The Effect of Health Education on Digital Game Addiction and Health Promotion Behavior in Adolescents

Saglik Bilimleri Universitesi Gulhane Tip Fakultesi160 enrolled

Overview

This study aimed to evaluate the effectiveness of a school nurse-led health education program in reducing digital game addiction and improving health-promoting behaviors among adolescents. Using a Solomon four-group randomized controlled trial design, the study examined whether the health education intervention affected digital game addiction and health-promoting behaviors and whether pretest measurement influenced the intervention outcomes.

This study was conducted using a Solomon four-group randomized controlled trial design in a public secondary school in Ankara, Türkiye. Participants were allocated to four study groups (Intervention I, Control I, Intervention II, and Control II) using stratified block randomization by grade level. The intervention consisted of a four-week school nurse-led health education program delivered in four weekly 40-minute sessions. The educational program addressed digital game addiction and health-promoting behaviors, including healthy digital technology use, physical activity, balanced nutrition, sleep hygiene, stress management, interpersonal relationships, and health responsibility. The intervention was supported by standardized educational presentations and printed materials. In accordance with the Solomon four-group design, Intervention I and Control I completed baseline assessments before the intervention, whereas Intervention II and Control II did not receive a pretest. Participants in both intervention groups received the same health education program, while the control groups continued their usual school curriculum. Post-intervention assessments were conducted at the three-month follow-up.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

160

Interventions

Health Education ProgramBEHAVIORAL

The intervention consisted of a four-week health education program delivered through four weekly 40-minute sessions. The program addressed digital game addiction and health-promoting behaviors, including healthy digital technology use, physical activity, balanced nutrition, sleep hygiene, stress management, interpersonal relationships, and health responsibility. The sessions were delivered using standardized PowerPoint presentations and supported by printed educational brochures.

Eligibility

Sex: ALLMin age: 10 YearsMax age: 14 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: Enrolled as a student at the study school Played digital games Had access to at least one digital device (smartphone, tablet, computer, or game console) Written informed consent provided by a parent or legal guardian Verbal assent provided by the participant Signed parental consent form returned within two weeks Exclusion Criteria: Diagnosis of attention-deficit/hyperactivity disorder (ADHD) Language or speech difficulties Psychiatric or educational problems that could interfere with participation Difficulty understanding written or spoken Turkish

Outcomes

Primary Outcomes

Digital Game Addiction Scale for Children (DGAS-C)

The Children's Digital Game Addiction Scale is a 24-item, 5-point Likert-type scale used to assess digital game addiction. The scale consists of four subscales: Excessive Focus and Conflict Related to Digital Gaming; Tolerance Development in Game Time and Value Assigned to the Game; Postponement of Individual and Social Tasks/Homework; and Psychological-Physiological Reflection of Withdrawal and Immersion in the Game. Total scores range from 24 to 120, with higher scores indicating higher levels of digital game addiction.

Time frame: 3 months after the intervention

Adolescent Health Promotion Scale (AHPS)

The Adolescent Health Promotion Scale (AHPS) is a 40-item, 5-point Likert-type scale used to assess health-promoting behaviors among adolescents. The scale includes six subscales: nutrition, interpersonal support, health responsibility, self-actualization, exercise, and stress management. The total score ranges from 40 to 200, with higher scores indicating a higher level of health-promoting behaviors.