Table 3.

Domain 1. Perceptions: smartphones and technology in a social context

Theme	Subtheme	Representative quotation
Active danger	Bullying	A lot of the chief complaints have to do with bullying and problems that happened on their phone, whether it’s social media or text, or whatever platform between their friend groups. (01U)
	Exposure to polarizing content or misinformation	It can be very dangerous, skewing their worldviews in certain ways. (06U)
	Hindrance to social development	It’s very much related to regression in young children…For primary school children, it’s usually related to a decline in academic success, but for adolescents, it can lead to risky behaviors like alcohol, substance use, or abusive relationships. (07T)
Distraction		I might miss something that’s said, or when I’m saying something to the other person, they might miss it. It creates more problems in the work environment, not so much in the friend environment (07T)
Legitimate tool	Research and work	It will aid in the discussion, that we’re having an informed debate about something (12U) The phubbing will at times contribute to this patient’s care; it is happening in real time; it can enrich the conversation and imbue it with facts. (01U)
	Patient connection	I think it’s complicated because, in therapy, you have to do work and you don’t let someone on your phone, but, also, my kids want to show me things. And it helps move them on to the next topic without looking at it so closely. And so, I allow it to a certain point: helpful for rapport and for feeling heard. (06U)
	Connection to community	In the course of two or three hours, my husband is at work trying to get a hold of me. My parents are somewhere else in the country. They need to connect with me. (01U)
	Personal health	Because I have diabetes, I use a sensor. I need to constantly open and check the sensor. So, I don’t have the luxury of staying away from the phone. It’s always in my pocket or by my bedside when I’m sleeping. It beeps when it falls, so I need to hear it. (07T)