Developing a systems-based programme theory for reducing night-time interactive electronic device use and improving sleep among adolescents

Rigby, Benjamin P., Martin, Anne, Shore, Colin B., Wu, Xueqi, Blake, Carolyn, Haughton, Dawn, Scott, Holly, Woods, Heather Cleland, Evans, Rhiannon ORCID: https://orcid.org/0000-0002-0239-6331 and Simpson, Sharon A. 2026. Developing a systems-based programme theory for reducing night-time interactive electronic device use and improving sleep among adolescents. PLoS ONE 21 (10) , e0359723. 10.1371/journal.pone.0359723

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Abstract

Background Adolescent night-time use of interactive electronic devices (IEDs) is increasingly linked to poor sleep, mental health challenges, and reduced academic performance. However, existing interventions often overlook the complex systems shaping these behaviours. This study presents a first-of-its-kind systems-based programme theory for CLOCK OFF – a peer influence intervention aimed at reducing night-time IED use and improving adolescent sleep – created through novel participatory mapping activities and analyses, which involved adolescents, parents and teachers. Methods We conducted five online participatory workshops with adolescents (aged 11–14 years), parents, and teachers across four United Kingdom schools, supported by desk-based research. Workshop activities were facilitated using StickyStudio software. Causal loop diagramming was used to identify system components and feedback loops influencing adolescent IED use and sleep. Causal loop diagrams (CLDs) were iteratively built using Kumu software, refined and validated through stakeholder input and network analysis. The final CLD informed the development of a systems-based programme theory. Results Thirty participants (23 adolescents, 7 adults) contributed to the systems mapping process. The final CLD comprised 68 factors (i.e., causal influences of night-time IED use) and 131 connections between these factors, spanning behavioural, educational, psychological, physiological, social, and technological domains. CLOCK OFF-related mechanisms were represented across a large proportion of the system’s identified feedback structures. The programme theory diagram included 72 factors and 147 feedback loops, grouped into five subsystems. These subsystems highlighted the dynamic interplay between enjoyment, overstimulation, fear of missing out (FOMO), emotional regulation, and educational stress. Conclusions Participatory systems mapping with adolescents is a feasible and valuable method for surfacing complex behavioural drivers and informing intervention design. CLOCK OFF’s systems-based programme theory offers a novel approach for understanding and addressing adolescent night-time IED use and sleep disruption. Findings support the need for multi-actor and peer-led, multi-level interventions embedded within broader systemic strategies.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Social Sciences (Includes Criminology and Education) Schools > School of Social and Spatial Sciences Research Institutes & Centres > Centre For Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Publisher:	Public Library of Science
ISSN:	1932-6203
Date of First Compliant Deposit:	29 October 2026
Date of Acceptance:	17 September 2026
Last Modified:	29 Oct 2026 13:00
URI:	https://orca.cardiff.ac.uk/id/eprint/190524

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