Reducing Screen Use Improves Mental Health in Youth: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On July 22, 2024, we reported on findings from a study published in JAMA Network Open that examined the effects of a screen media reduction intervention on children’s and adolescents’ mental health.

The study

Investigators conducted a prespecified secondary analysis of a cluster randomized clinical trial with a 2-week follow-up that included 89 families (with 181 children and adolescents) from 10 Danish municipalities. Requirements for participation were parental screen use time above the 40th percentile (based on 1000 families) and either full-time employment or full-time student status. Families with children younger than age 4 were not eligible.

In the screen media reduction group were 45 families (86 children) with a mean age of 8.6 (range, 4 to 17) years and an approximately even split between girls and boys. The control group families numbered 44 and included 95 children whose mean age was 9.5 (range 4 to 15) years with more girls (60%) than boys. The median number of household screen devices in the intervention group was 9 and in the control group 11. Researchers reported similar baseline characteristics across the groups.

The families were randomly assigned to the screen media reduction or control groups. Participants in the reduction group were allocated 3 hours per week or less per person for the 2-week intervention period and were required to surrender smart phones and tablets (a "non-smart" phone was provided for phone calls). They were asked additionally to reduce time spent on all other screen media other than required for self-reported work or school hours.

Participants were allowed 30 minutes per day of “necessary” screen media use for tasks including appointment-making and school assignments. Control group families were asked to continue their normal behavior until follow up measurements were completed.

The findings

Results showed a statistically significant between-group mean difference in change on the total difficulties score among the youths from baseline of −1.67 (95% CI, −2.68 to −0.67) that favored the reduction intervention (Cohen d effect size, 0.53). The greatest improvements were observed for internalizing symptoms (emotional symptoms and peer problems; between-group mean difference −1.03, 95% CI −1.76 to −0.29) and prosocial behavior (between-group mean difference 0.84, 95% CI 0.39-1.30).

Authors' comment

"Future research should explore the potential differential effects of various types of screen media use and look deeper into whether collective family participation in such interventions is a pivotal component for observed benefits. Moreover, more research is needed to confirm whether these effects are sustainable in the long term."

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