CYOA App Intervention for Social Media Use in Adolescents With Depression (CYOA)

November 9, 2026 updated by: University of Minnesota

Choose Your Own Adventure: A Novel Intervention to Regulate Social Media Use in Adolescents With Depression

This study will develop and test Choose Your Own Adventure, a personalized app-based intervention designed to help adolescents with depression regulate social media use.

Adolescents ages 13 to 17 years with major depressive disorder and daily TikTok use will be randomized to either the CYOA app intervention or no intervention. The CYOA app is designed to detect individualized patterns of problematic social media use and offer personalized options to disrupt "runaway train" social media use.

The study will assess feasibility, acceptability, preliminary effects on social media use and mood, and potential mechanisms including social media self-control failure. Participants will complete baseline, post-intervention, and 3-month follow-up assessments.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

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.

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Kathryn R. Cullen, MD
  • Phone Number: 612-624-3403
  • Email: rega0026@umn.edu

Study Locations

    • Minnesota
      • Minneapolis, Minnesota, United States, 55455
        • University of Minnesota Masonic Institute for the Developing Brain
        • Contact:
        • Principal Investigator:
          • Kathryn R Cullen, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

13 years to 17 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Age 13 to 17 years
  • Presence of major depressive disorder, with a current episode of at least 2 months
  • Adolescent and parent or guardian speak English
  • Adolescent is a current user of social media on a personal cell phone
  • Adolescent uses English-language TikTok for at least 2 hours per day on average

Exclusion Criteria:

  • Primary psychotic disorder, bipolar disorder, or neurodevelopmental disorder
  • Parent or guardian or child does not speak English
  • Adolescent does not own a personal cell phone
  • Adolescent does not use social media, specifically TikTok, at least 2 hours per day
  • Fetuses
  • Neonates
  • Prisoners
  • Adults lacking capacity to consent or adults with diminished capacity to consent
  • Non-English speakers
  • Individuals unable to read
  • Employees of the researcher
  • Students of the researcher
  • Active members of the military or DoD personnel
  • Individuals approached for research participation during a stressful situation, such as an emergency room setting or childbirth

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Choose Your Own Adventure App

Adolescents randomized to this arm will use the CYOA app for 2 weeks. The app is designed to detect individualized social media use patterns and offer personalized options to disrupt problematic "runaway train" social media use.

The CYOA app is a personalized social media self-regulation intervention for adolescents with depression. Adolescents identify social media situations that may be harmful to their well-being and select preferred options for responding when those situations arise. When the app detects a "runaway train" social media use pattern based on predefined thresholds, it offers personalized options such as pausing use, modifying sensory intensity, engaging in mindfulness, or editing the feed to remove problematic content.

Other Names:
  • CYOA App
No Intervention: No Intervention

Adolescents randomized to this arm will use social media as much or as little as preferred during the 2-week study period. They will still use the study app for data collection and complete the same study assessments as the intervention group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
CYOA App Use During Intervention Period
Time Frame: During the 2-week intervention period

Feasibility will be assessed by the number and proportion of days, out of 14 days, that adolescents assigned to the CYOA app use the intervention. The feasibility target is use of the app on at least 8 of 14 days.

During the 2-week intervention period
Acceptability of the CYOA App
Time Frame: Post-intervention visit, after the 2-week intervention period

Acceptability will be assessed using adapted Treatment Acceptability/Adherence Scale ratings with adolescents assigned to CYOA. Total score ranges from 9 to 63; higher scores indicate greater treatment acceptability/adherence. Create a separate outcome for qualitative interviews only if they are intended to be reported as an outcome, with a defined reporting measure.

Post-intervention visit, after the 2-week intervention period

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Social Media Use Patterns
Time Frame: During the 2-week intervention period

Social media use patterns will be assessed using data extracted by the study app, including engagement patterns and app-based social media use data, and by self-report using the Social Media Use Scale. Social media use will be assessed using the Social Media Use Scale (SMUS). Total scores range from 17 to 153; higher scores indicate worse outcomes." Move app-derived engagement patterns into separate outcome entries once their specific measures are defined.

During the 2-week intervention period
Daily Mood
Time Frame: Twice daily during the 2-week intervention period

Daily mood will be assessed using ecological momentary assessment prompts with items from the Positive and Negative Affect Schedule short form.

Twice daily during the 2-week intervention period
Sleep
Time Frame: Baseline, post-intervention after 2 weeks, and 3-month follow-up; daily during the 2-week intervention period

Sleep will be assessed using the Pittsburgh Sleep Quality Index at study visits and daily ecological momentary assessment of hours slept during the 2-week intervention period. Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI). Total scores range from 0 to 21; higher scores indicate worse sleep quality." Separate daily EMA hours slept.

