The Effect of Health Education on Digital Game Addiction and Health Promotion Behavior in Adolescents

NCT07002515 | Active Not Recruiting DMC

• 1 other identifier: 2025-29
• Study Type: interventional
• Target: 160
• Locations: 1 country
• Sites: 1

Brief Summary

Nowadays, among adolescents who are frequently exposed to digital technologies, problematic behaviors resulting from misuse such as problematic internet use, video game addiction, and online gaming disorder are commonly observed (Young, 2017). In the literature, the prevalence of digital game addiction among adolescents has been reported to range between 0.7% and 15.6% (Arifin et al., 2022; Karadağ \& Noyan, 2023; Miezaha et al., 2020; Yudes et al., 2021). Promoting health-enhancing behaviors plays a key role in combating digital game addiction in adolescent health (Daysal \& Yılmazel, 2020). Previous studies have found that adolescents generally exhibit a moderate level of health-promoting behaviors (Özdemir \& Bülbül, 2023). When behaviors such as regular sleep, stress management, exercise, and adequate and balanced nutrition are adopted by adolescents with the aim of improving health, the need for technology tends to decrease (Bebiş et al., 2015; Özcan et al., 2023; Hysing et al., 2021). When the existing literature is reviewed, it appears that there is a lack of randomized controlled trials that explain behavior change as a process through health education aimed at promoting healthy behaviors among individuals affected by digital game addiction, which is considered a significant problem in adolescents (Shinde et al., 2020; Yang, 2020). In this context, the aim of this study is to determine the effect of health education provided to adolescents on digital game addiction and health-promoting behaviors. The population of the study consisted of 5th, 6th, 7th, and 8th grade students (n = 825) enrolled at Etimesgut 15 July Martyrs Secondary School located in the city center of Ankara. When the study was completed with 136 participants, a post hoc power analysis indicated that with an effect size of f = 0.25, the study achieved 80% power and 95% confidence (1-α) based on a four-group experimental design with repeated measures ANOVA, with a minimum of 34 participants per group (Cohen, 1992). Considering potential participant loss, the sample size was increased by 15%, and the study was initiated with 160 participants, allocating 40 to each group. The study will begin after obtaining permission from the Ankara Provincial Directorate of National Education and approval from the Ethics Committee. Following the identification of voluntary adolescents who meet the inclusion criteria, information about the study will be provided to both the adolescents and their parents, and written informed consent will be obtained. In this randomized controlled study based on the Solomon four-group design, participants will be assigned to groups using the block randomization method (Group 1: Intervention Group 1, Group 2: Intervention Group 2, Group 3: Control Group 1, Group 4: Control Group 2). Research data will be collected through a pretest administered to Group 1 (intervention 1) and Group 3 (control 1) immediately after randomization and prior to training, and a post-test administered to all groups at the end of the third month following the completion of the four training sessions. The intervention groups will receive a standardized health education program delivered over four sessions spanning three months. The timing of the training sessions will be coordinated with the school administration to fit within the school schedule. The data collection tools used in the study include the Descriptive Information Form (20 items), the Digital Game Addiction Scale for Children (24 items), and the Adolescent Health Promotion Scale (40 items). If the data do not follow a normal distribution, non-parametric methods will be used, and analyses will be conducted using the Walrus package in the JAMOVI software. For analyzing the relationships between scales, Pearson or Spearman correlation coefficients will be used depending on the normality of the data. For categorical data, if the expected frequency is greater than 25, Pearson's chi-square test will be applied; if it is between 5 and 25, Yates' correction will be used; and if it is less than 5, Fisher's exact test will be employed. For the analysis of numerical demographic data, one-way ANOVA will be used if the data are normally distributed, and the Kruskal-Wallis test will be used if not. IBM SPSS Statistics version 23 will be used for statistical evaluations. A significance level of p \< 0.05 will be considered statistically significant in this study.

Conditions

Internet Addiction Disorder; Health Promotion

Keywords

Digital Technology; Health Promotion; Internet Addiction Disorder; Health Education; Adolescent

Outcome Measures

Primary Outcomes (2)

• Children's Digital Game Addiction Scale

  It was developed by Hazar and Hazar (2017) to determine the levels of digital game addiction in children aged 10-14. The scale, prepared as a 5-point Likert type, consists of 4 sub-factors and 24 items. Each item on the scale is coded as "1 = Strongly Disagree," "2 = Disagree," "3 = Neutral," "4 = Agree," and "5 = Strongly Agree." The lowest possible score on the scale is 24, and the highest is 120. The scoring classification is as follows: "1-24: Normal group, 25-48: Low-risk group, 49-72: Risk group, 73-96: Addicted group, 97-120: Highly addicted group." The sub-dimensions of the scale are: "Excessive Focus and Conflict Related to Digital Gaming," "Tolerance Development in Game Time and Value Assigned to the Game," "Postponement of Individual and Social Tasks/Homework," and "Psychological-Physiological Reflection of Withdrawal and Immersion in the Game." The Cronbach's alpha for the entire scale is 0.90, and for the sub-factors, it is 0.78, 0.81, 0.76, and 0.67, respectively.

