Abstract
PURPOSE: While previous research has highlighted the influence of family, school, and peer factors on smartphone addiction and sleep quality, the cumulative effects of these risk factors and their underlying causal relationships remain poorly understood. Therefore, based on the cumulative risk model and the bioecological model of human development, this study examined the longitudinal associations between cumulative ecological risk and smartphone addiction and sleep quality. METHODS: A survey was conducted among 653 Chinese university freshmen (mean age 18.56) at two distinct time points, with a 6-month interval. The initial assessment focused on family, school, and peer risk factors, while the subsequent assessment focused on smartphone addiction and sleep quality. RESULTS: Approximately 63.71% of university freshmen were found to be at risk of exposure. Compared to other risk-exposure groups, the group with no-risk exposure exhibited the lowest scores for smartphone addiction and sleep quality. The relationships between cumulative ecological risk and smartphone addiction and sleep quality displayed a linear pattern and a discernible "gradient effect". Smartphone addiction was identified as a fully mediating factor in the link between cumulative ecological risk and sleep quality, with a mediating effect value of 0.08 (representing 44.44% of the total effect). CONCLUSION: University freshmen face various risks associated with their families, schools, and peers. The cumulative ecological risk can, directly and indirectly, impact sleep quality by influencing smartphone addiction. Given the observed "gradient effect" of cumulative ecological risk on smartphone addiction and sleep quality, it is imperative to adopt comprehensive risk prevention strategies to mitigate the impact of each risk factor.