Mind over Matter: Testing the Efficacy of an Online Randomized Controlled Trial to Reduce Distraction from Smartphone Use

Effectiveness of sports intervention: A meta-analysis of the effects of different interventions on adolescent internet addiction

BACKGROUND

To evaluate the effects of different interventions on adolescent internet addiction, a meta-analysis and network meta-analysis were performed to determine the possible intervention effects of these interventions.

METHODS

Computer searches of the China National Knowledge Network, Wanfang, VIP, EMBASE, PubMed, Web of Science, EBSCO, and Cochrane Library databases were performed. The relevant randomized controlled trials were designed to assess the effects of interventions on adolescent internet addiction. The retrieval period ranged from the establishment of the database to January 31, 2024. Literature screening, data extraction, and bias risk assessment were carried out independently by two researchers. CMA 3.3, Stata 17.0 software and Review Manager 5.3 were used for the data analysis.

RESULTS

A total of 89 studies with 6876 samples were included. A traditional meta-analysis of 51 single interventions and controlled studies revealed that sports intervention, cognitive behavior therapy, family therapy, mindfulness intervention, attention bias training and group counseling significantly improved adolescent Internet addiction [standardized mean difference (SMD) = -1.75, 95 % CI (-2.07, -1.44), p < 0.01; I2 = 94 %] compared to no-treatment groups. A network meta-analysis showed that combined intervention (Sucra = 93.5) had the highest probability of being the best intervention for adolescent Internet addiction, and acupuncture interventions showed the most promise as a single intervention modality; however, due to the limited number of studies, we believe that sports intervention could be the most appropriate single intervention.

DISCUSSION

The evidence provided by existing studies shows that compared with other single interventions, combined interventions have the greatest effect on adolescent IA, and sports may be the best single intervention. However, because of the limitations of sample size and quality of individual studies, the strength of the evidence still needs to be further verified by additional standardized and high-quality studies.

The chain mediating role of rumination and social withdrawal in the relationship between smartphone distraction and depression among Chinese nursing students

Smartphone distraction (SD) is closely related to depression, and the prevalence of SD among nursing students is gradually increasing. However, the potential mechanism of the effect of SD on nursing students' depression is unclear. A total of 574 nursing students were assessed using Smartphone Distraction Scale, Ruminative Response Scale, Hikikomori Questionnaire, and Patient Health Questionnaire-9. The results indicated that SD among nursing students had an impact on depression through four pathways: (1) SD was positively associated with depression (β = 0.353, P < 0.001); (2) Rumination (β = 0.199, 95% CI: 0.081 to 0.162) and social withdrawal (β = 0.061, 95% CI: 0.034 to 0.091) mediated the effects of SD on depression, respectively; and (3) Rumination and social withdrawal played a chain mediating role in the effect of SD on nursing students' depression (β = 0.027, 95% CI: 0.015 to 0.042). The negative impact of SD on nursing students' mental health should not be taken lightly. Schools and hospitals should guide nursing students to use smartphones correctly, including providing mental health education and professional psychological counselling; families could play a supervisory role and communicate regularly to understand the psychological state and learning of nursing students. These measures can help nursing students cope with stress and reduce the risk of depression.

Mindfulness programs for problematic usage of the internet: A systematic review and meta-analysis

Introduction

Problematic usage of the internet (PUI) is an umbrella term for a range of uncontrolled, excessive, and potentially harmful online behaviors. Recently, numerous studies have examined the potential of mindfulness programs (MPs) for reducing PUI. We conducted a comprehensive systematic review and meta-analysis in this emerging field.

Methods

We searched eight databases from inception to October 18, 2022, with no language restrictions. We included randomized controlled trials (RCTs) and nonrandomized trials (NRTs). The primary outcome was change in self-reported PUI, the secondary outcome was change in screen time.

Results

Of 3,473 identified records, 19 RCTs and 20 NRTs with a total of 1,549 participants were included. Participation in an MP was associated with large reductions in PUI in between-group analysis in RCTs (k = 19; g = -1.67; 95% CI -2.15, -1.19) and in within-group pre-post analysis in all studies (k = 35; g = -1.67; 95% CI -1.99, -1.36). Screen time showed a medium reduction in within-group pre-post analysis (k = 10; g = -0.65; 95% CI -0.90, -0.41). The effects for PUI remained significant in a series of sensitivity analyses, such as excluding low quality studies, excluding outliers, adjusting for publication bias, or using follow-up data. Heterogeneity between studies was high and the overall quality of evidence was rated low.

