Passive smartphone monitoring was feasible and acceptable among diverse adolescents at high risk for suicidal thoughts and behaviors, with immigrant-origin adolescents displaying shorter but more stable sleep patterns compared to non-immigrant-origin adolescents who showed longer baseline sleep with steeper declines over time.
Key Findings
Results
Passive smartphone monitoring was feasible and acceptable among high-risk adolescents, yielding 1500 participant-weeks of data.
Ninety-nine adolescents aged 11-18 with recent suicidal thoughts and behaviors (STB) were enrolled.
Participants installed the iFeel app, which collected passive smartphone data for 6 months.
Average valid monitoring duration was 11.9 weeks per participant.
The study contributed a total of 1500 participant-weeks of data.
Authors described the approach as supporting 'the feasibility and acceptability of this approach.'
Results
Daily smartphone use time, social-media activity time, and sleep duration among participants were comparable to normative adolescent data.
Passive measures included total screen time, social-media screen time, and phone-inactivity-based proxy sleep indicators.
Sleep was inferred from nighttime phone inactivity rather than direct physiological measurement.
The observed behavioral metrics did not differ markedly from population norms for adolescents.
This comparison to normative data was noted as relevant context for interpreting the high-risk sample.
Results
No significant longitudinal differences in smartphone-derived behavioral features emerged between sexual and gender minority (SGM) and non-SGM adolescents.
SGM youth were identified as a minority subgroup of interest given their unique stressors and heightened mental-health risk.
Longitudinal comparisons were conducted across the 6-month monitoring period.
No significant differences were found in total screen time, social-media use, or sleep indicators between SGM and non-SGM participants.
The sample included adolescents at high risk for STB, which may have influenced group comparisons.
Results
Immigrant-origin adolescents displayed shorter but more stable sleep patterns compared to non-immigrant-origin adolescents over the monitoring period.
Non-immigrant-origin adolescents exhibited longer baseline sleep with steeper declines over time.
Immigrant-origin adolescents showed shorter sleep duration that remained more stable across the 6-month period.
Sleep was measured as a proxy using nighttime phone inactivity data collected by the iFeel app.
This difference was identified as a longitudinal finding across the monitoring window.
Conclusions
The study established a replicable passive smartphone monitoring framework for examining behavioral processes in diverse adolescents at high risk for suicidal thoughts and behaviors.
The iFeel app was used to collect passive data including screen time and nighttime phone inactivity.
The framework was described as 'feasible, inclusive, and scalable.'
The study included minority subgroups such as SGM youth and children of immigrant parents, groups underrepresented in prior research.
Authors noted the framework 'offers a scalable approach that future studies can apply to deepen real-time understanding of mental-health challenges and behavioral patterns among diverse adolescents.'
Background
Few prior studies have examined smartphone use among minority adolescents, including SGM youth and children of immigrant parents, who face unique stressors and heightened mental-health risk.
SGM youth and children of immigrant parents were identified as experiencing 'unique stressors and heightened mental-health risk.'
The gap in passive monitoring research among these groups motivated the study design.
Passive smartphone monitoring was characterized as 'a promising, low-burden method for continuously and objectively assessing real-world behavior.'
The study framed passive sensing as offering 'new opportunities to identify dynamic markers of mental health challenges, including suicide risk, in daily life.'
What This Means
This research suggests that passively monitoring smartphone behavior — such as screen time, social media use, and sleep patterns inferred from when phones are inactive at night — is a practical and acceptable way to study the daily lives of teenagers who have recently had suicidal thoughts or behaviors. Ninety-nine adolescents aged 11–18 installed a monitoring app on their phones for up to six months, generating nearly 1,500 weeks of data with an average of nearly 12 weeks of usable data per participant. The smartphone use and sleep patterns observed in this high-risk group were broadly similar to what is typically seen in adolescents generally.
One notable finding was that teenagers from immigrant families tended to sleep fewer hours overall, but their sleep remained relatively consistent over time. In contrast, teenagers from non-immigrant families started with longer sleep but showed a steeper decline in sleep duration across the monitoring period. Interestingly, no meaningful differences were found between sexual and gender minority (SGM) youth and their non-SGM peers in terms of smartphone use or sleep patterns, despite SGM youth being known to face higher rates of stress and mental health challenges.
This research suggests that passive smartphone monitoring is a low-burden, scalable tool that can be used inclusively across diverse groups of at-risk adolescents, including those from minority backgrounds who are often underrepresented in research. The framework developed here could help future researchers track real-world behavioral changes over time, potentially identifying early warning signs of worsening mental health or suicide risk without requiring participants to frequently complete surveys or questionnaires.
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Shahnovsky O, Ekstein D, Friedman T, Stemmer M, Carmi L, Benaroya-Milshtein N, et al.. (2026). Understanding sleep and smartphone use in diverse adolescents through passive digital monitoring.. Journal of research on adolescence : the official journal of the Society for Research on Adolescence. https://doi.org/10.1111/jora.70192