Community-Based Intervention to Reduce Problematic Video Game Use in First-Year Secondary School Students: A Cluster Randomised Controlled Trial

Condition(s) studied

Investigational drug(s) / intervention(s)

Community-Based Component: The community component is based on participatory action research and actively involves adolescents in identifying local leisure needs, recognising community assets, and co-designing healthy screen-free alternatives. It consists of three 50-minute classroom sessions facilitated by trained members of the research team. Students use community mapping and photovoice to explore their everyday leisure environments, produce photographs with short narratives, and contribute to a collective map. The materials are then discussed in small groups to identify available resources, barriers, and opportunities for improvement. Finally, students prioritise the proposals through voting and jointly develop two feasible community-based leisure activities. The core structure is standardised across schools, while the specific content and activities are adapted to each local context. Attendance, adaptations, and implementation fidelity are recorded throughout the process.

Adolescent Mindfulness Component: The adolescent mindfulness component is a structured classroom-based programme adapted from established Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy protocols. It aims to strengthen attention, emotional awareness, and behavioural self-regulation. The programme consists of eight face-to-face group sessions of approximately 50 minutes, delivered during school hours. Content follows a progressive sequence focused on awareness of the body and breathing, physical sensations, emotions, thoughts, and open awareness. Sessions combine guided mindfulness practices with age-appropriate reflection and discussion, helping students recognise internal experiences and respond to them in a less automatic way. Brief mindfulness exercises are also encouraged in other school settings to support the transfer of skills to daily life. No minimum group size is required, and the intervention is delivered in addition to usual educational activities.

Adult Mindfulness Component: The adult mindfulness component is an individual, self-guided online programme for parents, caregivers, teachers, healthcare professionals, and community representatives in the adolescents' immediate environment. It aims to improve participants' mindfulness and psychological well-being while providing practical tools to support adolescents in developing healthier leisure habits. The programme consists of six sessions of approximately 45 minutes each and is designed to be completed over eight weeks at the participant's own pace. Its content combines mindfulness practices with cognitive-behavioural strategies focused on emotional regulation, stress management, self-awareness, and more mindful responses in everyday situations. The programme is accessed through digital devices, requires no minimum number of participants, and is intended to strengthen adults' role as supportive models within adolescents' family, school, healthcare, and community environments.

Study summary

This cluster randomised controlled trial will evaluate whether a community-based, multicomponent intervention can reduce problematic video game use and gaming disorder among first-year secondary school students in Pontevedra, Spain.

The intervention combines three coordinated components: a participatory community programme in which adolescents identify local leisure resources and co-design healthy screen-free activities; a classroom-based mindfulness programme for adolescents; and an online mindfulness programme for parents, caregivers, teachers, healthcare professionals, and other adults in the adolescents' environment.

Schools will be randomly assigned to either the intervention group or a control group that continues with usual educational practice. Adolescents will be assessed before the intervention, after the intervention, and at 6-month follow-up. Adults will be assessed before and after the intervention.

The main hypothesis is that adolescents in intervention schools will show a greater reduction in problematic video game use and gaming disorder than adolescents in control schools. The study will also examine whether the intervention improves mindfulness, psychological well-being, perceived social support, and self-regulation, and reduces impulsivity and involvement in cyberbullying. In addition, it will explore whether changes in mindfulness and other psychological factors help explain the intervention's effects, and whether family involvement, adult mindfulness, cyberbullying, and baseline severity influence the results.

Eligibility

Primary outcome measure(s)

• Problematic Video Game Use and Game Addiction — One year and a half, and at follow-up (6 months after study completion)
  Change in problematic video game use and gaming disorder symptoms among adolescents, assessed using the validated Spanish versions of the Game Addiction Scale for Adolescents (GASA) and the Ten-Item Internet Gaming Disorder Test (IGDT-10). The GASA is a seven-item self-report instrument. Total scores range from 7 to 35, with higher scores indicating greater severity of problematic gaming and addiction-related symptoms. The scale has shown adequate internal consistency, with Cronbach's alpha values ranging from 0.81 to 0.83. The IGDT-10 is a ten-item self-report instrument assessing the nine DSM-5 criteria for Internet Gaming Disorder. Using the criteria-based scoring procedure, total scores range from 0 to 9, with higher scores indicating that a greater number of diagnostic criteria are met and greater gaming disorder severity. The instrument has demonstrated acceptable internal consistency, with Cronbach's alpha values ranging from 0.62 to 0.75.

Trial sites (1)

More Fundacin Biomedica Galicia Sur trials in Spain