Discussion and conclusions

MPs are probably effective in reducing PUI and might be effective in reducing screen time. Shortcomings in the quality of evidence highlight the need for high-quality controlled trials with long-term follow-ups to confirm results.

Emotional and Behavioural Factors Predisposing to Internet Addiction: The Smartphone Distraction among Italian High School Students

In a digitally oriented society, smartphones provide continual online accessibility to daily life while simultaneously predisposing adolescents to engage in prolonged connections for various purposes, thus escalating the risk of Internet addiction (IA). Cognitive processes such as multitasking and attentional shifting are frequently associated with smartphone activities. Additionally, online engagements may serve as emotional strategies for regulating negative states (e.g., boredom and distress), redirecting attention towards more gratifying activities, such as social media contents. This study delves into cognitive-emotional processes (i.e., emotion regulation, attention impulsiveness, online vigilance, and multitasking) and emotional/behavioural factors (i.e., emotional problems, conduct problems, hyperactivity/inattention, peer relationships, and prosocial behaviours) that may be implicated in smartphone activities and technology addiction among adolescents. A community sample of Italian high school students (N = 676; 42.2% females) completed the Smartphone Distraction Scale (SDS), the Strength and Difficulties Questionnaire (SDQ) for internalising/externalising symptoms and the Internet Addiction Test (IAT) to assess the presence and severity of IA. The scores on the SDS were found to be positively associated with IA levels. Furthermore, students exhibiting higher internalising/externalising symptoms, particularly those with traits of attention deficit hyperactivity disorder (ADHD), are more likely to manifest problematic smartphone usage. The implications for screening adolescents more susceptible to developing IA symptoms and for implementing preventive interventions are discussed.

Influence of Social Media Use on Body Image and Well-Being Among Adolescents and Young Adults: A Systematic Review

Social media has been classified as a new form of addiction. The aim of the current systematic review was to analyze social media's impact on body image and well-being among adolescents and young adults. Twenty-one articles published from 2015 to April 2020 were analyzed. Misuse or intensive use of social media was related to body dissatisfaction, low self-esteem, risky behaviors, and eating disorders. Information manipulation, lack of media literacy, and internalization of ideal body standards trigger mental problems and risky eating behaviors in this population. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 11-18.].

Evaluating the Effectiveness of Apps Designed to Reduce Mobile Phone Use and Prevent Maladaptive Mobile Phone Use: Multimethod Study

BACKGROUND

Mobile apps are a popular strategy for reducing mobile phone use and preventing maladaptive mobile phone use (MMPU). Previous research efforts have been made to understand the features of apps that have the potential to reduce mobile phone use and MMPU. However, there has been a lack of a comprehensive examination of the effectiveness of such apps and their features.

OBJECTIVE

This paper investigated existing apps designed to reduce mobile phone use and prevent MMPU and examined the evidence of their effectiveness. The research aimed to provide a comprehensive analysis of app features that can reduce mobile phone use and MMPU, while also assessing their effectiveness. In addition, we explored users' perceptions of these apps and the various features the apps offer to understand potential adoption issues and identify opportunities.

METHODS

This study used 3 methods: a review of scientific evidence, content analysis, and sentiment analysis.

RESULTS

Our study comprehensively examine the common features of 13 apps designed to reduce mobile phone use. We extracted and classified the features into 7 types: self-tracking, social tracking, goal setting, blocking, gamification, simplification, and assessment. The effectiveness of these apps in reducing mobile phone use and MMPU varied from weak to strong. On the basis of content analysis, self-tracking and goal setting were the most frequently used features, whereas gamification and assessment were used the least frequently. The intervention strategies that effectively reduce mobile phone use and MMPU included using grayscale mode, app limit features, and mixed interventions. Overall, users tended to accept these apps, as indicated by sentiment scores ranging from 61 to 86 out of 100.

CONCLUSIONS

This study demonstrates that app-based management has the potential to reduce mobile phone use and MMPU. However, further research is required to evaluate the effectiveness of app-based interventions. Collaborations among researchers, app developers, mobile phone manufacturers, and policy makers could enhance the process of delivering, evaluating, and optimizing apps aimed at reducing mobile phone use and MMPU.

The Impact of Social Media Use Interventions on Mental Well-Being: Systematic Review

BACKGROUND

There is some evidence that more social media use is related to poorer mental well-being and that social media use can become problematic when it starts to interfere with a person's daily life and mental well-being. To address this issue and improve users' mental well-being, social media use interventions (eg, abstinence from social media) have been developed and evaluated. However, there is limited understanding of the effectiveness of these interventions in improving mental well-being.