Baseline, post-intervention after 2 weeks, and 3-month follow-up; daily during the 2-week intervention period
Physical Activity
Time Frame: Baseline, post-intervention after 2 weeks, and 3-month follow-up; daily during the 2-week intervention period

Physical activity will be assessed using the Moderate to Vigorous Physical Activity screening measure and daily ecological momentary assessment of minutes of physical activity. Physical activity will be assessed using the Moderate to Vigorous Physical Activity (MVPA) screening measure. Scores range from 0 to 7; higher scores indicate better outcomes.

Baseline, post-intervention after 2 weeks, and 3-month follow-up; daily during the 2-week intervention period
Number of In-Person Social Interactions
Time Frame: Daily during the 2-week intervention period.

The number of meaningful in-person social interactions will be assessed using daily ecological momentary assessment (EMA) questions during the intervention period.

Daily during the 2-week intervention period.
Duration of In-Person Social Interactions
Time Frame: Daily during the 2-week intervention period.

The duration of meaningful in-person social interactions will be assessed using daily ecological momentary assessment (EMA) questions during the intervention period.

Daily during the 2-week intervention period.
Anxiety Symptoms
Time Frame: Daily during the 2-week intervention period.

Anxiety symptoms will be assessed using the Generalized Anxiety Disorder-7 scale.Anxiety symptoms will be assessed using the Generalized Anxiety Disorder-7 (GAD-7). Total scores range from 0 to 21; higher scores indicate greater anxiety symptom severity.

Daily during the 2-week intervention period.
Well-Being as Measured by the Flourishing Scale
Time Frame: Baseline, post-intervention at 2 weeks, and 3-month follow-up

Well-being will be assessed using the Flourishing Scale (FS). Total scores range from 8 to 56, with higher scores indicating greater well-being.

Baseline, post-intervention at 2 weeks, and 3-month follow-up
Well-Being as Measured by the Satisfaction with Life Scale
Time Frame: Baseline, post-intervention at 2 weeks, and 3-month follow-up

Well-being will be assessed using the Satisfaction with Life Scale (SWLS). Total scores range from 5 to 35, with higher scores indicating greater life satisfaction.

Baseline, post-intervention at 2 weeks, and 3-month follow-up
Social Connectedness
Time Frame: Baseline, post-intervention after 2 weeks, and 3-month follow-up

Social connectedness will be assessed using the Social Connectedness Scale-Revised. Social connectedness will be assessed using the Social Connectedness Scale-Revised (SCS-R). Scores range from 0 to 6; higher scores indicate greater social connectedness

Baseline, post-intervention after 2 weeks, and 3-month follow-up
Depression Symptoms - CDI-2 Child-Report
Time Frame: Baseline, post-intervention at 2 weeks, and 3-month follow-up

Depression symptoms will be assessed using the Children's Depression Inventory-2 (CDI-2), Child-Report. Scores range from 0 to 56; higher scores indicate greater depressive symptom severity.

Baseline, post-intervention at 2 weeks, and 3-month follow-up
Depression Symptoms - CDI-2 Parent-Report
Time Frame: Baseline, post-intervention at 2 weeks, and 3-month follow-up

Depression symptoms will be assessed using the Children's Depression Inventory-2 (CDI-2), Parent-Report. Scores range from 0 to 51; higher scores indicate greater depressive symptom severity.

Baseline, post-intervention at 2 weeks, and 3-month follow-up
Change in Social Media Self-Control Failure
Time Frame: Baseline, post-intervention after 2 weeks, and 3-month follow-up

Social media self-control failure will be assessed using the Social Media Self Control Failure scale. The study will evaluate whether CYOA is associated with greater decreases in social media self-control failure compared with no intervention. Social media self-control failure will be assessed using the Social Media Self Control Failure (SMSCF) Scale. Scores range from 3 to 15; higher scores indicate worse self-control failure.

Baseline, post-intervention after 2 weeks, and 3-month follow-up

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Kathryn R. Cullen, MD, University of Minnesota

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 1, 2027

Primary Completion (Estimated)

October 10, 2029

Study Completion (Estimated)

October 10, 2030

Study Registration Dates

First Submitted

October 21, 2026

First Submitted That Met QC Criteria

November 9, 2026

First Posted (Actual)

November 13, 2026

Study Record Updates

Last Update Posted (Actual)

November 13, 2026

Last Update Submitted That Met QC Criteria

November 9, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • PSYCH-2026-35108
  • R21MH145210 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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