Social Media Withdrawal in Pregnancy: Effects on Maternal Mental Health and Misinformation

Daily social media screen time, defined as total minutes per day spent in social media applications as captured by the device-native iOS Screen Time report, averaged across each 14-day observation window. For each participant, percent reduction is calculated as:

[(mean baseline daily minutes - mean post-intervention daily minutes) / mean baseline daily minutes] × 100 where the baseline value is the mean of daily social media minutes over the 14 days preceding randomization and the follow-up value is the mean over the 14-day window at the end of the intervention period. Mean percent reduction will be compared between the intervention (Brick device) group and the usual care group.

Number of participants enrolled and randomized, expressed as a proportion of those screened and confirmed eligible, and as the mean number enrolled per month over the recruitment period.

Proportion of randomized participants who complete the end-of-intervention assessment with evaluable primary outcome data (iOS Screen Time report for the final 14-day window)

Among participants randomized to the intervention, the proportion of the number of minutes during which the Brick device was in use divided by the number of minutes during the active intervention period; reported as the group mean and as the proportion of participants achieving ≥90% adherent days.

Change in depressive symptoms from enrollment to study completion, measured using the Edinburgh Postnatal Depression Scale (EPDS). The EPDS is a 10-item self-report questionnaire; each item is scored 0 to 3 and summed for a total score ranging from 0 to 30. Higher scores indicate more severe depressive symptoms (a worse outcome). Change is calculated as the study-completion score minus the baseline score, yielding a possible range of -30 to +30, where negative values indicate improvement.

Change in anxiety symptoms from baseline to study completion, measured using the Generalized Anxiety Disorder 7-item scale (GAD-7). The GAD-7 is a 7-item self-report questionnaire; each item is scored 0 to 3 and summed for a total score ranging from 0 to 21. Higher scores indicate more severe anxiety symptoms (a worse outcome). Change is calculated as the study-completion score minus the baseline score, yielding a possible range of -21 to +21, where negative values indicate improvement.

Change in well-being from baseline to study completion, measured using the World Health Organization-Five Well-Being Index (WHO-5). The WHO-5 is a 5-item self-report questionnaire; each item is scored 0 to 5 and summed for a raw score of 0 to 25, which is multiplied by 4 to yield a final score ranging from 0 to 100. Higher scores indicate greater well-being (a better outcome). Change is calculated as the study-completion score minus the baseline score, yielding a possible range of -100 to +100, where positive values indicate improvement.

Change in loneliness from baseline to study completion, measured using the Three-Item UCLA Loneliness Scale (UCLA-LS-3). The UCLA-LS-3 is a 3-item self-report questionnaire; each item is scored 1 to 3 and summed for a total score ranging from 3 to 9. Higher scores indicate greater loneliness (a worse outcome). Change is calculated as the study-completion score minus the baseline score, yielding a possible range of -6 to +6, where negative values indicate improvement.

Change in sleep quality from baseline to study completion, measured using the Brief Version of the Pittsburgh Sleep Quality Index (B-PSQI). The B-PSQI is a 6-item self-report questionnaire yielding five scored components (subjective sleep quality, sleep latency, sleep duration, sleep efficiency, and frequency of night awakenings), each scored 0 to 3 and summed for a global score ranging from 0 to 15. Higher scores indicate poorer sleep quality (a worse outcome). Change is calculated as the study-completion score minus the baseline score, yielding a possible range of -15 to +15, where negative values indicate improvement.