OBJECTIVE

This systematic review aimed to synthesize the literature on the effectiveness of social media use interventions in improving mental well-being in adults.

METHODS

A systematic search (January 1, 2004, to July 31, 2022) was completed across 3 databases in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Experimental studies evaluating the impact of social media use interventions on mental well-being in adults were included. Outcomes related to mental well-being, such as depression, anxiety, stress, and loneliness, were included. A narrative synthesis without meta-analysis was completed to summarize the study characteristics and effectiveness by outcome and intervention type. The Effective Public Health Practice Project Quality Assessment Tool was used to measure the quality of the studies.

RESULTS

Of the 2785 studies identified through the systematic search, 23 (0.83%) were included in the analysis. Many of the included studies (9/23, 39%) found improvements in mental well-being, some (7/23, 30%) found mixed effects, and others (7/23, 30%) found no effect on mental well-being. Therapy-based interventions that used techniques such as cognitive behavioral therapy were more effective than limiting use of social media or full abstinence from social media, with 83% (5/6) of these studies showing improvements in mental well-being compared with 20% (1/5) and 25% (3/12), respectively. Depression was the most frequently investigated and improved outcome with 70% (7/10) of the studies showing a significant improvement in depression after the intervention, whereas other outcomes showed more varied results. Quality was poor, with 96% (22/23) of the studies receiving a weak global score, mostly for issues related to selection bias because most of the studies (16/23, 70%) used a convenience sampling of university students.

CONCLUSIONS

This review provides some evidence that social media use interventions are effective in improving mental well-being, especially for depression and when using therapy-based interventions. Further experimental and longitudinal research is needed with representative samples to investigate who may benefit most from social media use interventions. This will help to develop guidance and recommendations for policy makers and clinicians on how best to manage problematic social media use.

Knowledge, Perceptions and Attitudes of eHealth and Health Technology among Nursing Students from Gauteng Province, South Africa

The use of technology in healthcare settings was identified as a crucial priority in many countries to provide quality healthcare services. eHealth or digital health technology is found to have a positive influence on improving the efficiency and quality of healthcare services. It has been proven to provide opportunities to strengthen health systems. This study aims to assess eHealth literacy, pre-existing knowledge and the nursing students' perceptions and attitudes towards eHealth. A quantitative, descriptive, cross-sectional survey was used in this study. The population of this study comprised 266 nursing students in the undergraduate programme of the Department of Nursing, among which 244 consented to participate in the study. A standardised and self-administered tool was utilised to collect data from nursing students across the four levels of study. Results showed that students in level four exhibit high scores of knowledge in the use of eLearning technology as compared to first-entry university nursing students. Nursing students used the internet frequently, especially to access social media and search for health and medical information for their study. Attitudes towards eHealth and technology were also found to be positive. The study recommends that digital literacy should be enhanced in the nursing education curriculum in other to further strengthen the knowledge and skills towards the use of eHealth and health technology among nursing students.

Lower Mindfulness is Associated with Problematic Social Media Use: A Meta-Analysis

Problematic social media use consists of use that interferes with individuals’ functioning, such as for example in failing to complete important tasks. A number of studies have investigated the association of trait mindfulness with problematic social media use. This meta-analysis synthesised research from 14 studies and a total of 5355 participants to examine the association between mindfulness and problematic social media use across studies. A lower level of mindfulness was associated with more problematic social media use, with a weighted effect size of r = -.37, 95% CI [-.42, -.33], k = 14, p < .001.

Is Nomophobia Problematic or Functional? A Perspective from Bifactor Structure

With the extensive use of mobile phones globally, some people engage in excessive or problematic phone use behaviors. However, little is known regarding the latent structure of problematic mobile phone use. The current study employed the Chinese versions of the Nomophobia Questionnaire, Mobile Phone Addiction Tendency Scale, and Depression-Anxiety-Stress Scale-21 to explore the latent psychological structure of problematic mobile phone use and nomophobia and their associations with mental health symptoms. Results showed that a bifactor latent model best fit nomophobia, which contained a general factor and four unique factors involving the fear of being unable to access information, losing convenience, losing contact, and losing one's Internet connection. Results also showed significant correlations among latent factors of nomophobia, problematic mobile phone use, and mental health symptoms. Through these findings, we can conclude that two problematic mobile phone use behaviors share a common factor concerning excessive use, and nomophobia has independent unique factors concerning usable function. This study clarifies the structure of problematic mobile phone use, and it implies that we can distinguish problematic mobile phone use from functional use; further investigation of problematic mobile phone use is warranted.

