CYOA App Intervention for Social Media Use in Adolescents With Depression

Choose Your Own Adventure is a pilot randomized controlled clinical trial testing a personalized app-based intervention to regulate social media use in adolescents with depression. The study will enroll 60 adolescents ages 13 to 17 years with major depressive disorder. Participants will be randomized 1:1 to the CYOA app intervention or no intervention. The intervention is designed to promote adolescent agency rather than force discontinuation of social media use. Adolescents assigned to CYOA will identify situations that may be harmful to their well-being and select preferred options for what to do when those situations arise. The app will sense and characterize social media content and engagement patterns. When it detects a predefined "runaway train" social media use pattern, it will offer personalized options based on the adolescent's plan. Options may include pausing after a specified time or number of videos, modifying sensory intensity, engaging in a mindfulness activity, or editing the feed to remove topics the adolescent identifies as problematic. Participants in both groups will download the study app and use it for 2 weeks. Adolescents will complete ecological momentary assessment prompts twice daily during the 2-week period. Baseline, post-intervention, and 3-month follow-up assessments will evaluate depression symptoms, anxiety, well-being, social connectedness, sleep, physical activity, social media self-control failure, and social media use patterns. The main goals are to assess feasibility, acceptability, preliminary impact, and potential mechanisms of the CYOA intervention compared with no intervention.