The purpose of the PeerScreen trial is to investigate whether reducing screen media use affects mental health, social interaction, sleep, physical activity, heart rate variability, and behavioral patterns in young people aged 13 to 24 years. The primary question the trial aims to answer is: Does reducing screen media use over a 4-week period improve mental health among young people? Researchers will compare a screen media reduction intervention with a control condition in which participants continue their usual screen media use to determine whether reducing screen media use leads to improvements in mental health. Participants will: * be allocated to either a 4-week screen media reduction intervention or a control condition * complete a study protocol including questionnaire-based assessments, daily self-reports, and objective monitoring of screen media use, sleep, physical activity, heart rate variability, social interactions, and geolocation
The PeerScreen trial is a parallel-group cluster-randomized controlled trial in which peer groups of adolescents and young adults aged 13-24 years are randomized to either a four-week screen media reduction intervention or a control condition. Random allocation of each peer group will occur after completion of a 14-day baseline assessment protocol. Randomization will be conducted using computer-generated block randomization (block sizes 2-6), stratified by mean peer group age (\<18 vs. ≥18 years). In practice, a researcher will log in to an online platform and click "randomize," thereby ensuring allocation concealment. Participants in the intervention group will be instructed to reduce smartphone use to one hour per day, limit television, computer, and tablet use to 14 hours per week, and keep screen media devices outside the bedroom. The target sample is 80 peer groups (2-6 peers per group) of adolescents (13-17 years) and young adults (18-24 years), to be recruited via a separate survey study. This survey will be conducted in classes across secondary and higher educational institutions (e.g., secondary schools, high schools, vocational schools, university colleges, and universities) and will describe screen media behaviors among Danish youth. Before administration of the survey, the research team will introduce the PeerScreen trial in each class. At the end of the survey, students will be asked whether they are interested in participating in an experimental study and whether the research team may contact them for follow-up. Written information about the experiment will be provided to interested students during classroom visits and distributed via the school and its online platforms, along with a registration link, after the visits. This procedure will allow students to express interest at a later stage if preferred. Data collection will combine questionnaires on mental health and well-being, daily reports of mood, sleepiness, and social interactions, and objective monitoring of screen media use, sleep, physical activity, and heart rate variability using a custom application and a wearable device. Bluetooth beacon data will be used to assess social interactions objectively, and geolocation data will be used to provide contextual information about these interactions.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
240
Participants will reduce their recreational screen media use across devices. For smartphone use, participants will be asked to reduce their use to a maximum of 1 hour/day. Because social media use will not be permitted on computers or tablets during the intervention, this limit will also encompass participants' social media use. Research staff will help each participant set up smartphone app limits for the ten most used social media and gaming applications, add a widget to their home screen showing the current amount of time they have spent on their phone, and turn off non-essential notifications. For television, computer and tablet use, participants will reduce their use to 14 hours/week (with no specific daily limit), but social media use is not allowed on these devices. We will recommend participants to particularly reduce their solitary screen media use. Participants will be asked to keep their devices outside the bedroom, and they will be provided with a free alarm clock.
Change in mental wellbeing on the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS)
Self-reported mental well-being assessed as change in total score on the 14-item Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Total scores range from 14 to 70 points. Higher scores indicate better mental well-being.
Time frame: From baseline (day 1) to post-intervention (day 42).
Change in total weekly duration of face-to-face social interaction with peer-group members measured by Bluetooth Low Energy (BLE) beacon proximity events
Face-to-face social interaction with peer-group members will be assessed as the total duration of proximity events, expressed in minutes per week, using Bluetooth Low Energy (BLE) beacon data collected via the SDU Connect application. The application logs the frequency and duration of proximity events between participants within a predefined distance threshold. The outcome measure is the change in weekly minutes of peer-group proximity from the 14-day baseline period before randomization to the final 21 days of the intervention period.
Time frame: From the 14-day baseline period before randomization to the final 21 days of the 4-week intervention period
Change in average weekly frequency of self-reported face-to-face social interactions with non-household, non-peer individuals
Face-to-face social interactions with individuals outside the participant's household and peer group will be assessed using daily self-report collected via the SDU Connect application. These interactions include, for example, family members not living in the household, other friends, and other relations. The outcome measure is the change in the average weekly frequency of self-reported face-to-face social interactions from the 14-day baseline period before randomization to the final 21 days of the intervention period.
Time frame: From the 14-day baseline period before randomization to the final 21 days of the 4-week intervention period
Change in average nightly total sleep time measured by Garmin Venu 4
Total sleep time will be assessed using continuous monitoring with the Garmin Venu 4 wearable device. Total sleep time will be derived using the device's sleep algorithm and expressed as average minutes of sleep per night. The outcome measure is the change in average nightly total sleep time from the 14-day baseline period before randomization to the final 21 days of the 4-week intervention period.
Time frame: From the 14-day baseline period before randomization to the final 21 days of the 4-week intervention period.
Change in average daily step count measured by Garmin Venu 4
Physical activity will be assessed using continuous monitoring with the Garmin Venu 4 wearable device. Physical activity will be expressed as average number of steps per day derived from the device. The outcome measure is the change in average daily step count from the 14-day baseline period before randomization to the final 21 days of the 4-week intervention period.
Time frame: From the 14-day baseline period before randomization to the final 21 days of the 4-week intervention period
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