eAppendix. National Middle and High School Cell Phone & Related Technologies Survey
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Tandon PS, Zhou C, Hogan CM, Christakis DA. Cell Phone Use Policies in US Middle and High Schools. JAMA Netw Open. 2020;3(5):e205183. doi:10.1001/jamanetworkopen.2020.5183
Cell phone use among middle and high school students is ubiquitous, starts at younger ages, and is negatively associated with children’s academic and social-emotional outcomes.1 Parents and educators are concerned about the association of cell phone use with child well-being.2,3 Despite these concerns, there are limited rigorous data on school cell phone use policies and practices. The aim of this study was to describe US cell phone policies and practices in middle and high schools.
For this survey study, we obtained a listing from the National Center for Education Statistics4 of all US public schools serving sixth to twelfth grade in 2019. We focused on public schools because they serve more than 91% of children.5 The cross-sectional survey design was based on stratified probability sampling to create a nationally representative sample of middle and high schools (eAppendix in the Supplement). With use of schools listed in the sampling frame, 10% from each stratum defined by levels (middle school only, high school only, and combined schools serving grades 6-12) were randomly selected (1140 schools). Data were collected from school principals (or their representative) using an online or telephone survey. This study was approved by the Seattle Children’s institutional review board, and informed consent was waived. Data were deidentified.
The survey included questions about the presence of a cell phone policy for students and staff and about restrictions on phone use (class time, lunch time, recess, and class transitions). Additional questions related to consequences of policy violation, whether teachers used cell phones for curricular activities, and principals’ attitudes. Information about the school’s characteristics was collected. Survey items were characterized by grades served and overall. The primary outcomes were the school's cell phone use policies during times of the day. We summarized items using proportions and means (SDs) according to item type. Between-group comparisons were conducted using χ2 tests and analysis of variance. All tests were 2-sided, and P < .05 was considered statistically significant. Analyses were performed using R, version 3.6.3 (R Project for Statistical Computing).
The total sample comprised 210 schools (response rate, 18.4%) with over half the students eligible for free or reduced-priced lunch (Table 1), consistent with national estimates.6 Responding schools were similar to nonresponding schools in grades served, students receiving free or reduced-price lunch, and race/ethnicity except that nonresponding schools had a larger proportion of black students (16.8% vs 12.5%; P < .001).
A total of 103 middle schools (97%) reported having a cell phone policy for students (Table 2). Phone use during lunch and recess was not restricted by 71 middle schools (33%) and 10 high schools (69%). Across school levels, over 90% of principals supported restrictions on cell phone use for students in middle and high schools, and over 80% believed that cell phone use during school has negative consequences for social development and academics.
This study found that although most US middle and high schools have cell phone policies in place, a notable percentage of them allow students to use their phones during class, lunch, and recess. Most principals agreed that cell phone use policies should exist at both middle and high school levels.
Whether cell phone use is occurring during class or recess, it is contributing to children’s cumulative 24-hour screen exposure. Given that most children spend the majority of their waking hours in schools, limiting phone access during the entire school day may be associated with significantly decreased exposure.
This study has several limitations, including a low response rate, although we found no differences between responding and nonresponding schools except for the proportion of black students. Also, school policies may not always be enforced and these results are subject to a response bias, wherein we may overestimate restrictive policies. Despite these limitations, to our knowledge, this was the first national survey of school cell phone policies and lays a foundation for subsequent work in this understudied area.
With increasing concerns for problematic media use, schools have a unique opportunity to create predictable screen-free time for children. Just as schools are now considered critical to helping children meet guidelines for optimal physical activity and nutrition, they should support recommendations on screen time and media use. Along with focusing on potential ramifications of cell phone use during classroom time, the consequences of students viewing screens during lunch and recess should be studied.
Accepted for Publication: March 12, 2020.
Published: May 18, 2020. doi:10.1001/jamanetworkopen.2020.5183
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Tandon PS et al. JAMA Network Open.
Corresponding Author: Pooja S. Tandon, MD, MPH, Center for Child Health, Behavior, and Development, Seattle Children’s Research Institute, M/S CW8-6, PO Box 5371, Seattle WA 98145-5005 (firstname.lastname@example.org).
Author Contributions: Drs Tandon and Zhou had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Tandon, Zhou, Christakis.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: All authors.
Critical revision of the manuscript for important intellectual content: Tandon, Zhou, Christakis.
Statistical analysis: Zhou, Christakis.
Obtained funding: Christakis.
Administrative, technical, or material support: Tandon, Hogan.
Supervision: Tandon, Christakis.
Conflict of Interest Disclosures: Dr Christakis serves on the advisory board of Children and Screens, a not-for-profit foundation with a mission to help children lead healthy lives in a digital world. No other disclosures were reported.
Disclaimer: The Children and Screens foundation had no role in this study.
Additional Contributions: David Thomas, BSc, Nguyen Tran, BSc, Amanda Marchese, MA, and Fahmo Abdulle from Seattle Children’s Hospital assisted with data collection and management and received compensation. Christine Lee, University of Washington, also assisted with data collection and management and did not receive compensation.
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