Screen-Free Time With Friends to Promote Face-to-Face Peer Interaction and Reduce Recreational Screen Use Among Children Aged 9-11 Years: Protocol for a Cluster Randomized Controlled Trial.

Background: Children's leisure time has changed in recent decades-with more time spent on screen media and less time face-to-face with peers-potentially affecting their physical and mental well-being. Objective: This protocol outlines a cluster randomized controlled trial evaluating the Screen-Free Time With Friends intervention, which aims to promote face-to-face peer interaction and reduce recreational screen media use among children aged 9-11 years. Methods: The study is conducted as a cluster randomized controlled trial involving 9-11-year-old children and their parents from 18 schools in Denmark. Schools are randomized (1:1) to either a control or an intervention group. The intervention includes five core components: (1) curricular activities, (2) two family meetings, (3) a brief parent exercise, (4) a development program for after-school clubs, and (5) two community workshops. It is designed to allow local adaptation while maintaining fidelity to the core components. Primary and key secondary outcomes, including face-to-face peer interaction across leisure domains and solitary screen time, are assessed at baseline, 6-10 months, and 13-15 months follow-up. Additional exploratory outcomes (e.g., leisure activities, social relations, and well-being) are measured at baseline and follow-up. Time spent in face-to-face interactions with peers was assessed using a short SMS-based questionnaire sent to registered parents. The instrument has not been formally validated but was tested in a feasibility study. A comprehensive process evaluation explores implementation, context, and mechanisms of change. Results: The project was funded in July 2020. Schools were recruited from July 2023 to January 2024, while children and parents were recruited from November 2023 to April 2024. At baseline, 685 children were enrolled at the participating schools, with 343 (50%) having at least one parent enrolled in the questionnaire. The primary outcome is therefore assessed among a subset of participants, which may affect the effective sample size. Baseline data were collected from December 2023 to June 2024, and follow-up data from March to August 2025. As of March 2026, data analysis has not yet commenced, and no study results are currently available. Findings are expected to be published by the end of 2026. Conclusions: Regardless of the findings, this study will generate important knowledge about the intervention's potential effectiveness, complemented by insights into its implementation, context, and mechanisms of change. These insights can assist municipalities, schools, after-school clubs, community stakeholders, and parents in shaping everyday environments that foster children's face-to-face interaction and encourage balanced screen use. The findings may inform policy decisions, guide the development of new national and local initiatives, and inspire future research into feasible, real-world interventions that support meaningful and enriching leisure experiences for children.