Introduction: Digital device helps children enhance academic, cognitive and psychomotor skills. However, prolonged use causes physical inactivity, poor interpersonal skills and communication problems. Information on digital device use among young children in Malaysia is currently limited. Hence, this study aimed to determine the prevalence of digital device utilisation among preschool children in Kota Setar District, Kedah. Methods: A cross-sectional study at government preschools in Kota Setar District was conducted from February to April 2020. Selection of preschools and students was done using multistage simple randomisation. A self-administered questionnaire containing demographic and digital device use details was filled by parents. Results: The prevalence of digital device use among preschool children was 95.9% and mostly used smartphones (94.2%). Most children (95%) did not own the device, and usage was under supervision (95.7%). The reason for supervision was to prevent exposure to inappropriate content (70.5%). The common reasons for allowing digital device use were for educational (37.4%) and entertainment purposes (36%) through videos (30.9%) and games (30.2%). Approximately 21.5% and 50.3% of the children spent more than 1 and 2 hours on digital devices during weekdays and weekends, respectively. Conclusion The prevalence of digital device use among the preschool children in Kota Setar District was very high. Most of them used digital devices for educational and entertainment purposes under parental supervision. However, some exceeded the recommended screen time on weekends. These findings could promote awareness of digital device use among young children and help design public health awareness programmes and future policies.
Child ; Child, Preschool ; Prevalence ; Smartphone ; Screen time

BACKGROUND: To combat coronavirus disease 2019 (COVID-19), many countries have used contact tracing apps, including Japan's voluntary-use contact-confirming application (COCOA). The current study aimed to identify industry and workplace characteristics associated with the downloading of this COVID-19 contact tracing app. METHODS: This cross-sectional study of full-time workers used an online survey. Multiple logistic regression analysis was used to evaluate the associations of industry and workplace characteristics with contact tracing app use. RESULTS: Of the 27,036 participants, 25.1% had downloaded the COCOA. Workers in the public service (adjusted odds ratio [aOR] = 1.29, 95% confidence interval [CI] 1.14-1.45) and information technology (aOR = 1.38, 95% CI 1.20-1.58) industries were more likely to use the app than were those in the manufacturing industry. In contrast, app usage was less common among workers in the retail and wholesale (aOR = 0.87, 95% CI 0.76-0.99) and food/beverage (aOR = 0.81, 95% CI 0.70-0.94) industries, but further adjustment for company size attenuated these associations. Workers at larger companies were more likely to use the app. Compared with permanent employees, the odds of using the app were higher for managers and civil servants but lower for those who were self-employed. CONCLUSIONS Downloading of COCOA among Japanese workers was insufficient; thus, the mitigating effect of COCOA on the COVID-19 pandemic is considered to be limited. One possible reason for the under-implementation of the contact tracing app in the retail and wholesale and food/beverage industries is small company size, as suggested by the fully adjusted model results. An awareness campaign should be conducted to promote the widespread use of the contact tracing app in these industries.
Adult ; COVID-19/prevention & control* ; Contact Tracing/methods* ; Cross-Sectional Studies ; Female ; Humans ; Industry/classification* ; Japan/epidemiology* ; Male ; Middle Aged ; Mobile Applications/statistics & numerical data* ; SARS-CoV-2 ; Smartphone ; Workplace/statistics & numerical data*

PURPOSE: This study aimed to develop a smartphone overdependence prevention program for college students based on the self-determination theory (SDT) and evaluate its effectiveness.METHODS: A non-equivalent control group repeated measures design was used for the study. Participants were 64 university freshmen (experimental group: 29, control group: 35). The developed program consists of eight sessions conducted twice a week. The program was designed to promote autonomy, competence, and relatedness the three elements of the basic psychological needs of self-determination theory. The participants were assessed before the program, immediately after, and 1 and 3 months after the program. Data were collected from April 23 to September 14, 2018 and analyzed by performing a Chi-square test, Fisher's exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 23.0.RESULTS: This study showed improvement in the basic psychological needs (F=3.90, p =.010) in the experimental group compared to the control group. Specifically, competence (F=2.93, p =.035), relatedness (F=2.89, p =.045), and self-regulatory ability (F=3.11, p =.028) improved significantly.CONCLUSION: Study findings indicate thatthe smartphone overdependence prevention program based on the Self-determination theory could be an effective intervention for improving basic psychological needs and self-regulation ability. Therefore, this program could be an efficient strategy for smartphone overdependence prevention in university students.
Humans ; Mental Competency ; Personal Autonomy ; Self-Control ; Smartphone

