A Mobile Intervention for Self-Efficacious and Goal-Directed Smartphone Use in the General Population: Randomized Controlled Trial.

action planning behavior change digital detox problematic smartphone use randomized controlled trial self-efficacy smartphone time smartphone unlocks time-out

Journal

JMIR mHealth and uHealth
ISSN: 2291-5222
Titre abrégé: JMIR Mhealth Uhealth
Pays: Canada
ID NLM: 101624439

Informations de publication

Date de publication:
23 11 2021
Historique:
received: 10 12 2020
accepted: 10 09 2021
revised: 15 03 2021
entrez: 24 11 2021
pubmed: 25 11 2021
medline: 2 2 2022
Statut: epublish

Résumé

People spend large parts of their everyday life using their smartphones. Despite various advantages of the smartphone for daily life, problematic forms of smartphone use exist that are related to negative psychological and physiological consequences. To reduce problematic smartphone use, existing interventions are oftentimes app-based and include components that help users to monitor and restrict their smartphone use by setting timers and blockers. These kinds of digital detox interventions, however, fail to exploit psychological resources, such as through promoting self-efficacious and goal-directed smartphone use. The aim of this study is to evaluate the theory-based smartphone app "Not Less But Better" that was developed to make people aware of psychological processes while using the smartphone and to support them in using their smartphone in accordance with their goals and values. In a randomized controlled trial, effects of a 20-day intervention app consisting of five 4-day training modules to foster a goal-directed smartphone use were evaluated. In the active control condition (treatment as usual), participants received a digital detox treatment and planned daily time-outs of at least 1 hour per day. Up to a 3-week follow-up, self-reported problematic smartphone use, objectively measured daily smartphone unlocks, time of smartphone use, self-efficacy, and planning towards goal-directed smartphone use were assessed repeatedly. Linear 2-level models tested intervention effects. Mediation models served to analyze self-efficacy and planning as potential mechanisms of the intervention. Out of 232 enrolled participants, 110 (47.4%; 55 participants in each condition) provided data at postintervention and 88 (37.9%; 44 participants in each condition) at 3-week follow-up. Both conditions manifested substantial reductions in problematic smartphone use and in the amount of time spent with the smartphone. The number of daily unlocks did not change over time. Further, modelling changes in self-efficacy as a mediator between the intervention and problematic smartphone use at follow-up fit well to the data and showed an indirect effect (b=-0.09; 95% bias-corrected bootstrap CI -0.26 to -0.01), indicating that self-efficacy was an important intervention mechanism. Another mediation model revealed an indirect effect from changes in planning via smartphone unlocks at postintervention on problematic smartphone use at follow-up (b=-0.029, 95% bias-corrected bootstrap CI -0.078 to -0.003). An innovative, theory-based intervention app on goal-directed smartphone use has been found useful in lowering problematic smartphone use and time spent with the smartphone. However, observed reductions in both outcomes were not superior to the active control condition (ie, digital detox treatment). Nonetheless, the present findings highlight the importance in promoting self-efficacy and planning goal-directed smartphone use to achieve improvements in problematic smartphone use. This scalable intervention app appears suitable for practical use and as an alternative to common digital detox apps. Future studies should address issues of high attrition by adding just-in-time procedures matched to smartphone users' needs. German Clinical Trials Register DRKS00017606; https://tinyurl.com/27c9kmwy.