Effects of online mindfulness-based interventions on the mental health of university students: A systematic review and meta-analysis

Objectives

Mental health problems among university students are a cause of widespread concern. Mindfulness-based interventions (MBIs) delivered online have considerable potential to help university students manage mental health challenges. However, there is no consensus regarding the efficacy of online MBIs. This meta-analysis aims to determine whether MBIs are feasible and effective for improving university students' mental health.

Methods

Randomised controlled trials (RCTs) in Web of Science, PubMed, Cochrane Library, Embase and the US National Library of Medicine (Clinical Trial Registry) published through August 31, 2022, were searched. Two reviewers selected the trials, conducted a critical appraisal, and extracted the data. Nine RCTs met our inclusion criteria.

Results

This analysis showed that online MBIs were effective in improving depression (standardised mean difference [SMD] = -0.27; 95% confidence interval [CI], -0.48 to -0.07; P = 0.008), anxiety (SMD = -0.47; 95% CI, -080 to -0.14; P = 0.006), stress (SMD = -0.58; 95% CI, -0.79 to -0.37; P < 0.00001), and mindfulness (SMD = 0.71; 95% CI, 0.17 to 1.25; p = 0.009) in university students. No significant effect was found on wellbeing (SMD = 0.30; 95% CI, -0.00 to 0.60; P = 0.05).

Conclusion

The findings indicated that online MBIs could effectively improve the mental health of university students. Nevertheless, additional rigorously designed RCTs are required.

Systematic review registration

https://inplasy.com/inplasy-2022-9-0099/, identifier INPLASY202290099.

Digital Dependence in Organizations: Impacts on the Physical and Mental Health of Employees

Digital Dependence is a person's persistent inability to regulate digital devices on which they have become highly dependent. Internet dependence has been described since the mid-1990s, and studies on this topic have intensified since 2010. This type of individual dependence has received considerable published literature, but it is new in the collective setting of organizations, offering the hypothesis that it can also be collective, given the impacts it can provide. Research has evolved geographically from three countries to 17 since the beginning of the last decade, with 7 new scales for digital dependence. There were 13 new revalidations of the Nomophobia Questionnaire (NMP-Q), with an increase from 1,000 to 13,000 volunteers. Geographical evolution and an increase in the number of scales and volunteers and their different profiles were described. New approaches reinforce evolution and its impacts on human behavior. This study provides historical insight into Digital Dependence and opens new prospects for research on the differences between nations and people, sexes, professionals, and the need for further research in organizations.

Prevalence of Nomophobia in University Students: A Systematic Review and Meta-Analysis

OBJECTIVES

The aim of this study was to assess the prevalence of nomophobia in university students.

METHODS

A systematic search was conducted of the following databases: Web of Science/ Core Collection, Scopus, PubMed, Embase, and Ovid/ MEDLINE until March 2021. Cross-sectional studies reporting the prevalence of nomophobia in undergraduate or postgraduate university students that assessed nomophobia with the 20-item Nomophobia Questionnaire (NMP-Q) tool were included. Study selection, data extraction, and risk of bias assessment were performed in duplicate. A meta-analysis of proportions was performed using a random-effects model. Heterogeneity was assessed using sensitivity analysis according to the risk of bias, and subgrouping by country, sex, and major.

RESULTS

We included 28 cross-sectional studies with a total of 11,300 participants from eight countries, of which 23 were included in the meta-analysis. The prevalence of mild nomophobia was 24% (95% confidence interval [CI], 20%-28%; I2 = 95.3%), that of moderate nomophobia was 56% (95% CI, 53%-60%; I2 = 91.2%), and that of severe nomophobia was 17% (95% CI, 15%-20%; I2 = 91.7%). Regarding countries, Indonesia had the highest prevalence of severe nomophobia (71%) and Germany had the lowest (3%). The prevalence was similar according to sex and major.

CONCLUSIONS

We found a high prevalence of moderate and severe nomophobia in university students. Interventions are needed to prevent and treat this problem in educational institutions.

