The mediating role of family communication in the associations of problematic smartphone use with family functioning: A population-based study

Abstract

Background and Objectives: Associations of problematic smartphone use (PSU) with individual health are well-documented, but little is known about the impacts of PSU in the family context. We examined associations among PSU, family communication, and family functioning in Chinese adults in Hong Kong. Methods: We conducted a territory-wide probability-based telephone survey among 1351 respondents (mean age (SD) = 47.6 (18.1), 45.9% male), as a part of 2016/17 Family and Health Information Trend survey (FHinTs) under FAMILY Project. PSU was assessed by the Smartphone Addiction Scale-Short Version (range 10-60) with cut-off values of ≥31 for males and of ≥33 for females denoting PSU. Family functioning was assessed by the Family APGAR Index (range 0-10) with a cut-off value of ≤6 indicating family dysfunction. Sufficiency (range 1-5) and quality (range 0-10) of perceived family communication were rated. Data were weighted by age, sex, and educational attainment distributions of the general population. We used multivariable regression to examine the associations of PSU with family functioning and tested whether family communication mediated the associations. Results: The prevalence (95% confidence interval [CI]) of PSU and family dysfunction were 40.6% (36.5%, 44.8%) and 54.0% (50.3%, 57.5%), respectively. PSU was inversely associated with perceived family communication sufficiency (β = -0.26, 95% CI = -0.33, -0.19), communication quality (β = -0.27, 95% CI = -0.39, -0.16), and family functioning (odds ratio = 0.74, 95% CI = 0.56, 0.96), adjusting for sociodemographic variables. Almost half (42.4%) of the total effects of PSU on family functioning were mediated by perceived family communication sufficiency and quality (β = -0.033, 95% CI = -0.064, -0.010). Conclusions: PSU was associated with family dysfunction in Chinese adults in Hong Kong, which was partially mediated by insufficient and poor quality of family communication. Prospective cohort studies are warranted to examine the causality.