The Effect of Health Education Based Laughter Yoga Applied to Adolescents on Stress and Digital Gaming Habits

The Effect of Health Education Based Laughter Yoga Applied to Adolescents on Stress and Digital Gaming Habits

Adolescents may turn to digital games as a coping mechanism for stress, which can lead to addiction and various health problems. School-based health education and laughter yoga are promising interventions for reducing stress and promoting healthy behaviors. This randomized controlled trial with a Solomon four-group design aims to evaluate the effects of health education and laughter yoga on stress levels and digital game habits among adolescents.

Study Hypotheses:

H0-1: Health education and laughter yoga have no effect on adolescent stress. H1-1: Health education and laughter yoga reduce adolescent stress. H0-2: Health education and laughter yoga do not affect digital game habits. H1-2: Health education and laughter yoga reduce digital game habits.

This study is designed as a four-arm randomized controlled trial using the Solomon design. It aims to evaluate the effects of health education and laughter yoga on adolescents' stress levels and digital gaming habits. The intervention will be conducted during April-May 2025 with middle school students enrolled in grades 5 through 8.

The study sample will include 68 volunteer students who meet the inclusion criteria and provide parental consent. Participants will be assigned to four groups using stratified simple randomization: Intervention I, Intervention II, Control I, and Control II.

• Intervention I Group: Participants will complete a pre-test, receive a single-session health education on stress and coping, followed by laughter yoga sessions conducted twice weekly for six weeks (total of 12 sessions). A post-test will be administered at the end.
• Intervention II Group: Participants will receive the same health education and laughter yoga intervention without a pre-test. Post-test will be conducted after the sessions.
• Control I Group: Participants will complete the pre-test but will not receive any intervention during the study. A post-test will be applied at the end of the study, followed by an optional laughter yoga session.
• Control II Group: Participants will not complete a pre-test or receive any intervention. A post-test will be administered at the end of the study, followed by an optional laughter yoga session.

The assessment tools include the "Digital Game Addiction Scale for Children" and the "Adolescent Stress Questionnaire - Short Form." At the end of the intervention, participant satisfaction will also be assessed using group-specific satisfaction questionnaires.

Data analysis will involve descriptive statistics (frequency, percentage, mean, standard deviation) and appropriate inferential tests based on the distribution of the data. Parametric or non-parametric tests will be used as applicable. Linear models will assess the main effects of group and time, as well as the interaction between them. The significance level will be set at p<0.05.

This research is expected to contribute to school-based public health interventions by evaluating a combined strategy involving health education and a non-pharmacological stress management technique (laughter yoga) among adolescents.

Inclusion Criteria:

• Adolescents who are students in the 5th, 6th, 7th, and 8th grades,
• whose parents and themselves volunteer to participate in the study,
• who play digital games using devices such as mobile phones, tablets, computers, or game consoles will be included in the study.

Exclusion Criteria:

• Adolescents who have any health condition that prevents them from exercising; -who have undergone abdominal surgery within the last three months; or
• who have diabetes, glaucoma, hypertension, epilepsy, asthma,
• hernia will be excluded from the study.