Sections du résumé

BACKGROUND
People spend large parts of their everyday life using their smartphones. Despite various advantages of the smartphone for daily life, problematic forms of smartphone use exist that are related to negative psychological and physiological consequences. To reduce problematic smartphone use, existing interventions are oftentimes app-based and include components that help users to monitor and restrict their smartphone use by setting timers and blockers. These kinds of digital detox interventions, however, fail to exploit psychological resources, such as through promoting self-efficacious and goal-directed smartphone use.
OBJECTIVE
The aim of this study is to evaluate the theory-based smartphone app "Not Less But Better" that was developed to make people aware of psychological processes while using the smartphone and to support them in using their smartphone in accordance with their goals and values.
METHODS
In a randomized controlled trial, effects of a 20-day intervention app consisting of five 4-day training modules to foster a goal-directed smartphone use were evaluated. In the active control condition (treatment as usual), participants received a digital detox treatment and planned daily time-outs of at least 1 hour per day. Up to a 3-week follow-up, self-reported problematic smartphone use, objectively measured daily smartphone unlocks, time of smartphone use, self-efficacy, and planning towards goal-directed smartphone use were assessed repeatedly. Linear 2-level models tested intervention effects. Mediation models served to analyze self-efficacy and planning as potential mechanisms of the intervention.
RESULTS
Out of 232 enrolled participants, 110 (47.4%; 55 participants in each condition) provided data at postintervention and 88 (37.9%; 44 participants in each condition) at 3-week follow-up. Both conditions manifested substantial reductions in problematic smartphone use and in the amount of time spent with the smartphone. The number of daily unlocks did not change over time. Further, modelling changes in self-efficacy as a mediator between the intervention and problematic smartphone use at follow-up fit well to the data and showed an indirect effect (b=-0.09; 95% bias-corrected bootstrap CI -0.26 to -0.01), indicating that self-efficacy was an important intervention mechanism. Another mediation model revealed an indirect effect from changes in planning via smartphone unlocks at postintervention on problematic smartphone use at follow-up (b=-0.029, 95% bias-corrected bootstrap CI -0.078 to -0.003).
CONCLUSIONS
An innovative, theory-based intervention app on goal-directed smartphone use has been found useful in lowering problematic smartphone use and time spent with the smartphone. However, observed reductions in both outcomes were not superior to the active control condition (ie, digital detox treatment). Nonetheless, the present findings highlight the importance in promoting self-efficacy and planning goal-directed smartphone use to achieve improvements in problematic smartphone use. This scalable intervention app appears suitable for practical use and as an alternative to common digital detox apps. Future studies should address issues of high attrition by adding just-in-time procedures matched to smartphone users' needs.
TRIAL REGISTRATION
German Clinical Trials Register DRKS00017606; https://tinyurl.com/27c9kmwy.

Identifiants

pubmed: 34817388
pii: v9i11e26397
doi: 10.2196/26397
pmc: PMC8663477
doi:

Banques de données

DRKS
['DRKS00017606']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e26397

Informations de copyright

©Jan Keller, Christina Roitzheim, Theda Radtke, Konstantin Schenkel, Ralf Schwarzer. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 23.11.2021.

Références

J Behav Addict. 2018 Jun 1;7(2):252-259
pubmed: 29895183
Addict Behav Rep. 2017 Jul 19;6:90-95
pubmed: 29450241
J Soc Psychol. 2018;158(4):496-507
pubmed: 29558267
Annu Rev Psychol. 2009;60:549-76
pubmed: 18652544
Digit Health. 2018 Mar 05;4:2055207618759167
pubmed: 31463071
Health Psychol Rev. 2016 Sep;10(3):277-96
pubmed: 26854092
J Mem Lang. 2013 Apr;68(3):
pubmed: 24403724
J Affect Disord. 2017 Jan 01;207:251-259
pubmed: 27736736
J Phys Ther Sci. 2016 Jan;28(1):186-9
pubmed: 26957754
J Med Internet Res. 2005 Mar 31;7(1):e11
pubmed: 15829473
Health Psychol. 2019 Jul;38(7):623-637
pubmed: 30973747
Perspect Psychiatr Care. 2019 Oct;55(4):752-759
pubmed: 31402459
Med Hypotheses. 2014 Apr;82(4):405-11
pubmed: 24529915
Ann Behav Med. 2007 Apr;33(2):156-66
pubmed: 17447868
Int J Public Health. 2015 Feb;60(2):277-86
pubmed: 25645102
Ann Behav Med. 2013 Aug;46(1):81-95
pubmed: 23512568
PLoS One. 2019 Jun 6;14(6):e0217743
pubmed: 31170206
Muscle Nerve. 2015 Aug;52(2):183-8
pubmed: 25914119
BMC Public Health. 2011 Jan 31;11:66
pubmed: 21281471
Appl Psychol Health Well Being. 2014 Mar;6(1):1-47
pubmed: 24591064
J Med Internet Res. 2015 Jan 30;17(1):e30
pubmed: 25639757
JMIR Mhealth Uhealth. 2016 Jun 10;4(2):e72
pubmed: 27287964
Int J Behav Nutr Phys Act. 2019 Apr 3;16(1):31
pubmed: 30943983
JMIR Serious Games. 2018 Jan 16;6(1):e2
pubmed: 29339346
Psychometrika. 2010 Jun;75(2):243-248
pubmed: 20640194

Auteurs

Jan Keller (J)

Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.

Christina Roitzheim (C)

Department of Psychology, Humboldt Universität zu Berlin, Berlin, Germany.

Theda Radtke (T)

Institute of Psychology, University of Wuppertal, Wuppertal, Germany.

Konstantin Schenkel (K)

Department of Psychology, University of Zurich, Zurich, Switzerland.

Ralf Schwarzer (R)

Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.
SWPS University of Social Sciences and Humanities, Wroclaw, Poland.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH