Abstract
BackgroundStudents are vulnerable to Internet addiction (IA). Influences of cognitions based on the Health Belief Model (HBM) and perceived number of peers with IA (PNPIA) affecting students’ IA, and mediating effects involved, have not been investigated.MethodsThis cross-sectional study surveyed 9518 Hong Kong Chinese secondary school students in the school setting.ResultsIn this self-reported study, the majority (82.6 %) reported that they had peers with IA. Based on the Chinese Internet Addiction Scale (cut-off =63/64), the prevalence of IA was 16.0 % (males: 17.6 %; females: 14.0 %). Among the non-IA cases, 7.6 % (males: 8.7 %; females: 6.3 %) perceived a chance of developing IA in the next 12 months. Concurring with the HBM, adjusted logistic analysis showed that the Perceived Social Benefits of Internet Use Scale (males: Adjusted odds ratio (ORa) = 1.19; females: ORa = 1.23), Perceived Barriers for Reducing Internet Use Scale (males: ORa = 1.26; females: ORa = 1.36), and Perceived Self-efficacy for Reducing Internet Use Scale (males: ORa = 0.66; females: ORa = 0.56) were significantly associated with IA. Similarly, PNPIA was significantly associated with IA (‘quite a number’: males: ORa = 2.85; females: ORa = 4.35; ‘a large number’: males: ORa = 3.90; females: ORa = 9.09). Controlling for these three constructs, PNPIA remained significant but the strength of association diminished (‘quite a number’: males: multivariate odds ratio (ORm) = 2.07; females: ORm = 2.44; ‘a large number’: males: ORm = 2.39; females: ORm = 3.56). Hence, the association between PNPIA and IA was partially mediated (explained) by the three HBM constructs. Interventions preventing IA should change these constructs.ConclusionsIn sum, prevalence of IA was relatively high and was associated with some HBM constructs and PNPIA, and PNPIA also partially mediated associations between HBM constructs and IA. Huge challenges are expected, as social relationships and an imbalance of cost-benefit for reducing Internet use are involved. Perceived susceptibility and perceived severity of IA were relatively low and the direction of their associations with IA did not concur with the HBM. Group cognitive-behavioral interventions involving peers with IA or peers recovered from IA are potentially useful to modify the HBM constructs and should be tested for efficacy.
Highlights
Students are vulnerable to Internet addiction (IA)
We investigated the prevalence of IA among Chinese secondary school students in Hong Kong, China
The Chinese Internet Addiction Scale (CIAS) scores were not normally distributed according to Kolmogorov-Smirnov test both for males (p < 0.01) and females (p < 0.01), but our logistic regression analysis was not affected because our dependent variable of IA was binary and such analysis does not require normal distribution for the dependent variable
Summary
Students are vulnerable to Internet addiction (IA). Influences of cognitions based on the Health Belief Model (HBM) and perceived number of peers with IA (PNPIA) affecting students’ IA, and mediating effects involved, have not been investigated. Internet addiction (IA) is defined as an impulse-control disorder of Internet use that has negative impacts on daily life function, family relationships, and emotional stability [1,2,3]. Previous studies conducted in Asia (e.g., Taiwan [20,21,22,23,24,25], Hong Kong [16,17,18], South Korea [11, 26, 27], and mainland China [13, 28]) reported significant risk factors of IA, including sexual intercourse experience, family problems, low selfesteem, social isolation, impulsivity, Internet accessibility and other risk behaviors [12, 27, 29,30,31,32]
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