ArticleJAMA network open2022
Prevalence and Characteristics of Manipulative Design in Mobile Applications Used by Children.
Article in JAMA network open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Assessment of Changes in Child and Adolescent Screen Time During the COVID-19 Pandemic: A Systematic Review and Meta-analysis.JAMA pediatrics · 2022Pooled it
- Bombarded? Child's-eye views of smartphone-based game application advertising: objective insights from Aotearoa New Zealand.Health promotion international · 2026Article
- Epidemiology of adolescent gaming disorder: A 6-year population-based longitudinal study (2019-2024).European psychiatry : the journal of the Association of European Psychiatrists · 2026Article
- How School-Related Internet Use Shapes Teens' Learning, Communication, Academic Stress, Online Behavior: A Qualitative Study.Academic pediatrics · 2026Article
- Digital Ecosystems, Children, and Adolescents: Policy Statement.Pediatrics · 2026Article
- Digital Ecosystems, Children, and Adolescents: Technical Report.Pediatrics · 2026Review
- Heavy spenders in digital games: expenditure disparities and associations between microtransactions, gaming disorder and gambling disorder among adolescents.Frontiers in public health · 2026Article
- [Consequences of digital media on the health of children and adolescents with a focus on the consumption of unhealthy foods].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2024Review
- Applying the science of learning to EdTech evidence evaluations using the EdTech Evidence Evaluation Routine (EVER).NPJ science of learning · 2023Article
- Screens Are Not the Enemy: Recommendations for Developing Healthy Digital Habits in Youth.Missouri medicineArticle
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
Importance: Manipulative design features (known as dark patterns) are common in video games and adult-directed technologies, but their prevalence in children's interactive media has not been described. Objectives: To develop a reliable coding scheme for gathering data on manipulative digital designs, describe their prevalence within apps used by a community-based sample of young children, and test hypotheses about associations of manipulative design features with socioeconomic status (SES). Design, Setting, and Participants: This cross-sectional study of a convenience sample of parents of children aged 3 to 5 years was conducted online. Eligible parents were legal guardians of a 3-to-5-year-old child, lived with their child at least 5 days per week, understood English, and were part of a family that owned at least 1 Android or iOS tablet or smartphone. For each participant, the 3 apps used for the longest duration by children with their own mobile devices were downloaded, played, and coded. Data were analyzed between April and August 2021. Exposures: Child SES, operationalized as parent educational attainment and household income-to-needs ratio. Main Outcomes and Measures: Researchers assigned each child a prevalence score for manipulative design features (overall, gameplay pressure, purchase pressure, and advertisement viewing pressure) within the apps children played. Results: Of 160 children in the sample, mean (SD) age was 4.0 (0.6) years; 120 children (75.0%) were non-Hispanic White, and 96 (60.0%) had a parent with a college degree or more. Manipulative designs promoted prolonged gameplay or purchases through 4 user experience typologies: parasocial relationship pressure occurred in 33 (24.8%) and 25 (18.8%) apps with characters; time pressure in 23 (17.3%) and 14 (10.5%) apps; navigation constraints in 61 (45.9%) and 49 (36.8%) apps; and attractive lures in 60 (45.1%) and 61 (45.9%) apps, respectively. Children from households whose parents had lower education levels had higher manipulative design prevalence scores than children whose parents had graduated from college (median [IQR] 3.7 [2.5-5.0] vs 3.0 [2.0-4.0]; P = .02), gameplay-prolonging design (2.3 [1.6-3.0] vs 2.0 [1.5-2.8]; P = .047), and purchase pressure (1.0 [0.5-1.5] vs 0.6 [0-1.3]; P = .02). Purchase pressure prevalence scores were higher for children from households with lower income (R = -0.18; P = .02). Conclusions and Relevance: Design features that encourage monetization of children's digital experiences were common in this sample and disproportionately occurred in apps used by children with lower SES.
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