[Behavioral (non-chemical) addictions and COVID-19]

The review examines the impact of the COVID-19 pandemic on the prevalence, manifestation, as well as the possibility of preventing and treating behavioral (non-chemical) addictions. Particular attention is paid to various manifestations of Internet addiction (IA): gaming, gambling, cybersexual and food addiction (FA). During the pandemic, Internet use increased significantly, leading to an increase in IA, mainly due to gaming, which correlated with the level of psychosocial problems. The increase in gambling occurred mainly in individuals with addiction or risk groups, while in the population the frequency of gambling decreased or did not change. Immediately after the start of the COVID-19 pandemic, the number of requests to porn sites increased dramatically, suggesting an increase in cybersex addiction. However, longitudinal studies in adolescents show a slight decrease in the interest in pornography in boys, and an increase from an initially low level in girls. The proportion of eating disorders and FA significantly increased. An increase in FA was associated with depression, anxiety, and also in obese individuals. In the era of COVID-19 prevention practices and general remedial activity should take into account the needs of the general population, emphasizing the importance of self-regulating and balanced lifestyles with moderate and sensible Internet use during the pandemic.

Adolescent Anxiety and TikTok: An Exploratory Study

Introduction Social media is ubiquitous in adolescents' lives. TikTok is a medium primarily used by adolescents and young adults under 30 years. TikTok is thus an appropriate social media platform with which to examine discussions of anxiety among this age cohort. In this exploratory mixed-methods study we aimed to evaluate the scope of anxiety content available on TikTok in English in December 2021, and to further develop methods for analysing TikTok content. Methods We analysed a data set of 147 TikToks with the hashtag #anxiety. The data set consisted both of metadata and TikTok videos. This data set represented 18% of all TikToks featuring the hashtag #anxiety in December 2021. We examined the following research questions (RQs). RQ1: What are the creator identities reflected in the final data set in this study?; RQ2: What are the metadata characteristics of the TikToks in the final data set?; RQ3: What are the anxiety content themes in the final data set?; and RQ4: What are the characteristics of the data set based on an anxiety management reference checklist? This study involves public data that can reasonably be observed by strangers. This study does not include any identifiable human participants. Results Influencers were the most frequent creator identity in our data set. Influencers comprised 85.5% of the 147 TikToks in our final data set. We coded 79 female (54%) and 45 male (31%) influencers. We found male influencers created the most played (mean 8,114,706), and most liked (mean 1,510,585) TikToks. We found content themes varied by influencer gender. The notable findings were (a) the greater use of humour by males (22.7% males; n=10, and females 12.6%; n=10); and (b) inspiration (38.7%; males n=17; and 13.9%; females n=11). Among female influencers, we identified self-disclosure as the most common theme (n= 40 and 50.7% compared with n=11 and 25% male influencers). Overall, we found limited references to evidence-based anxiety self-care content in our final data set. Discussion We suggest that the TikToks in our data set were primarily directed at raising awareness of and de-stigmatising anxiety symptoms. TikTok anxiety content may be viewed by adolescents for emotional self-regulation beyond evidence-based health information seeking. Self-disclosure on TikTok may also provide symptomatic relief to adolescents with anxiety. We suggest that gender is a salient consideration when considering TikTok content. Conclusions Our findings are consistent with existing literature on adolescent social media use and epidemiological data on anxiety. This research also provides methodological insights for researchers and clinicians seeking to understand TikTok, and to develop engaging content targeted at the specific concerns and preferences of adolescent TikTok consumers.

A Nudge-Based Intervention to Reduce Problematic Smartphone Use: Randomised Controlled Trial

Problematic smartphone use is rising across the world. We tested an intervention with ten strategies that nudge users to reduce their smartphone use, for example by disabling non-essential notifications and changing their display to greyscale. Participants first completed baseline measures of smartphone use, well-being, and cognition before choosing which intervention strategies to follow for 2 to 6 weeks. Study 1 ( N = 51 ) used a pre-post design while study 2 ( N = 70 ) compared the intervention to a control group who monitored their screen time. Study 1 found reductions in problematic smartphone use, screen time, and depressive symptoms after 2 weeks. Study 2 found that the intervention reduced problematic smartphone use, lowered screen time, and improved sleep quality compared to the control group. Our brief intervention returned problematic smartphone use scores to normal levels for at least 6 weeks. These results demonstrate that various strategies can be combined while maintaining feasibility and efficacy.

