared between smartphone non-users and their user counterparts. Based on the Conservation of Resources theory, structural equation modeling was then used to test the mediating roles of social support, quality of peer relationship, and self-esteem.

RESULTS

Around 56.8% of smartphone non-users had probable depression and they reported significantly higher depressive symptoms (Cohen's d = 0.52) and loneliness (Cohen's d = 0.30) than users. The hypothesized mediation model was well supported with good model fit. Lower levels of social support, quality of peer relationship, and self-esteem fully mediated the total effect of smartphone non-use status on loneliness and explained 69.4% of the total effect on depression.

LIMITATIONS

Findings might be subject to self-reporting bias and limitations due to a cross-sectional design.

CONCLUSIONS

The study adds new evidence that the minority group of smartphone non-users exhibited disproportionately greater psychological distress than users resulting from lower supportive social relationships and positive sense of self. The findings inform the future investigation into digital divide in smartphone use/access and its negative impact on population's psychological well-being.

Association between daily smartphone use and consumption: Should we put the phones down?

Previous research has established that eating while viewing television is related to increased calorie consumption. However, despite the growing prevalence of smartphone use in daily life, very little research has investigated the relationship between phone use and eating behavior. Moreover, what little research exists has all been laboratory-based. The present study sought to fill this research gap by investigating smartphone use and eating behavior in everyday life. One hundred and thirty eight participants logged all foods and drinks consumed using MyFitnessPal and submitted smartphone screen time data for three consecutive days (Thursday through Saturday). Results revealed no significant associations between smartphone use and calorie consumption on any of the three study days. Additionally, morning phone use did not predict calories eaten during subsequent meals on any day. The type of phone use (e.g., social networking, reading, etc.) was also not related to total daily calorie intake. These findings on eating behavior in daily life contradict laboratory research, suggesting that smartphone use may not promote increased calorie intake in the same way that television viewing does.

Psychometric properties of the metacognitions about smartphone use questionnaire (MSUQ) in Chinese college students

AIMS

Over the last ten years, several studies investigating the role of metacognitions in addictive behaviors, including technological addictions, have been published. Problematic Smartphone use has been conceptualized as a behavioural addiction and a psychometrically sound self-report measure to assess metacognitions about PSU has been recently published. The objective of this study was to evaluate some psychometric properties (e.g., factor structure, reliability, and validity) of the Chinese Metacognitions about Smartphone Use Questionnaire (Chinese MSUQ).

METHODS

A sample of 698 undergraduates (F = 54.70%, mean age = 19.89 ± 1.38 years) were enrolled in China. An exploratory factor analysis was first performed in a randomly allocated subsample of 349 participants. A confirmatory factor analysis was then computed on a second subsample of 349 participants to test its fitting with the identified factor structure. Internal consistency and predictive validity were verified.

RESULTS

The result of exploratory factor analysis showed a 2-factor structure, which consists of positive metacognitions concerning emotional and cognitive regulation and social advantages of smartphone use (MSUQ-PM) and negative metacognitions about uncontrollability and cognitive harm of smartphone use (MSUQ-NM). The confirmatory factor analysis indicated that the 2-factor structure of Chinese MSUQ had appropriate fit. Cronbach's Alphas ranged from 0.90 to 0.92. Additionally, regression analysis showed that MSUQ-PM and MSUQ-NM positively predicted PSU. Notably, MSUQ-NM is a stronger predictor of PSU compared with MSUQ-PM, with a rescaled importance of 86.36%.

CONCLUSIONS

The Chinese MSUQ has appropriate psychometric properties, suggesting it is a reliable instrument to assess metacognitions about smartphone use in the Chinese context.

Smartphone Use Associated with Refractive Error in Teenagers: The Myopia App Study

PURPOSE

To investigate the association between smartphone use and refractive error in teenagers using the Myopia app.

DESIGN

Cross-sectional population-based study.

PARTICIPANTS

A total of 525 teenagers 12 to 16 years of age from 6 secondary schools and from the birth cohort study Generation R participated.