  3 months

• Adolescent Health Promotion Scale

  The Adolescent Health Promotion Scale (AHPS) was developed by Mei-Yen Chen and colleagues in 2003. Its Turkish validity and reliability studies were conducted by Ortabağ et al. (2011) and Bayık Temel et al. (2011), and both studies indicated that the scale is valid and reliable for use in the Turkish population. The scale's Cronbach's alpha reliability coefficient is reported as 0.86. The Adolescent Health Promotion Scale consists of 40 items. Its subscales are nutrition (6 items), interpersonal support (7 items), health responsibility (8 items), self-actualization (8 items), exercise (4 items), and stress management (6 items). The items are rated on a 5-point Likert scale as follows: "1 = never, 2 = sometimes, 3 = usually, 4 = often, 5 = always." Scores for each subscale are obtained by summing the item scores within that subscale, and the total scale score is obtained by summing all subscale scores. The possible total score ranges from 40 to 200.

  3 months

Study Arms (4)

Intervention Group 1

EXPERIMENTAL

contains 40 adolescents

Other: Health education

Intervention Group 2

EXPERIMENTAL

contains 40 adolescents

Other: Health education

Control Group 1

NO INTERVENTION

contains 40 adolescents

Control Group 2

NO INTERVENTION

contains 40 adolescents

Interventions

Health education OTHER

Randomized controlled studies that explain behavior change as a process through health education aimed at promoting healthy behaviors in individuals with digital game addiction.

Also known as: Prevention of digital game addiction

Intervention Group 1; Intervention Group 2

Eligibility Criteria

• Age: 10 Years - 14 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Currently enrolled and continuing education at the center where the study is conducted
• Living with their parents
• Owning a technical device such as a mobile phone/tablet/computer/game console and playing digital games
• Having voluntary consent from both the adolescent and their parents

You may not qualify if:

• Having psychiatric or educational difficulties such as attention deficit and hyperactivity disorder, specific learning disabilities, intellectual disabilities, language and speech impairments, etc.
• Voluntarily withdrawing from the study
• Not attending at least one session of the health education program

Sponsors & Collaborators

• Saglik Bilimleri Universitesi Gulhane Tip Fakultesi: lead

Study Sites (1)

Saglik Bilimleri Universitesi Gulhane Hemsirelik Fakultesi

Ankara, Etlik, 06010, Turkey (Türkiye)

Location

Related Publications (18)

• Chen MY, Wang EK, Yang RJ, Liou YM. Adolescent health promotion scale: development and psychometric testing. Public Health Nurs. 2003 Mar-Apr;20(2):104-10. doi: 10.1046/j.1525-1446.2003.20204.x.

  PMID: 12588427 BACKGROUND

• Ortabag T, Ozdemir S, Bakir B, Tosun N. Health promotion and risk behaviors among adolescents in Turkey. J Sch Nurs. 2011 Aug;27(4):304-15. doi: 10.1177/1059840511408322. Epub 2011 May 6.

  PMID: 21551314 BACKGROUND

• Hazar, Z., ve Hazar, M. (2017). Çocuklar İçin Dijital Oyun Bağımlılığı Ölçeği. Journal of Human Sciences, 14(1), 203-216. Doi:10.14687/jhs.v14i1.4387

  BACKGROUND

• Cohen J. A power primer. Psychol Bull. 1992 Jul;112(1):155-9. doi: 10.1037//0033-2909.112.1.155.

  PMID: 19565683 BACKGROUND

• Shinde S, Weiss HA, Khandeparkar P, Pereira B, Sharma A, Gupta R, Ross DA, Patton G, Patel V. A multicomponent secondary school health promotion intervention and adolescent health: An extension of the SEHER cluster randomised controlled trial in Bihar, India. PLoS Med. 2020 Feb 11;17(2):e1003021. doi: 10.1371/journal.pmed.1003021. eCollection 2020 Feb.

  PMID: 32045409 BACKGROUND

• Hysing M, Askeland KG, La Greca AM, Solberg ME, Breivik K, Sivertsen B. Bullying Involvement in Adolescence: Implications for Sleep, Mental Health, and Academic Outcomes. J Interpers Violence. 2021 Sep;36(17-18):NP8992-NP9014. doi: 10.1177/0886260519853409. Epub 2019 Jun 10.

