Teen screen diets and their relationships with dietary intake: setting the stage for precision interventions and evidence-based policies

Adolescents’ eating behaviors are influenced by their media environments. However, very little is known about the food and beverage-related environment that adolescents experience on their smartphones. Adolescents increasingly interact with the world through smartphone screens that are almost always with them. Thus, any attempt to study or change policy, systems and environmental influences on adolescents’ food and beverage preferences, purchases and consumption must consider the nutrition- related environment and behavior on their smartphone screens. Until now, a comprehensive view of life experienced on smartphones has been invisible to researchers. We have developed a novel method for capturing everything that appears on teens’ smartphone screens – a fully encrypted record of digital life – by taking snapshots of the screen every 5 seconds the devices are on. The resulting sequence of screenshots, including all words and images on the screen, constitute an individual’s screenome. We will collect six months of continuous smartphone screenshots and three 24-hour dietary recall interviews at baseline and after 2, 4, and 6 months, from a national sample of 300 adolescents age 13- 17 years, balanced between female and male, and at least 30% identified as racial/ethnic minority. Aim 1. Describe the food and beverage environment adolescents experience on their smartphone screens Using the text and images from smartphone screenomes, we will create the first comprehensive description of the food and beverage environments being experienced by adolescents on their smartphones. Aim 2. Elucidate the between-person relationships between smartphone food and beverage screenomes and dietary intake. we will examine how differences in digital exposures to food and beverage screenome features are associated with differences in dietary consumption. Aim 3. Elucidate the within-person relationships between changes in smartphone food and beverage screenomes and changes in dietary intakes. Leveraging natural experiments embedded in the screenome data. This study will provide the first comprehensive description of the food and beverage environment that adolescents experience on their smartphones and represents a true paradigm shift in studying media impacts on adolescents’ eating behaviors. The results of this study will identify novel intervention targets and opportunities for smartphone-based precision nutrition interventions and evidence-based policies to improve adolescents’ health.