METHODS

A smartphone application (Myopia app; Innovattic) was designed to measure smartphone use and face-to-screen distance objectively and to pose questions about outdoor exposure. Participants underwent cycloplegic refractive error and ocular biometry measurements. Mean daily smartphone use was calculated in hours per day and continuous use as the number of episodes of 20 minutes on screen without breaks. Linear mixed models were conducted with smartphone use, continuous use, and face-to-screen distance as determinants and spherical equivalent of refraction (SER) and axial length-to-corneal radius (AL:CR) ratio as outcome measures stratified by median outdoor exposure.

MAIN OUTCOME MEASURES

Spherical equivalent of refraction in diopters and AL:CR ratio.

RESULTS

The teenagers on average were 13.7 ± 0.85 years of age, and myopia prevalence was 18.9%. During school days, total smartphone use on average was 3.71 ± 1.70 hours/day and was associated only borderline significantly with AL:CR ratio (β = 0.008; 95% confidence interval [CI], -0.001 to 0.017) and not with SER. Continuous use on average was 6.42 ± 4.36 episodes of 20-minute use without breaks per day and was associated significantly with SER and AL:CR ratio (β = -0.07 [95% CI, -0.13 to -0.01] and β = 0.004 [95% CI, 0.001-0.008], respectively). When stratifying for outdoor exposure, continuous use remained significant only for teenagers with low exposure (β = -0.10 [95% CI, -0.20 to -0.01] and β = 0.007 [95% CI, 0.001-0.013] for SER and AL:CR ratio, respectively). Smartphone use during weekends was not associated significantly with SER and AL:CR ratio, nor was face-to-screen distance.

CONCLUSIONS

Dutch teenagers spent almost 4 hours per day on their smartphones. Episodes of 20 minutes of continuous use were associated with more myopic refractive errors, particularly in those with low outdoor exposure. This study suggested that frequent breaks should become a recommendation for smartphone use in teenagers. Future large longitudinal studies will allow more detailed information on safe screen use in youth.

Examining associations between smartphone use, smartphone addiction, and mental health outcomes: A cross-sectional study of college students

Background: Prior studies have indicated the complex relationships of smartphone use and smartphone addiction with mental health and life satisfaction. The purpose of this study was to investigate the structural relationships among smartphone use, smartphone addiction, mental health problems (e.g., depression, anxiety, stress [DAS] and satisfaction with life [SWL]).

Methods: Cross-sectional data were collected by convenience sampling via an online survey of undergraduate students at a Midwestern university in the United States. The sample size of601 collected from undergraduate students that owned a smartphone and completed responses to the variables was utilized in this study. We assessed the hypothesized variables, including smartphone use, smartphone addiction, and mental health outcomes variables on a Likert-type scale. Structural analysis was used to examine the relationships.

Results: Results suggested that smartphone use had a significant negative association with DAS symptoms (β = -.31, t = -3.81, P < .001) and was positively associated with SWL (β =.25, t = 3.41, P < .001). However, smartphone use had a significant positive relationship with smartphone addiction (β = .48, t = 5.51, P < .001). Smartphone addiction was positively related to DAS (β = .44, t = 6.33, P < .001), but it was not related to SWL (β = -.08, t = -1.26, P > .05).

Conclusion: This study enhances our understanding of the associations between smartphone use and the health and well-being of undergraduate students. Implications for supporting their psychological health are discussed.

The experience and acceptability of smartphone reminder app training for people with acquired brain injury: a mixed methods study

Smartphones are useful compensatory memory aids, yet training on how to use them is seldom offered as part of rehabilitation for acquired brain injuries (ABIs). We aimed to explore the experience and acceptability of a smartphone training intervention in 26 people with ABI who participated in a pilot randomized controlled trial comparing three skills training approaches. Participants completed questionnaire ratings and a semi-structured interview, six weeks post-training. Most participants rated the training as enjoyable (80.8%) and reasonable in duration (88.5%). Others reported that more than one training session was needed to learn the app (34.6%). Five themes were identified from qualitative data through thematic analysis: (1) Attitudes and pre-existing factors, (2) Experiencing the intervention, (3) Tailoring the intervention to the individual, (4) Facilitators and barriers to implementation and (5) Enhancing smartphone use in everyday life. These themes were juxtaposed with a theoretical framework of acceptability, which indicated that some elements (e.g., having a structured session and a supportive trainer) contributed to the acceptability of the intervention by minimizing training burden and increasing self-efficacy. Tailoring the training to the individual's technological skills and lifestyle, providing post-training resources and involving family members were identified as factors that could improve intervention acceptability.