Problematic use of the internet during the COVID-19 pandemic: Good practices and mental health recommendations

With the onset of the COVID-19 pandemic and the accelerated spread of the SARS-CoV-2 virus came jurisdictional limitations on mobility of citizens and distinct alterations in their daily routines. Confined to their homes, many people increased their overall internet use, with problematic use of the internet (PUI) becoming a potential reason for increased mental health concerns. Our narrative review summarizes information on the extent of PUI during the pandemic, by focusing on three types: online gaming, gambling and pornography viewing. We conclude by providing guidance for mental health professionals and those affected by PUI (with an outline of immediate research priorities and best therapeutic approaches), as well as for the general public (with an overview of safe and preventative practices).

Psychometric Properties of the Smartphone Distraction Scale in Chinese College Students: Validity, Reliability and Influencing Factors

AIM

The objective of this study was to evaluate the Chinese version of the Smartphone Distraction Scale (C-SDS), which is an easy-to-use tool for screening the risk of smartphone distraction in Chinese college students.

METHODS

The C-SDS, Smartphone Addiction Scale - Short Version (SAS-SV), Fear of Missing Out scale (FoMO) and Metacognition about Smartphone Use Questionnaire (MSUQ) were used in a sample of 1,002 Chinese college students to test smartphone distraction and its influencing factors. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to test measurement properties and factor structures of the C-SDS. Multi-variable linear regressions examined the relationships of sex, age, education level, the purpose of using a smartphone, usage of smartphone (hours per day), fear of missing out, smartphone addiction and positive and negative metacognitions about smartphone use with the C-SDS.

RESULTS

The EFA showed a 3-factor structure, which consisted of attention impulsiveness, multitasking and emotion regulation. The CFA showed that the 3-factor demonstrated an overall better model fit (RMSEA = 0.07, SRMR = 0.05, CFI = 0.94, TLI = 0.93). The C-SDS showed internal consistency (Cronbach's α = 0.88, McDonald's Omega ω = 0.88). Findings included that negative metacognition about smartphone use was most correlated with the C-SDS (b = 0.73; p < 0.001). Smartphone addiction, positive metacognition about smartphone use and fear of missing out also correlated with the C-SDS (b = 0.66, p < 0.001; b = 0.53, p < 0.001; b = 0.40, p < 0.001, respectively). The study shows that males compared to females (b = -1.65; p = 0.003), had a higher C-SDS score.

CONCLUSION

The C-SDS was valid and reliable for assessing the distraction of using smartphones in the Chinese context. Being female, the purpose of using a smartphone, smartphone usage (hours per day), fear of missing out, smartphone addiction and positive and negative metacognitions about smartphone use were positively correlated to the C-SDS.

Mobile Apps That Promote Emotion Regulation, Positive Mental Health, and Well-being in the General Population: Systematic Review and Meta-analysis

BACKGROUND

Among the general public, there appears to be a growing need and interest in receiving digital mental health and well-being support. In response to this, mental health apps (MHapps) are becoming available for monitoring, managing, and promoting positive mental health and well-being. Thus far, evidence supports favorable outcomes when users engage with MHapps, yet there is a relative paucity of reviews on apps that support positive mental health and well-being.

OBJECTIVE

We aimed to systematically review the available research on MHapps that promote emotion regulation, positive mental health, and well-being in the general population aged 18-45 years. More specifically, the review aimed at providing a systematic description of the theoretical background and features of MHapps while evaluating any potential effectiveness.

METHODS

A comprehensive literature search of key databases, including MEDLINE (via Ovid), EMBASE (via Ovid), PsycINFO (via Ovid), Web of Science, and the Cochrane Register of Controlled Trials (CENTRAL), was performed until January 2021. Studies were included if they described standalone mental health and well-being apps for adults without a formal mental health diagnosis. The quality of all studies was assessed against the Mixed Methods Appraisal Tool. In addition, the Cochrane Risk-of-Bias tool (RoB-2) was used to assess randomized control trials (RCTs). Data were extracted using a modified extraction form from the Cochrane Handbook of Systematic Reviews. A narrative synthesis and meta-analysis were then undertaken to address the review aims.

RESULTS

In total, 3156 abstracts were identified. Of these, 52 publications describing 48 MHapps met the inclusion criteria. Together, the studies evaluated interventions across 15 countries. Thirty-nine RCTs were identified suggesting some support for the role of individual MHapps in improving and promoting mental health and well-being. Regarding the pooled effect, MHapps, when compared to controls, showed a small effect for reducing mental health symptoms (k=19, Hedges g=-0.24, 95% CI -0.34 to -0.14; P<.001) and improving well-being (k=13, g=0.17, 95% CI 0.05-0.29, P=.004), and a medium effect for emotion regulation (k=6, g=0.49, 95% CI 0.23-0.74, P<.001). There is also a wide knowledge base of creative and innovative ways to engage users in techniques such as mood monitoring and guided exercises. Studies were generally assessed to contribute unclear or a high risk of bias, or to be of medium to low methodological quality.