PURPOSE: To examine the effects of a smartphone application-based exercise program on self-efficacy expectations (SEE) and outcome expectations regarding exercise (OEE), physical fitness, activity level, physiological indices, and health-related quality of life in a sample of hemodialysis patients.METHODS: A quasi-experimental control group pre-test post-test design was used. Subjects were recruited from two university hospitals in G city. The subjects were assigned randomly by coin toss: 33 participants to the experimental group and 30 to the control group. A literature review and the self-efficacy theory were used to develop the smartphone program. Experts designed and verified the program to be userfriendly and in consideration of user interaction. Data were collected through a self-report pre-test post-test questionnaire and online medical records.RESULTS: In the experimental group, the levels of physical fitness and physical activity were significantly improved post-test, but the scores on health-related quality of life and the physical indices did not improve. In the experimental group, the SEE and OEE post-test scores were also significantly higher than the pre-test scores, but the control group's scores did not change.CONCLUSION: The smartphone application-based exercise program based on self-efficacy theory significantly improved the level of physical fitness and activity, SEE, and OEE for hemodialysis patients. The use of this application-based exercise program for hemodialysis patients might be an effective nursing intervention tool for improving SEE, OEE, level of physical fitness, and physical activity.
Hospitals, University ; Humans ; Medical Records ; Motor Activity ; Numismatics ; Nursing ; Physical Fitness ; Quality of Life ; Renal Dialysis ; Self Efficacy ; Smartphone

PURPOSE: This study aimed to identify the effects of utilizing Smartphone Application Peer Support (SAPS) on health behavior and body mass index (BMI) among overweight or obese breast cancer survivors (BCS). METHODS: A nonequivalent control group with a non-synchronized design was utilized and 36 participants (experimental group 14, control group 22) were recruited from August 2017 to September 2018. Participants were 40~65 years old, overweight or obese, had completed primary cancer treatment within the 12 months prior to the study, and had not done regular exercise during the last 6 months. The 3-month SAPS consisted of exercise and diet education (once p/2 weeks), peer support (once p/week), and self-monitoring using smartphone applications (5 times p/week). All participants underwent assessments at baseline, right after SAPS, and at 3 months after SAPS. Data were analyzed using repeated measures ANOVA. RESULTS: At the completion of SAPS significant differences were found between groups in motivation for exercise (t=−3.24, p=.005), physical activity (t=−4.15, p<.001), total calorie intake (t=3.42, p=.002), calories from fat (t=−3.01, p=.005), intake of vegetables (t=−2.83, p=.008), and BMI (t=5.21, p<.001). Significant differences in BMI (t=4.13, p<.001) remained up to 3 months after SAPS completion. No significant differences was shown between groups in self-efficacy for exercise, either immediately after or 3 months after SAPS. CONCLUSION: The SAPS has the potential to improve motivation for exercise, health behavior, and BMI of BCS. However, special efforts are required to encourage participants to complete the intervention and maintain long-term effects for future trials.
Body Mass Index ; Breast Neoplasms ; Breast ; Diet ; Education ; Health Behavior ; Humans ; Motivation ; Motor Activity ; Overweight ; Peer Group ; Smartphone ; Survivors ; Vegetables

OBJECTIVES: We investigated the correlation between oral health behaviors and problematic experiences associated with smartphone use in adolescents. METHODS: Raw data from the 13th National Health and Nutrition Examination Survey (KNHANES) were used. The data were analyzed using a composite sample-planning file. Statistical analysis was performed using PASW Statistics 21.0 (SPSS Inc., Chicago, IL, USA). Statistical significance was set at P<0.05. RESULTS: There was a negative correlation between family conflicts due to the use of smartphones and brushing teeth after lunch and twice a day. Additionally, there was a negative correlation between peer conflict experiences due to the use of smartphone and brushing teeth twice a day. Academic difficulties of adolescents due to the use of smartphone were negatively correlated with using supplementary oral hygiene devices and brushing teeth twice a day. CONCLUSIONS: Based on the above results, we confirmed that problematic experiences associated with the use of smartphone are correlated with oral health behaviors. Therefore, it is necessary to plan ways to reduce the excessive use of smart phones in adolescents. In addition, it is necessary to develop an efficient tooth-brushing management system that incorporates the use of smartphones or modern devices.
Adolescent ; Family Conflict ; Humans ; Lunch ; Nutrition Surveys ; Oral Health ; Oral Hygiene ; Smartphone ; Tooth

