When simple solutions become complex: lessons from a family screen-time feasibility study

Abstract

Abstract Background Screen use has become a public health concern due to its potential impact on children’s wellbeing, sleep, and mental health. Scalable, low-effort strategies, such as grayscale, have previously shown potential to support healthy digital habits, with promising results among young adults. Given the limited evidence in real-life family settings, the primary objective was to examine feasibility of a family-based grayscale intervention, with effectiveness outcomes explored only descriptively. Methods Families (n = 21) were recruited via four Danish public schools and randomized to a two- or four-week control period, followed by grayscale activation for 4–6 weeks. Data were collected via weekly questionnaires and post-intervention interviews. Feasibility outcomes included recruitment, adherence, acceptability, and implementation. Limited efficacy testing assessed self-reported and device-measured smartphone screen-time and children’s self-reported wellbeing and sleep. Results Adherence to weekly data collection varied from 22% to 44%, with 22% of children activating grayscale as intended during the intervention. Qualitative findings indicated substantial implementation challenges, including ease of deactivation, competing family priorities, and behavioral burden. Some participants reported situational benefits (e.g. reduced bedtime use), but the intervention was rarely sustained. A reduction in screen-time was observed in the 4-week group (–13 min/day), and a modest increase (+2 min/day) in the 2-week group. Wellbeing and sleep data were insufficient for analyses. Conclusions Despite its simplicity, grayscale was difficult to implement and sustain in family settings. Findings highlight a mismatch between user-dependent interventions and everyday family complexity, underscoring the need to rethink methods that support healthy family digital habits. Screen reduction findings in the 4-week group support previous findings in grayscale interventions. Key messages • Findings improve understanding of how to support families in building healthy digital habits, emphasizing the need for practical, low-effort solutions in everyday family life. • This study provides key insights into family recruitment challenges in health interventions, emphasizing that successful recruitment and participation requires partnerships and relevant study designs.