Award Title: SMART Schools: Smartphones, social Media and Adolescent mental wellbeing: the impact of school policies Restricting dayTime use
Funder: Department of Health and Social Care

Abstract: Most adolescents own a smartphone and many use social media. In moderation, these interactive technologies can be advantageous for mental wellbeing. Yet negative wellbeing tends to increase with the increasing amount of time adolescents spend using smartphones and social media. We do not know exactly how much time adolescents spend using smartphones and social media, but we know that use in most adolescents is likely to be at levels that are potentially detrimental to wellbeing. We also have little current understanding of the nature of phone/media use in this age group and how this relates to wellbeing._x000D_
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Many secondary schools have introduced policies that restrict phone use during the school day, however some schools have a more permissive approach to phones, allowing use at break and lunchtimes. This provides an opportunity to examine the impact of these restrictive school policies by comparing phone use and mental wellbeing in pupils attending schools restricting phone use, with those attending schools which allow phone use. _x000D_
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School phone/media policies are a plausible mental wellbeing intervention. Prior research suggests that schools are effective contexts to deliver health interventions, positively impact mental wellbeing, and support phone/media use behaviours. In addition, the UK government recently reported that schools urgently need evidence-based guidance on phone/media use to help them make informed decisions about how better to support adolescents uses of phones/media and their mental wellbeing._x000D_
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This proposed study will build on prior evidence to add new understandings on what types of school policies and phone/media use are optimal for adolescent mental wellbeing. We will work closely with secondary schools, senior leaders, teachers, governors, parents, adolescents and key stakeholders so that across the two school groups (schools that do not permit smartphone use and schools that permit smartphone use) we can:_x000D_
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1.	Compare the impacts of the two policy types on mental wellbeing _x000D_
2.	Compare differences in: adolescents’ uses of phones/media (within school, over 24hrs and across 7 days); reasons why adolescents use their phones/media; and levels of addictive use_x000D_
3.	Compare behavioural outcomes that are often associated with mental wellbeing, including sleep, physical activity, classroom behaviour and attainment_x000D_
4.	Talk with school senior leader staff, teachers, parents, and governors to better understand the school phone/media policies that are implemented and what family/home factors influence policy implementation and phone/wellbeing relationships_x000D_
5.	Talk to adolescents to better understand how they experience relationships between their phone/media use, school policies and mental wellbeing_x000D_
6.	Assess the impact of these school policies on teachers’ time use to provide evidence of their value for money in terms of improving adolescent mental wellbeing_x000D_
7.	Engage with policy makers, national agencies and local authorities to communicate the findings to inform national policy and guidance, school policy and curricula, and the design and implementation of future interventions to improve mental wellbeing._x000D_
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This study will address current gaps in evidence, identify how to maximise benefits and minimise harms of phones/media for mental wellbeing and inform future school policy.

Lay Abstract: BACKGROUND_x000D_
Adolescence is a crucial period for developing social and emotional habits important for mental wellbeing. Smartphones and social media (phones/media) is a habitual behaviour during adolescence. Evidence suggests that moderate amounts of time spent on phones/media is beneficial for mental wellbeing, and other wellbeing promoting behaviours: sleep, physical activity, school behaviour and attainment. At higher levels of use the reverse effect is seen, with increasing time on phones/media associated with decreasing levels of mental wellbeing, higher anxiety and depression, and addictive use. Many, but not all schools, are currently altering adolescents’ uses of phones/media through school policies that restrict daytime phone/media use. These policies have the potential to lower the overall time adolescents spend on their phones/media and improve mental wellbeing.  However, there is currently no evaluation of the effect of school policies that restrict school time smartphone use and there is limited evidence on how these policies are implemented in schools. _x000D_
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AIM_x000D_
To determine the impact of school time restrictions of smartphone use on mental wellbeing (primary outcome), anxiety, depression, sleep, physical activity, classroom behaviour, attainment, and addictive use, and assess the costs of policy implementation from an education sector perspective._x000D_
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METHODS_x000D_
This is a natural experimental study using mixed methods to compare the impact of school daytime restrictions on smartphone use on mental wellbeing in 2 secondary school contexts: schools that do not permit phone use (intervention) vs schools that permit phone use (control). The focus is on adolescents aged 11-12 years and 14-15 years (population). The primary outcome will be mental wellbeing, and we will measure secondary outcomes of anxiety, depression, classroom behaviour, attainment, physical activity, sleep, and addictive phone/media use. We will examine how the school environment, individual factors and family/home factors influence relationships between school policies, phone/media use and mental wellbeing._x000D_
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Data will be collected from 30 schools (15, intervention, 15 control) and 750 adolescents. To measure the primary and secondary outcomes we will collect data from a student online survey and accelerometers. We will conduct document/website analysis and teacher and senior leadership team surveys to understand how school policies are implemented and to complete an economic analysis. Qualitative data will be collected from 6 case study schools (3 intervention, 3 control) to examine the influence of the school environment, individual factors and family/home factors. 36 focus group interviews will be completed with adolescents (n=12), school staff (n=12) and parents (n=12).  _x000D_
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TIMELINE_x000D_
This is a 28 month study, starting September 2021._x000D_
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IMPACT _x000D_
This study will establish whether restrictive school phone/media use policies are an effective mental wellbeing intervention. We will also determine key features of school phone/media policy implementation that positively influence mental wellbeing and related outcomes, inclusive of associated costs, to facilitate adoption of and adherence to effective policies across school contexts. We will disseminate the outcomes to relevant channels to inform national policy and guidance, school policy and curricula, and the design and implementation of future interventions to improve mental wellbeing.

Research Activity Codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health Categories: MENTAL HEALTH