A brief intervention to reduce burnout and improve sleep quality in medical students

BACKGROUND

Perceived stress, burnout, and poor sleep quality are high among medical students. Interventions designed to target these issues are necessary to promote the health and well-being of medical students. The purpose of this study was twofold: 1) to assess the feasibility of implementing a sunrise alarm clock intervention with medical students and 2) to evaluate the impact of the intervention on perceived stress, burnout scores, and sleep quality.

METHODS

We conducted a feasibility study to evaluate the efficacy of a two-week, sunrise alarm clock intervention in combination with electronic device removal at bedtime. We assessed first- and second-year medical students' perceived stress, burnout scores, including Emotional Exhaustion, Depersonalization, and Low Sense of Personal Achievement, and sleep quality before and after the intervention. In addition, we measured smartphone addiction prior to the intervention.

RESULTS

A total of 57 students consented to participate, of which 55 completed both the pre- and post-assessments (3.5% attrition). The mean age of the participants was 24.8 ± 1.9 years, 50.9% (n = 29) identified as women, and 68.4% (n = 39) identified as white. Pre-intervention, 42.1% (n = 24) of students met criteria for smartphone addiction and 77.2% (n = 44) met criteria for poor sleep quality. In addition, 22.8% (n = 13) of participants had high emotional exhaustion, 64.9% (n = 31) high depersonalization, and 42.1% (n = 24) low sense of personal accomplishment prior to the intervention. Following the two-week intervention, participants showed improvements in emotional exhaustion (p = 0.001, Cohen's d = 0.353), depersonalization (p = 0.001, Cohen's d = 0.411) low sense of personal accomplishment (p = 0.023, Cohen's d = 0.275), perceived stress (p < .001, Cohen's d = .334), and sleep quality (p < 0.001, Cohen's d = 0.925). The number of participants who reported poor sleep quality decreased to 41.8% (n = 23), demonstrating a significant decline (p = 0.026). Participants also improved subjective sleep quality (p < 0.001, Cohen's d = 1.033), sleep duration (p = 0.001, Cohen's d = 0.431), sleep latency (p < 0.001, Cohen's d = 0.433), and sleep efficiency (p = 0.021, Cohen's d = 0.673).

CONCLUSIONS

These findings suggest that the two-week sunrise alarm clock protocol with electronic device removal was effective in improving sleep quality and reducing burnout scores, and perceived stress. However, additional research comparing this intervention to a proper control group is needed to draw meaningful conclusions about the effectiveness of this intervention.

Does mindfulness reduce the effects of risk factors for problematic smartphone use? Comparing frequency of use versus self-reported addiction

BACKGROUND

There is growing concern regarding problematic smartphone overuse. Practiced mindfulness, the state of being aware of the present moment, may protect against problematic smartphone use by reducing the strength of risk factors.

PURPOSE

We hypothesized that trait mindfulness can reduce the impact of risk factors on a) objective smartphone use and b) subjective problematic smartphone use.

METHODS

Our sample (n = 135, M_age = 19.15, 68% female) consisted of college students from a large university. Participants completed self-report measures of boredom proneness, impulsivity, technology-related anxiety (nomophobia), trait mindfulness, smartphone use frequency, and problematic use.

RESULTS

Higher mindfulness was significantly associated with lower boredom proneness, impulsivity, and problematic use (F = 12.12, p < .01). Hierarchical regression revealed that the positive relationships between nomophobia, and problematic use decreased as mindfulness levels increased. A similar protective effect was observed for boredom proneness, although the effect dissipated as impulsivity rose. A second regression revealed no significant predictors of weekly smartphone use.

CONCLUSIONS

Effects of nomophobia and boredom proneness on problematic smartphone use diminish with increased mindfulness, but impulsivity may interfere with this. Risk and protective factors for 'addiction' appear unrelated to smartphone use frequency. Future research should examine benefits of mindfulness-based interventions in promoting emotional and cognitive self-regulation, focusing on those who use smartphones in dysfunctional ways.