  PMID: 31179829 BACKGROUND

• Özcan, M., Polat, T.ve Alkan-Polat, B. (2023). Adölesanlarda E-Sağlık Okuryazarlığının Sağlığı Geliştirme Davranışına Etkisi, Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 12(3), 1060- 1071

  BACKGROUND

• Bebiş, H., Akpunar, A., Özdemir, S. ve Kılıç, S.(2015). Bir Ortaöğretim Okulundaki Adölesanların Sağlığı Geliştirme Davranışlarının İncelenmesi. Gülhane Tıp Dergisi, 57, 129-135.

  BACKGROUND

• Özdemir, S. ve Bülbül, F.(2023) Adölesanlarda Sağlığı Geliştirme ve Yaşamda Anlam Arasındaki İlişki. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 10(1):1- 8. DOI: 10.31125/hunhemsire.1272589

  BACKGROUND

• Yudes C, Rey L, Extremera N. The Moderating Effect of Emotional Intelligence on Problematic Internet Use and Cyberbullying Perpetration Among Adolescents: Gender Differences. Psychol Rep. 2022 Dec;125(6):2902-2921. doi: 10.1177/00332941211031792. Epub 2021 Jul 9.

  PMID: 34240633 BACKGROUND

• Miezah, D., Batchelor, J., Megreya, A.M., Richard Y. ve Moustafa A.A. (2020). Video/Computer Game Addiction among University Students in Ghana: Prevalence, Correlates and Effects of Some Demographic Factors. Psychiatry and Clinical Psychopharmacology.30(1):17-23. Doi:10.5455/PCP.20200320092210.

  BACKGROUND

• Karadağ, Y. E. ve Noyan, C. O. (2023) Teknoloji Bağımlılığını Önlemeye Yönelik Psikoeğitim Programının 8. Sınıf Öğrencileri Üzerindeki Etkisi. Bağımlılık Dergisi, 24(1), 43-52. Doi: 10.51982/bagimli.1090570.

  BACKGROUND

• Arifin, R., Wedhatami, B., Alkadri, R. ve Daniel, N. (2022). The internet gang of violence: Trend of cyberbullying on the internet. AIP Conference Proceedings, 2573, 040012-1- 040012-5.

  BACKGROUND

• Tunç,C.(2023).Lise Öğrencilerinde Dijital Oyun Bağımlılığı ve Siber Zorbalık. Yayınlanmamış Yüksek Lisans Tezi,Van Yüzüncüyıl Eğitim Bilimleri Enstitüsü, Van.

  BACKGROUND

• Daysal, B., ve Yılmazel, G. (2020). Halk Sağlığı Gözüyle Akıllı Telefon Bağımlılığı ve Ergenlik. Turkish Journal of Family Medicine and Primary Care, 14(2), 316-322. Doi: 10.21763/tjfmpc.730254.

  BACKGROUND

• Young, K. S. (2017). Assessment Issues with Internet-Addicted Children and Adolescents. In Young, K.S. and de Abreu, C.N., Eds., Internet Addiction in Children and Adolescents: Risk Factors, Assessment, and Treatment. Springer Publishing Company, New York, 143-160. Doi: 10.1891/9780826133731.0008

  BACKGROUND

• Yang SY. Effects of Self-efficacy and Self-control on Internet Addiction in Middle School Students: A Social Cognitive Theory-Driven Focus on the Mediating Influence of Social Support. Child Health Nurs Res. 2020 Jul;26(3):357-365. doi: 10.4094/chnr.2020.26.3.357. Epub 2020 Jul 31.

  PMID: 35004479 BACKGROUND

• Li S, Ren P, Chiu MM, Wang C, Lei H. The Relationship Between Self-Control and Internet Addiction Among Students: A Meta-Analysis. Front Psychol. 2021 Nov 24;12:735755. doi: 10.3389/fpsyg.2021.735755. eCollection 2021.

  PMID: 34899477 BACKGROUND

MeSH Terms

Conditions

Internet Addiction Disorder; Health Education

Condition Hierarchy (Ancestors)

Technology Addiction; Behavior, Addictive; Compulsive Behavior; Impulsive Behavior; Behavior; Adherence Interventions; Medication Adherence; Patient Compliance; Patient Acceptance of Health Care; Treatment Adherence and Compliance; Health Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD

Model Details: A four-arm randomized controlled study using the Solomon design.

Study Record Dates

• First Submitted: May 25, 2025
• First Posted: June 3, 2025
• Study Start: December 3, 2024
• Primary Completion: May 23, 2025
• Study Completion: September 30, 2025
• Last Updated: June 3, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)