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Peer-reviewedCC BYPLOS One

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

  • Benjamin P Rigby1,2
  • Anne Martin2,3
  • Colin B Shore2,4
  • Xueqi Wu2,5
  • Carolyn Blake2
  • Dawn Haughton2
  • Holly Scott6
  • Heather Cleland Woods6
  • Rhiannon Evans7
  • Sharon A Simpson2
7 affiliations
  1. 1Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.
  2. 2School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
  3. 3Austrian National Public Health Institute, Vienna, Austria.
  4. 4School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom.
  5. 5Institute for Implementation Science in Healthcare, University of Zurich, Zurich, Switzerland.
  6. 6Psychology and Neuroscience Education Hub, University of Glasgow, Glasgow, United Kingdom.
  7. 7DECIPHer, School of Social Sciences, Cardiff University, Cardiff, United Kingdom.
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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.

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Cite

BibTeXRIS
BibTeX
@article{rigby2026developing,
  title = {{Developing a systems-based programme theory for reducing night-time interactive electronic device use and improving sleep among adolescents}},
  author = {Benjamin P Rigby and Anne Martin and Colin B Shore and Xueqi Wu and Carolyn Blake and Dawn Haughton and Holly Scott and Heather Cleland Woods and Rhiannon Evans and Sharon A Simpson},
  journal = {PLOS One},
  year = {2026},
  month = oct,
  doi = {10.1371/journal.pone.0359723},
  url = {https://doi.org/10.1371/journal.pone.0359723},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Developing a systems-based programme theory for reducing night-time interactive electronic device use and improving sleep among adolescents
AU  - Benjamin P Rigby
AU  - Anne Martin
AU  - Colin B Shore
AU  - Xueqi Wu
AU  - Carolyn Blake
AU  - Dawn Haughton
AU  - Holly Scott
AU  - Heather Cleland Woods
AU  - Rhiannon Evans
AU  - Sharon A Simpson
PY  - 2026
DA  - 2026/10/21
JO  - PLOS One
DO  - 10.1371/journal.pone.0359723
UR  - https://doi.org/10.1371/journal.pone.0359723
AB  - 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.
SN  - 1932-6203
ER  -