Do smartphones and social network sites become more important when experiencing stress? Results from longitudinal data

Previous research on stress and media use mainly concentrated on between-person effects. We add to this research field by additionally assessing within-person associations, assuming that experiencing more stress than usual goes along with more nomophobia (“no-mobile-phone phobia”) and more passive and active Facebook use than usual, cross-sectionally and over time, and by exploring potential age differences. We conducted a secondary analysis of three waves of a representative multi-wave survey of adult Dutch internet users (N = 861). Specifically, we used two subsamples: (1) smartphones users for the analyses on nomophobia (n = 600) and (2) Facebook users for the analyses on social media (n = 469). Employing random-intercept cross-lagged panel models, we found within-person correlations between nomophobia and stress at one time-point, but not over time. For the younger age group (18–39 years), more passive Facebook use than usual was associated with more stress than usual six months later, and more stress than usual was followed by less passive Facebook use six month later. There were no longitudinal relationships for active Facebook use across the different age groups. Methodological and theoretical implications are discussed.

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We study the relationships of nomophobia, Facebook use and stress over time.

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Nomophobia and stress correlate on the within-person level at one time-point.

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Passive Facebook use is associated with more stress over time for younger adults.

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Stress relates to less passive Facebook use six months later for younger adults.

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There are no longitudinal effects for nomophobia, active Facebook use, and stress.

Relationship of smartphone use at night with sleep quality and psychological well-being among healthy students: A pilot study

OBJECTIVE

To examine the differences between objective and subjective measures of smartphone use at night as predictors of sleep quality and psychological well-being: anxiety, depression, and fear of missing out (FoMO).

METHODS

Smartphone use after sleep onset was measured using objective and subjective measures among 40 college students. The morning after the fourth night, they completed online questionnaires: Pittsburgh Sleep Quality Index (PSQI), Trait Anxiety Inventory (STAI-T), Beck Depression Inventory (BDI-II), and FoMO Scale (FoMOs).

RESULTS

Objective measures showed that 40% of the participants actually awoke during the night and checked their smartphone. However, the subjective measures showed that they overestimated this behavior. More frequent nighttime checking of one's smartphone, as recorded by objective measures, was associated with lower sleep quality and psychological well-being.

CONCLUSIONS

This study demonstrated differences between objective and subjective measures of smartphone use at night. It also showed that an objective measurement of smartphone use could identify participants at risk for reduced sleep quality and psychological well-being.

Rumination and negative smartphone use expectancies are associated with greater levels of problematic smartphone use: A latent class analysis

Problematic smartphone use (PSU) is related to psychopathology symptoms, such as depression and anxiety. However, less is known about how responses to and coping with psychopathology correlate with PSU. We conducted a web survey of 286 American college students, querying depression and anxiety symptoms, rumination (a coping process to avoid negative emotion), PSU, and expectancies about smartphone use for mood alleviation. We conducted latent class analysis (LCA) of PSU symptom ratings, finding support for two latent subgroups of participants, involving mild and severe PSU, especially distinguished by severity of withdrawal symptoms. Rumination and negative smartphone use expectancies (i.e., to reduce distress) positively related to the more symptomatic PSU class. Results are discussed in context of the I-PACE theoretical model of problematic internet use (PIU). We emphasize the importance of response variables in I-PACE, such as internet-related cognitive bias and coping, over background psychopathology variables in influencing PIU and PSU.

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.

Behavioral Addictions: Excessive Gambling, Gaming, Internet, and Smartphone Use Among Children and Adolescents

The introduction of behavioral addictions is a relatively new concept in psychiatry. It was not until 2010 that the term behavioral addictions was added to the official classification of psychiatric diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Gambling, typically thought to be an adult behavior, has become commonplace among adolescents. Although technological advances have made accessing information and communication easier, excessive use of the Internet and smartphones can result in multiple mental and physical health issues. Gambling disorders, gaming disorders, Internet use disorder, and excessive smartphone use often begin during childhood and adolescence.

