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| ID | Type | Description | Link |
|---|---|---|---|
| HHB/H/41/208 | Other Grant/Funding Number | Health Bureau, Hong Kong SAR |
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This study will develop and evaluate a smartphone-based behavioral intervention for adolescents with Attention-Deficit Hyperactive Disorder (ADHD) and smartphone overuse in Hong Kong. The main questions it aims to answer are:
Adolescent participants will:
Parent participants will:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Smartphone Intervention | Experimental | The treatment group will receive a 12-week individualized smartphone-based behavioral intervention based on the following strategies. They will be contacted once a week to collect the objective smartphone use patterns and check for compliance of the intervention strategies. |
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| Control | Placebo Comparator | The control group will receive information about the known benefits and risks of SO and activate their smartphones' screentime monitoring setting. They will be contacted once a week to collect the objective smartphone use patterns, but they will self-monitor their smartphone usage. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Smartphone-based behavioral intervention | Behavioral | The proposed study will use a behavioral smartphone-based intervention in a 12-week RCT among clinically diagnosed ADHD adolescents in Hong Kong. Guided by a conceptual framework on SO in ADHD, we will implement specific strategies that counter the potentially addictive qualities of smartphones using built-in smartphone functions that have been previously shown to be effective. |
| Measure | Description | Time Frame |
|---|---|---|
| Minutes of smartphone use | Objective smartphone use data will be collected via smartphone apps (e.g., "ScreenTime" on Apple or "Digital Wellbeing" on Android) to trace the pattern of smartphone use of each participant. Participants will send screenshots of the minutes of smartphone use over the previous 7 days on their phones. | Baseline, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 weeks, and 12 months |
| Categories of smartphone use | Objective smartphone use data will be collected via smartphone apps (e.g., "ScreenTime" on Apple or "Digital Wellbeing" on Android) to trace the pattern of smartphone use of each participant. Participants will send screenshots of the distribution of minutes spent according to categories of use (social networking, games, entertainment, productivity, etc.) over the previous 7 days on their phones. | Baseline, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 weeks, and 12 months |
| Number of screen unlocks or "pickups" | Objective smartphone use data will be collected via smartphone apps (e.g., "ScreenTime" on Apple or "Digital Wellbeing" on Android) to trace the pattern of smartphone use of each participant. Participants will send screenshots of the number of screen unlocks or "pickups" over the previous 7 days on their phones. | Baseline, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 weeks, and 12 months |
| Number of notifications | Objective smartphone use data will be collected via smartphone apps (e.g., "ScreenTime" on Apple or "Digital Wellbeing" on Android) to trace the pattern of smartphone use of each participant. Participants will send screenshots of the number of notifications received over the previous 7 days on their phones. | Baseline, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 weeks, and 12 months |
| Smartphone dependence |
| Measure | Description | Time Frame |
|---|---|---|
| ADHD symptoms | Parents will rate their child's behaviors on a 7-point scale using the Strengths and Weaknesses of Attention Deficit Hyperactivity Disorder Symptoms and Normal Behaviour Scale, which rephrased the 18 ADHD items of the DSM into neutral or positive statements. Scores of each statement range from -3 (far above average) to +3 (far below average), anchoring on normative behavior in age-matched adolescents. Two subscales on inattention and hyperactivity-impulsivity symptoms can be derived. Adolescents will also self-rate their ADHD symptoms. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yen Na Yum | Contact | (+852) 29488225 | yyum@eduhk.hk |
| Name | Affiliation | Role |
|---|---|---|
| Yen Na Yum | The Education University of Hong Kong | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41174591 | Derived | Yum YN, Li X, Poon KY, Leung CH. Reducing smartphone overuse for adolescents with attention-deficit hyperactive disorder: study protocol for a randomized controlled trial. BMC Psychiatry. 2025 Oct 31;25(1):1043. doi: 10.1186/s12888-025-07493-w. |
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Aggregate and anonymized data will be shared in open access publications, but individual participant data will not shared to protect the privacy of the participants, as stipulated in the ethical review approval.
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| ID | Term |
|---|---|
| D000082424 | Internet Addiction Disorder |
| ID | Term |
|---|---|
| D000088942 | Technology Addiction |
| D016739 | Behavior, Addictive |
| D003192 | Compulsive Behavior |
| D007175 | Impulsive Behavior |
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| Self-monitoring of smartphone use | Other | Participants will receive information about the known benefits and risks of SO and activate their smartphones' screentime monitoring setting. They will receive weekly reminders to submit their smartphone usage data. |
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To allow for comparisons with existing studies, we will use the Smartphone Addiction Scale - Short Version validated in Hong Kong, which was designed for the assessment of smartphone dependence and showed good reliability and validity. The scale has ten items, such as "Missing planned work due to smartphone use" and "I will never give up using my smartphone even when my daily life is already greatly affected by it". Each item was measured by 6-point scales, from 1= "strongly disagree" to 6 = "strongly agree". Total score on the scale will be used to assess the degree of each participant's smartphone dependence, with suggested cut-off values of smartphone overuse for male and female was 31 and 33, respectively.
| Baseline, 13 weeks, and 12 months |
| Baseline, 13 weeks, and 12 months |
| Resting-state EEG frequency | During the EEG recording process, adolescent participants will be asked to relax and avoid swallowing and movements that may cause artifacts. For 5 min of recording, participants will look at a blank piece of paper on the table. For another 5 min of recording, they will look at their own smartphone, face-down with notifications and sound turned off, on the table. The order will be counterbalanced across participants. The target outcome measures are alpha (8-12Hz) and delta (1-4Hz) EEG frequency bands. | Baseline, 13 weeks, and 12 months |
| D001519 |
| Behavior |