Promoting healthy digital device usage: recommendations for youth and parents

Young people's usage of digital devices is currently a central topic of interest for researchers, clinicians and the general public, particularly with regards to the impact of social media on adolescents’ mental health. Notably, the duration of screen time is not the primary determinant of mental health outcomes ¹ , ² . Rather, the “quality” of an individual's device usage patterns, experiences and interactions online, and how they correlate with other lifestyle variables (e.g., sedentary time and sleep) appear to matter most ¹ , ³ , ⁴ .

Other than avoiding the more clear‐cut “online harms” (e.g., addictive behaviors, cyberbullying, and online blackmail or exploitation), there is a lack of consensus on how youth can improve the “quality” of their online time. This is in part because the details of what constitutes “healthy” device usage are unclear, and likely differ with regards to sociodemographic factors ¹ . Here we sought to produce a simplified set of recommended actions to promote adolescents’ healthy digital device usage.

We assembled a multidisciplinary team of individuals with expertise across child and adolescent mental health, social media research, behavior change interventions, and public health. We then identified and reviewed recently published guideline/recommendation articles, online resources and reports from independent think tanks – particularly those that included feedback from young people themselves. We checked these resources for directly actionable advice, rather than general principles on healthy usage patterns. We then considered the recommended actions from such documents alongside the underlying scientific evidence and the team's experience, in order to put forward the top three tips for healthy device usage in adolescents. We also produced a further set of recommendations for parents who wish to implement such changes in their family units.

The top three tips for adolescents are the following:

• Out of sight, out of mind. The implementation of tech‐free zones and times is featured consistently across existing guidelines/recommendations ⁴ , ⁵ , ⁶ , empirical studies ⁷ , ⁸ , and youth feedback ⁹ . The most common recommendation is aiming for at least one hour of tech‐free time before bed, to mentally disconnect from the online world and promote adequate, restful sleep ⁴ , ⁵ , ⁶ . Designating bedrooms as tech‐free zones at night and setting up device charging stations in other locations may help youngsters build these habits. Many sources also recommend keeping family mealtimes as tech‐free zones ⁶ , ⁸ . The adoption of such breaks may improve mental health outcomes ² , ⁸ , ⁹ . However, to increase the chance of success, they must be agreed upon and adhered to as a family, rather than imposed by parents ⁷ .

• Use device features to control usage. Digital devices, particularly smartphones, increasingly offer a range of technological features for tracking and managing one's usage. There are specialist apps through which the user can customize restrictions around content access and usage durations. The default features in iOS and Android systems now readily enable screen time tracking, timing (with reminders), notification blocking, and privacy controls. So far, the use of screen time reminders alone appears to be ineffective, largely because the user can dismiss these easily when immersed in device usage ⁶ , ⁷ . Nonetheless, the “Do Not Disturb” setting (which blocks notifications unless they are specifically allowed from family or friends) is emerging as an effective technological strategy to reduce distraction overall ⁶ , ⁷ , and “Notifications” settings can be used to tackle more specific bad habits by preventing alerts from individual apps ⁷ . Thus, users should become familiar with these features and learn to use them appropriately ⁵ , ⁷ , ⁹ .

• Replace rather than restrict. One of the primary downsides of digital device usage is the extent to which online time can detract from healthy behaviors, such as regular physical activity, adequate sleep, and real‐world socialization ¹ , ⁴ . Efforts to reduce the use of devices during the day will be more acceptable, enjoyable and effective when the user focuses on replacing screen time with engaging, healthy activities ¹ , ⁵ , ⁹ , ideally performed with friends and/or family members to also enhance socio‐emotional skill acquisition. Alongside this, the physical and mental health outcomes of device usage can be improved by replacing some of the time spent passively consuming social media with intentional engagement in “healthier” online activities. This might include sourcing out (or even creating) content on goal‐based behaviors that are in keeping with the user's own interests, for example fitness or mindfulness, or interacting positively with supportive social networks of friends and associates online ¹ , ² , ⁴ .

The recommendations for parents are the following:

• Agree on a plan. Many professional bodies and independent think tanks recommend that families discuss the best ways to manage digital device usage and put the results “in writing” as some form of agreement or plan ⁵ , ⁶ , ⁹ . Ideally, this text should encompass agreed tech‐free times/zones, screen time replacement activities, boundaries on app/website usage, and plans for raising concerns or discussing experiences regarding adverse interactions or content in the online world ⁵ , ⁹ . For maximum acceptability, sustainability and effectiveness, the plan should: a) be created with youth input ⁴ , ⁵ , ⁹ ; b) be reviewed regularly, with adherence barriers discussed openly and non‐punitively; and c) remain fluid, to account for young people's development and new technologies or trends ² , ⁴ , ⁶ .

• Become an example. Parents who set a good example of healthy device usage form a central aspect of promoting these behaviors in youngsters ⁵ , ⁹ . Recent data suggest that healthy device usage among parents is strongly associated with positive outcomes for their children's screen time use as well as mental health outcomes ² , ⁸ . Although the exact rules agreed regarding adolescents’ use of screens may not be directly applicable to their parents (e.g., due to home‐office notebook usage), adherence to the agreed tech‐free zones during family time will promote adoption of such habits, while also fostering opportunities for deeper interactions and conversations as a family ² , ⁶ . Along with these benefits, the process of modelling these behaviors may incidentally improve parents’ own device usage, time use, and consequently mental health and well‐being ¹ .

• Communicate often and openly. Maintaining a non‐judgemental frame and encouraging a two‐way conversation about the content and quantity of online time is essential for: a) supporting the adoption of healthy device usage in young people ⁴ , ⁵ , and b) creating well‐functioning pathways for identifying and managing more serious threats that may arise, such as cyberbullying or online exploitation ⁶ . It should be noticed that, while some parental limit‐setting is acceptable and beneficial to young people ⁸ , ⁹ , adopting a strict, authoritarian approach may be damaging to family dynamics, reducing youth's well‐being ⁶ , ⁹ , and increasing the likelihood of media usage outside of agreed times and types ² .

As digital device usage has been increasing worldwide, the impact on youth mental health has emerged as a central concern. We sought to produce a set of best‐practice approaches, on the basis of available evidence and guidelines, for adolescents and their parents looking to improve their device usage patterns. Ultimately, however, managing this issue at a societal level will require a whole system approach, involving partnerships between governments, social media companies, and health care organizations. To propel this, more high‐quality research is urgently needed to determine what actions policy makers, clinicians and the public can take, including the perspectives of young people themselves.