Use of smartphone and perception towards the usefulness and practicality of its medical applications among healthcare workers in Saudi Arabia

Background

In Saudi Arabia, healthcare industry is undergoing major expansions to meet the demand of rapidly growing healthcare needs. The aims of this study were; (1) to assess the pattern of smartphone use in healthcare facilities, and (2) to determine perception towards its use among healthcare workers.

Method

A cross-sectional survey of 351 healthcare workers (HCWs) at King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia was conducted, from October to November 2016, using a previously validated perception domain to measure perception towards usefulness (5 statements) and practicality (5 statements) of smartphones in clinical settings. Pattern of use of smartphones and health-related applications in healthcare facilities was also investigated. Logestic regression models were applied to identify the predictors of smartphone use and installation of health-related applications for use in healthcare facilities. Significance was considered at p-value of < 0.05.

Results

Utilization rate of smartphone was 42.3%, and only 6.1% of all healthcare providers reported always using applications in their practice. Reasons for use were: as a source of drug information (69.8%), for disease diagnosis (56.4%), to access medical websites (42.5%), to review guidelines and protocols related to healthcare (34.1%), for procedure documentation (23.5%), and as a source of patients education materials (22.3%). Perceptions of HCWs towards smartphone use was less than satisfactory (Overall percentage mean score = 60.4 ± 18.7), with only 11.6% reporting positive perception. After adjusting for possible confounders, the total perception mean score was a significant predictor of both smartphone use (β = 0.033, p < 0.001) and medical applications installation (β = 0.033, p < 0.001). Installation of medical applications was also predicted by being a physician (β = 0.008, p = 0.024).

Conclusion

Smartphone utilization in healthcare facilities by HCWs in Saudi Arabia is low. This could be attributed to their less than satisfactory level of perception towards its use. Smartphone use and installation of medical applications for use in health facilities were predicted by perceived usefulness and practicality of its use. Intervention from higher health authorities is necessary to enforce the importance of smartphone use in clinical practice. Conduction of further studies on the impact of smart phone use on the healthcare quality in Saudi Arabia is recommended.

Short-Term Longitudinal Relationships Between Smartphone Use/Dependency and Psychological Well-Being Among Late Adolescents

PURPOSE

The aim of the study was to determine the short-term longitudinal pathways between smartphone use, smartphone dependency, depressive symptoms, and loneliness among late adolescents.

METHODS

A two-wave longitudinal survey was used using adolescents between the ages of 17 and 20 years. The interval between wave 1 and wave 2 was between 2.5 and 3 months. Using convenience sampling, the total number of participants who completed both waves of data collection was 346. Validated measures assessed smartphone dependency, smartphone use, depressive symptoms, and loneliness. The longitudinal model was tested using path modeling techniques.

RESULTS

Among the 346 participants (33.6% male, mean [standard deviation] age at wave 1, 19.11 [.75] years, 56.9% response rate), longitudinal path models revealed that wave 1 smartphone dependency predicted loneliness (β = .08, standard error [SE] = .05, p = .043) and depressive symptoms (β = .11, SE = .05, p = .010) at wave 2, loneliness at wave 1 predicted depressive symptoms at wave 2 (β = .21, SE = .05, p < .001), and smartphone use at wave 1 predicted smartphone dependency at wave 2 (β = .08, SE = .05, p = .011).

CONCLUSIONS

Considering the rates of smartphone ownership/use among late adolescents (95%), the association between smartphone use and smartphone dependency, and the deleterious effects of loneliness and depression within this population, health practitioners should communicate with patients and parents about the links between smartphone engagement and psychological well-being.

Joint associations of smartphone use and gender on multidimensional cognitive health among community-dwelling older adults: a cross-sectional study

Background

Smartphone use has become an increasingly pervasive part of our daily lives, and as a portable media device, smartphones provide good support for cognitive training during aging. However, little is known about the joint association of smartphone use and gender on the cognitive health of older adults, particularly with regard to multi-domain cognition.

