The mediating role of daytime sleepiness in the relationship between Smombie behavior and injury-related health beliefs in adolescents.

PURPOSE: The aim of this study was to examine the mediating role of daytime sleepiness in the relationship between smombie behavior and injury-related health beliefs in adolescents.

METHODS

This cross-sectional and correlational study included 425 adolescents aged 14-18 years and was conducted between April and June 2025. Data were collected using the Health Belief Model-Based Injury Scale (HBM-Injury), the Cleveland Adolescent Sleepiness Questionnaire (CASQ), and the Adolescent Smombie Scale (SSA). Data were analyzed using Pearson correlation, regression, and PROCESS Macro Model 4 mediation analyses.

RESULTS

The mean age of participants was 15.84 ± 0.88 years, and most participants were female. Daily phone usage time was positively associated with SSA and CASQ scores (p < .001). Sleep problems, morning tiredness, and phone use while walking in traffic were significantly correlated with both SSA and CASQ scores (p < .001). Female adolescents had higher CASQ and HBM scores (p < .001). SSA was positively correlated with CASQ (r = 0.377, p < .001); however, CASQ did not mediate the relationship between SSA and HBM.

CONCLUSIONS

This study suggests that smombie behavior in adolescents may be more closely associated with technology usage habits and daytime sleepiness than with injury-related health beliefs.

IMPLICATIONS FOR PRACTICE: Routine assessment of adolescents' smartphone use habits, sleep quality, and daytime sleepiness may be integrated into pediatric nursing care, and school- and community-based preventive interventions may be promoted to reduce smombie-related risks.