Association between 24-Hour Movement Behaviors and Smartphone Addiction among Adolescents in Foshan City, Southern China: Compositional Data Analysis.

ABSTRACT

Smartphone addiction has become a public health issue. To help reduce smartphone addiction, we assessed the combined effect of 24-Hour Movement Behaviors on smartphone addiction during Corona Virus Disease 2019 (COVID-19) home confinement in Foshan, China. Data were collected in a sample of 1323 senior middle school students ((mean age ± standard deviation) 16.4 ± 0.9 years; 43.46% males) during the COVID-19 lockdown. Their 24-Hour movement behaviors were assessed by a self-reported questionnaire, The Smartphone Addiction Scale-Short Version (SAS-SV). The compositional multiple linear regression model and compositional isotemporal substitution model were used to examine the association between the time budget composition of the day and smartphone addiction. Smartphone addiction occurred in 671 (50.72%) of the 1323 students. Compared with smartphone-addicted adolescents, non-smartphone-addicted adolescents had more moderate-to-vigorous physical activity (MVPA) and sleep duration (SLP), and less sedentary behavior (SB). The distribution of time spent in 24-Hour movement behaviors was significantly associated with smartphone addiction. The negative effect was found for the proportion of time spent in MVPA or SLP (ilr1-MVPA = -0.453, p < 0.001. ilr1-SLP = -3.641, p < 0.001, respectively) relative to the other three behaviors. Conversely, SB was positively associated with the score of smartphone addiction (ilr1-SB = 2.641, p < 0.001). Reallocating one behavior to remaining behaviors was associated with smartphone addiction. Noticeably, the effects of one behavior replacing another behavior and of one behavior being displaced by another behavior were asymmetric. The 24-Hour movement behaviors of adolescents are closely related to smartphone addiction, and future intervention studies should focus on the compositional attribute of 24-Hour movement behaviors.