Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Oct 6, 2025
Date Accepted: Apr 9, 2026
Traditional Social Sports Games and Mental Training for Smartphone Addiction and Psychological Distress in School-Based Adolescents: A Randomized Controlled Trial
ABSTRACT
Background:
Problematic smartphone use (PSU) among adolescents is a growing public health concern, closely associated with psychological distress and loneliness. Effective, culturally grounded, school-based interventions are needed.
Objective:
The aim of this study was to assess the effects of a 12-week program combining traditional social sports games and mental training (TSSG-ME) on smartphone addiction, nomophobia, psychological distress, and loneliness in adolescents.
Methods:
In this randomized controlled trial, 69 school-recruited Tunisian adolescents (aged 14–16 years) with clinically elevated smartphone addiction scores were assigned to an experimental group (EG, n = 36) or a control group (CG, n = 33). The EG received a 12-week intervention comprising four weekly sessions integrating Traditional Social Sports Games with Mental Exercises (TSSG-ME), while the CG continued standard physical education. Outcomes, including smartphone addiction, nomophobia, psychological distress, and loneliness, were assessed at baseline and post-intervention using validated Arabic scales.
Results:
Linear mixed-effects models adjusted for age, gender, and body mass index (BMI) revealed significant Group × Time interactions of moderate magnitude across all outcomes (all p < .05), favouring the experimental group (EG). Adjusted post-intervention comparisons confirmed significantly lower scores in the EG for smartphone addiction, nomophobia, psychological distress, and loneliness (all p < .05; partial ηp² = 0.08–0.12). Mediation analysis indicated that reductions in loneliness accounted for 34.4% of the intervention’s effect on smartphone addiction, consistent with partial mediation.
Conclusions:
A culturally adapted, school-based intervention combining traditional games and mental exercises significantly reduced PSU and improved psychological well-being. The partial mediation through reduced loneliness highlights the critical role of social connectedness in adolescent digital health interventions. Clinical Trial: Pan African Clinical Trials Registry PACTR202601838702413; https://pactr.samrc.ac.za/ (retrospectively registered on 30 January 2026).
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