PURPOSE: The aims of this study were to evaluate a hypothetical model explaining undergraduates' interpersonal relationship ability associated with the stress of life, self-esteem, and their communication ability and to identify the mediating effect of a smartphone addiction tendency on the identified associations. METHODS: Data were collected from 201 undergraduates using a structured questionnaire from August to September 2017. Data analyses included descriptive statistics, Pearson's correlation coefficients, and structural equation modeling with SPSS AMOS 22.0. RESULTS: The participants' interpersonal relationship ability was 65.9%, explained by the stress of life, self-esteem, communication ability, and smartphone addiction tendency. The factors of undergraduates' interpersonal relationship ability were self-esteem (β=.10, p<.01) and communication ability (β=.14, p<.001). Stress of life (β=.15, p<.01) directly affected the participants' smartphone addiction tendency, which was not associated with interpersonal relationship ability. CONCLUSION: Based on our study findings, self-esteem and communication ability should be considered for developing nursing interventions to improve interpersonal relationship ability. However, a smartphone addiction tendency may be managed for undergraduates who experience excessive stress of life rather than interpersonal relationship ability. Thus, a tailored approach targeting specific needs or competence should be developed based on our data-based framework.
Behavior, Addictive ; Communication ; Humans ; Interpersonal Relations ; Mental Competency ; Negotiating ; Nursing ; Smartphone ; Statistics as Topic ; Stress, Psychological

PURPOSE: In 2015, South Korea had the highest global smartphone penetration (88%). However, smartphone addiction can seriously disrupt daily life and have a major negative impact on academic achievement. METHODS: A structured questionnaire was completed by 250 nursing students for this descriptive study. RESULTS: Students who were older, more satisfied with their major, exercised, and used their smartphone for less than 30 minutes before sleeping had higher learning engagement than those who were younger, less satisfied, did not exercise and used their smartphone for more than three hours. Quality of sleep and smartphone addiction were negatively correlated as was quality of sleep and daytime sleepiness. Interestingly, sleep pattern did not impact learning engagement directly. CONCLUSION: Smartphone usage influences learning engagement of nursing students rather than their sleeping patterns, which suggests a need to develop self-disciplining strategies for smartphone use to enhance learning engagement.
Humans ; Korea ; Learning ; Nursing ; Smartphone ; Students, Nursing

PURPOSE: Recently, considering the large number of adolescents suffering from chronic illness, it is important to identify the factors affecting the quality of life (QoL) in order to develop intervention programs. METHODS: Data were analyzed using IBM SPSS 21.0. The general characteristics, psychosocial health status, and life satisfaction distributions of the participants were analyzed using frequency, percentage, mean, and standard deviation. Cronbach's alpha coefficients were calculated to test the reliability of the instrument. The differences in psychosocial health status and life satisfaction according to gender were tested with t-test and Chi-square test. Additionally, multiple regression analysis was used to examine the effect of psychosocial health status on life satisfaction. RESULTS: The multiple regression analysis revealed that depression, ego resilience, and self-esteem were associated with the QoL in both male and female participants. Economic status, subjective health, peer attachment, and smart phone addiction were associated with the QoL in male participants, while exercise time during physical education classes, social withdrawal, and school adaptation were associated with the QoL in female participants. CONCLUSION: The findings suggest that a health promotion program should be developed, which reflects gender differences, to improve the QoL of adolescents with chronic illness.
Adolescent ; Chronic Disease ; Depression ; Diagnostic Self Evaluation ; Ego ; Female ; Health Promotion ; Humans ; Male ; Physical Education and Training ; Quality of Life ; Smartphone ; Social Class

PURPOSE: Smartphone overdependence in young adults is a growing issue, that requires a vigorous approach to manage its associated problems in the affected ones. This study was designed to suggest a detailed direction to help university students with smartphone overdependence, who would be internally motivated through satisfying their basic needs based on the self-determination theory (SDT). METHODS: The data were collected via face-to-face interviews with twenty program providers, who have managed the program for preventing and treating the smartphone overdependence. All interviews were audio-recorded and transcribed. The data were analyzed using directed qualitative content analysis. RESULTS: One core category emerged from the findings: ‘Empowering motivation of autonomous actor of change associated with environmental context,’ which three generic categories and seven subcategories supported. Apart from the three basic needs in the SDT, autonomy, relatedness, and competence, no additional concepts were mentioned, but the participants complained about the practical difficulties of running programs with non-motivated students. CONCLUSION: Our study findings emphasize that research and clinical practice for young people with smartphone overdependence should focus more on developing detailed program contents synchronized with theoretical and conceptual guidance.
Behavior, Addictive ; Humans ; Mental Competency ; Motivation ; Qualitative Research ; Running ; Smartphone ; Young Adult