CONCLUSIONS

The emerging evidence for MHapps that promote positive mental health and well-being suggests promising outcomes. Despite a wide range of MHapps, few apps specifically promote emotion regulation. However, our findings may position emotion regulation as an important mechanism for inclusion in future MHapps. A fair proportion of the included studies were pilot or feasibility trials (k=17, 33%), and full-scale RCTs reported high attrition rates and nondiverse samples. Given the number and pace at which MHapps are being released, further robust research is warranted to inform the development and testing of evidence-based programs.

Acceptability, Engagement, and Exploratory Outcomes of an Emotional Well-being App: Mixed Methods Preliminary Evaluation and Descriptive Analysis

BACKGROUND

There is growing evidence suggesting that the emotional well-being of the public has been negatively affected in the past year. Consequently, demand for well-being support has increased. Although there is substantial empirical support for mental health apps that target diagnosed conditions, there is less research on emotional well-being apps. Among existing well-being apps, few studies have been conducted on apps that are based on lived experience and those that seek to enhance users' understanding of their emotional patterns. Thus, the acceptability of these novel apps requires further evaluation before upscaling.

OBJECTIVE

This evaluation aims to describe the acceptability, engagement, and preliminary outcomes of using an app (Paradym) designed to promote emotional well-being and positive mental health.

METHODS

This is a pre-post, mixed-methods, single-arm evaluation that is aggregated with digital analytics data. We anonymously collected real-world data on the demographics and well-being of the participants as well as the usability and acceptance of the app using validated questionnaires and open-ended questions. Participants tested the app for a minimum of 2 weeks before completing the follow-up measures. Google Analytics was used to record the level of app engagement. Chi-square and 2-tailed t tests were conducted to analyze quantitative data, and a thematic analysis approach was adopted for qualitative data.

RESULTS

A total of 115 participants completed baseline questionnaires, of which 79.1% (91/115) users downloaded the app. The sample was diverse in terms of ethnicity, including 43.4% (50/115) people who self-identified as belonging to minority ethnic groups. Most of the participants were female (78/115, 67.8%) and between the ages of 18 and 25 years (39/115, 33.9%). A total of 34 app users who completed questionnaires at baseline and follow-up provided valuable feedback to inform the future directions of Paradym. Favorable themes emerged describing the app's content, functionality, and underlying principles. Although usability feedback varied across items, a considerable number of participants (22/34, 64%) found that the app was easy to use. Google Analytics revealed that at least 79% (27/34) of people used the app daily. On the basis of preliminary observations, app users experience increased mental well-being. Post hoc analyses indicated that the reduction in depression scores (t₃₃=-2.16) and the increase in the well-being measures (t₃₃=2.87) were statistically significant. No adverse events were reported during the follow-up period.

CONCLUSIONS

The findings of this evaluation are encouraging and document positive preliminary evidence for the Paradym app.

A Mixed-Method Assessment of a 10-Day Mobile Mindfulness Intervention

Mobile mindfulness interventions represent a promising alternative to traditional in-person interventions that are resource demanding and have limited accessibility, preventing use by many populations. Despite greater accessibility and popularity of mobile mindfulness applications (apps), research is needed testing the effectiveness of brief interventions delivered via these platforms. The present study assessed the efficacy of a brief mobile mindfulness intervention compared to an active control for increasing state and trait mindfulness and improving mood, as well as the acceptability of the app, in a sample of undergraduate students. Participants (N=139; M_age=19.43years, 80.6% female, 83.5% White) were randomly assigned to either a 10-day mobile mindfulness (Headspace) or cognitive training (Peak) condition. Trait mindfulness was measured pre- and post-intervention. During the 10-day intervention, participants completed 10-min daily exercises on the assigned app, responded to daily questionnaires of state mindfulness and mood, and completed a daily written log of their reactions to the app exercises. Attrition was low (90% completion rate) and did not differ by condition. Participants in the mindfulness condition spent an average of 88.15min (SD=24.75) meditating out of the full 100min prescribed by the intervention. State mindfulness significantly increased across the 10-day intervention for participants in the mindfulness, but not the cognitive training, condition beginning around days 5 and 6. Some aspects of trait mindfulness increased and mood improved from pre- to post-intervention, but these changes were observed in both conditions (i.e., no significant differences were observed by condition). Qualitative analysis of open-ended reactions to the mindfulness app indicated that participants reported more likes than dislikes. Common themes for likes were that participants experienced feelings of calm and focus following the daily mindfulness exercises. Dislikes included discomfort and anxiety associated with increased awareness of thoughts and physical sensations. These findings suggest that while a brief mobile mindfulness intervention is acceptable to undergraduate college students and effective at increasing state mindfulness, a longer intervention may be needed in order to elicit corresponding changes in trait-level mindfulness or mood.