Methods

A face-to-face survey of 3230 older adults aged 60+ years was conducted in Xiamen, China, in 2016. The Montreal Cognitive Assessment (MoCA) score was used to measure both general and multi-domain cognition. Smartphone use was self-reported and the number of the smartphone functions used (NSFU) was classified as 0, 1, and 2+. General and subdomain cognitive functions were modelled on NSFU only, gender only, and NSFU and gender combined by using a series of proportional-odds cumulative logit models. Furthermore, joint associations of gender and NSFU on both general and multi-domain cognition were estimated, and a four-category quantile classification was used to evaluate the total MoCA score.

Results

Among all 3230 respondents, 2600 remained after exclusion of respondents with very low MoCA scores (below the education-adjusted cut-offs for dementia). Only 29.96% of older adults used smartphones, 473 (60.72%) of which were men. Respondents who had a higher NSFU maintained a better general and sub-domain cognition except for memory and orientation. Although women had lower values compared to men in visuospatial ability (OR (95% CI): 0.46 (0.37–0.57)), they outperformed their male counterparts in memory (OR (95% CI): 1.38 (1.10–1.73)). The results of the joint association showed that women’s inferiority in visuospatial ability diminished when they had a NSFU of 2+. However, a significantly better improvement in memory for male was achieved when they had a NSFU of 1 rather than 2 + .

Conclusions

A higher NSFU was positively associated with increased general and partial subdomain cognitive functions. However, gender differences were found in visuospatial ability and memory, which could be alleviated by smartphone use.

The Role of Executive Functioning and Technological Anxiety (FOMO) in College Course Performance as Mediated by Technology Usage and Multitasking Habits

This study investigated how technology use impacts academic performance. A proposed model postulated that academic performance could be predicted by a cognitive independent variable-executive functioning problems-and an affective independent variable-technological anxiety or FOMO (fear of missing out)-mediated by how students choose to use technology. An unobtrusive smartphone application called "Instant Quantified Self" monitored daily smartphone un-locks and daily minutes of use. Other mediators included self-reported smartphone use, self-observed studying attention, self-reported multitasking preference, and a classroom digital metacognition tool that assessed the student's ability to understand the ramifications of technology use in the classroom that is not relevant to the learning process. Two hundred sixteen participants collected an average of 56 days of "Instant" application data, demonstrating that their smartphone was unlocked more than 60 times a day for three to four minutes each time for a total of 220 daily minutes of use. Results indicated that executive functioning problems predicted academic course performance mediated by studying attention and a single classroom digital metacognition subscale concerning availability of strategies of when to use mobile phones during lectures. FOMO predicted performance directly as well as mediated by a second classroom digital metacognition concerning attitudes toward mobile phone use during lectures. Implications for college students and professors include increasing metacognition about technology use in the classroom and taking "tech breaks" to reduce technology anxiety.

Predictors of willingness to use a smartphone for research in underserved persons living with HIV

OBJECTIVES

The burden of HIV/AIDS is borne disproportionally by a growing number of racial and ethnic minorities and socioeconomically disadvantaged individuals. Developing mHealth interventions for the everyday self-management needs of persons living with HIV (PLWH) can be challenging given the current constraints of the U.S. healthcare system, especially for those from underserved communities. In order to develop effective, evidence-based mHealth self-management interventions, we need a better understanding of the factors associated with mHealth research. The purpose of this study was to assess factors associated with PLWH's for participation in research using smartphones.

METHODS

We conducted a prospective cohort study (parent study) to examine the relationships among HIV self-management, age, gender and mental wellness. Relevant to this study, we analyzed the relationship between self-reported use of smartphones, willingness to use a smartphone for research, and other predictor variables including: HIV stigma, social isolation, social integration functions, and depression. We selected these variables because previous work indicated they may influence smartphone or mHealth use and because they also tend to be elevated in PLWH.

RESULTS

We found increased age, HIV stigma and social isolation were negatively associated with smartphone use, which supports the use of smartphones for conducting research with PLWH but also suggests that age, stigma, social integration functions and social isolation need to be considered in research involving PLWH.

CONCLUSIONS

Findings here support smartphone use in research involving PLWH. However, future mHealth interventions targeting PLWH should take into account the inverse relationship between smartphone use and age, HIV stigma, and social isolation, and other predictor variables.