Emerging Health and Education Issues Related to Internet Technologies and Addictive Problems

This timely editorial paper outlines some of the main emerging research on technological topics on health and education approaches to Internet use-related problems before and during the beginning of coronavirus disease 2019 (COVID-19). Background: The aim is to provide a brief overview to facilitate a rapid comprehensive and practical approach to these new trends to promote research, interventions, education, and prevention. Methods: The rapid review includes an analysis of both health and education technologies studies on Internet use-related addiction problems included in the Special Issue “Internet and Smartphone Use-Related Addiction Health Problems: Treatment, Education and Research” to extract recent findings and a few reflections about the development of the field before and during the first wave of the COVID-19. Results: Main findings highlighted studies which tended to be empirical, with a relational type associating specific addictive problems with individual and a few contextual factors in adult populations. Psychometric studies about scales are prevalent, but predictive and mixed methods ones are starting to emerge, together with reviews about conceptualisation, measure, treatment, and prevention. Conclusions: From the arrival of Internet, our societies have converged in a global culture which has impacted health and educational domains. Internet use-related addiction problems have globally emerged and common knowledge, advances, and strategies exist to overcome challenges which are starting to be tested, and prevention interest has arisen in a pandemic situation with global health problems holistically tackled.

Exploring the Dimensions of Smartphone Distraction: Development, Validation, Measurement Invariance, and Latent Mean Differences of the Smartphone Distraction Scale (SDS)

Background: Distraction is a functional emotion regulation strategy utilized to relieve emotional distress. Within the attention economy perspective, distraction is increasingly associated with digital technology use, performance impairments and interference with higher-order cognitive processes. Research on smartphone distraction and its association with problematic smartphone use is still scarce and there is no available psychometric assessment tool to assess this cognitive and emotive process parsimoniously. Method: The present study reports the development and evaluation of the psychometric properties of the Smartphone Distraction Scale (SDS) through exploratory and confirmatory factor analysis, construct validity, gender invariance, and latent mean differences. The study was conducted in a sample of British university students (N = 1,001; M = 21.10 years, SD = 2.77). Results: The 16-item SDS was best conceptualized in a four-factor model solution comprising attention impulsiveness, online vigilance, emotion regulation, and multitasking. Construct validity was established using relevant psychosocial and mental health measures, with SDS scores being moderately associated with deficient self-regulation and problematic social media use. Gender measurement invariance was achieved at the configural, metric, and scalar levels, and latent mean differences indicated that females had significantly higher means than males across all four SDS latent factors. Discussion: The SDS presents with several strengths, including its theoretical grounding, relatively short length, and sound psychometric properties. The SDS enables the assessment of distraction, which appears to be one of the pathways to problematic smartphone use facilitating overuse and overreliance on smartphones for emotion regulation processes. The assessment of distraction in relation to problematic use in vulnerable populations may facilitate interventions that could encourage metacognition and benefit these groups by allowing sustained productivity in an increasingly disrupted work and social environment.

Developing and Testing a Scale Designed to Measure Perceived Phubbing

Phubbing (phone snubbing) has become a commonplace behavior. The more we are phubbed the more likely we are to phub others. The extraordinary attention-grabbing ability of the smartphone would only be an interesting story if not for its impact on social media use and, ultimately, stress and depression. In Study 1 (n = 258, M_age = 20), we develop a parsimonious and valid measure of phubbing. Extant “phubbing” measures all lack important qualities needed to be able to assess phubbing with a brief and valid scale that can be replicated and used in a variety of research settings. In Study 2 (n = 157, M_age = 39), we test and extend the David and Roberts (2017) phubbing model, while further validating our perceived phubbing measure. We use Social Exchange Theory and Kardefelt-Winther’s (2014) model of compensatory internet use as theoretical support for our expected findings. Results find that phubbed individuals experience a sense of social exclusion that, paradoxically, is associated with an increased use of social media. This increased use of social media is associated with higher reported levels of anxiety and depression. Future research directions and study limitations are discussed.