Background: With mobile technology becoming central to education, communication and entertainment, young users are spending extended hours on screens. Prolonged usage without ergonomic awareness may lead to significant postural issues and spinal complications. This study aimed to assess spinal health knowledge and screen-related habits among youth in Kangra district, Himachal Pradesh. Materials and Methods: A descriptive cross-sectional study was conducted from January to March 2025 among 440 participants aged 15–25 years. A structured bilingual questionnaire assessed socio-demographic data, spinal health awareness, screen usage patterns and preventive behaviors. Knowledge scores were classified as Very Good (≥80%), Good (60–79%), Fair (41–59%) and Poor (<40%). Statistical tests evaluated associations between awareness levels and demographic variables. Results: Out of 440 respondents, 66.8% demonstrated good to very good knowledge about spinal posture and mobile usage. While 79.3% identified poor posture risks, only 45.0% reported engaging in preventive habits like stretching. Misconceptions were more prevalent among rural and less-educated groups. A gap between knowledge and behavior was evident. Conclusion: The study reveals moderate spinal health awareness among Kangra's youth, but limited application of preventive measures. Strengthening awareness through schools, community platforms and digital media is essential to foster healthier digital habits and prevent long-term spinal complications.
With the digital age reshaping lifestyles, smartphones have become a necessity rather than a luxury for the youth. From virtual classrooms and video calls to gaming and social networking, mobile devices play a central role in how young individuals interact with the world. However, increased screen time without attention to body mechanics has led to emerging musculoskeletal issues, especially related to posture [1,2].
Sustained forward head posture, slouched sitting and screen use in bed are among the most common habits contributing to neck and lower back pain in adolescents and young adults. Poor posture during critical developmental years can set the stage for chronic spinal problems later in life. Although many youths experience symptoms like stiffness, discomfort and fatigue, few associate them with spinal strain or take corrective measures [3,4].
The rural-urban divide adds another dimension to this problem. In districts like Kangra, where mobile usage is surging, ergonomic literacy remains limited. Formal education systems often overlook spinal health and cultural awareness around posture remains low. This gap poses risks to a generation heavily dependent on screens without adequate knowledge of protective practices.
This study was conducted to assess the level of awareness about spinal posture and mobile device usage among youth in Kangra district. The aim is to identify key knowledge gaps and behavior patterns and to propose strategies for early intervention and digital wellness promotion.
Study Design: Descriptive cross-sectional survey
Location: Kangra District, Himachal Pradesh
Study Period: January to March 2025
Sample Size: 440 participants (aged 15–25 years)
Sampling Technique
Purposive and convenience sampling via schools, colleges and youth clubs.
Inclusion Criteria
Aged between 15–25 years
Daily user of mobile devices (≥1 hour/day)
Resident of Kangra district
Provided informed consent
Exclusion Criteria
Diagnosed spinal deformities or neurological conditions
Incomplete responses
Survey Instrument
A bilingual (Hindi/English) structured questionnaire comprising three parts:
Socio-demographic details (age, gender, education, residence)
Twenty multiple-choice questions (MCQs) on spinal health, posture, screen time and ergonomics
Screen behavior and physical activity habits
Scoring and Analysis
Each correct answer scored one point. Knowledge scores were categorized as:
Very Good: ≥80%
Good: 60–79%
Fair: 41–59%
Poor: <40%
Data were processed in SPSS v26. Descriptive statistics and chi-square tests were used to evaluate relationships (p<0.05 considered significant).
Ethical Clearance
Approved by the Ethics Board. Informed consent was obtained from all participants.
RESULTS
Participants were relatively evenly split by gender and included a range of educational backgrounds. A slight majority resided in rural areas, making this a representative sample of Kangra’s youth. Most were either school- or college-going, thus reflecting the core demographic most affected by digital lifestyle changes.
Participants were relatively evenly split by gender and included a range of educational backgrounds. A slight majority resided in rural areas, making this a representative
Table 1: Socio-Demographic Profile of Participants (N=440)
| Variable | Category | Frequency (n) | Percentage (%) |
| Age Group | 15–18 | 176 | 40.0 |
| 19–22 | 164 | 37.3 | |
| 23–25 | 100 | 22.7 | |
| Gender | Male | 226 | 51.4 |
| Female | 214 | 48.6 | |
| Education Level | School (up to 12th) | 184 | 41.8 |
| Undergraduate | 179 | 40.7 | |
| Postgraduate | 77 | 17.5 | |
| Residence | Urban | 203 | 46.1 |
| Rural | 237 | 53.9 |
sample of Kangra’s youth. Most were either school or college going, thus reflecting the core demographic most affected by digital lifestyle changes.
Nearly 67% of participants demonstrated good or very good awareness. However, the remaining third fell into the fair and poor categories. Rural students and those in school-level education were most likely to have limited knowledge, emphasizing the need to target these groups for educational interventions.
This study confirms that spinal health, while increasingly relevant, remains underemphasized among digital-savvy youth. Although the majority recognized the symptoms and consequences of poor posture, many lacked clarities on preventive behaviors and daily practices that could help reduce long-term damage.
The findings reveal a common behavioral contradiction: youth acknowledge that prolonged device use can harm their posture but rarely take corrective steps. For instance, fewer than half reported engaging in regular screen-time breaks and most continued to use devices while lying in bed or slouching. This suggests that awareness alone is insufficient structured behavior change strategies are required [5,6].
Education was a strong predictor of awareness. Those with postgraduate education scored significantly higher than those in school. Rural participants consistently lagged behind urban ones in both awareness and behavior. These trends are consistent with broader disparities in health literacy and access to information [7,8].
The knowledge gap regarding ergonomics is especially concerning. Many youths are unaware of safe device-holding postures, the role of back support or how frequently breaks should be taken. Given that these habits are being established early in life, lack of intervention now could translate into widespread chronic spinal issues in adulthood.
The solution lies in early, repeated and practical education. Schools should integrate spine-friendly posture training into digital literacy programs. Posters, animated videos, peer-led discussions and involvement of physiotherapists in campus health activities could make a meaningful difference. Parents and community health workers should also be educated to reinforce these habits at home.
Table 2: Spinal Health Knowledge Questions and Correct Responses
No. | Question | Options | Correct Answer | Correct (n) | % Correct |
1 | Forward head posture leads to? | a) Fever, b) Neck and back pain, c) Weak eyes, d) Hearing loss | b | 349 | 79.3 |
2 | Recommended daily non-academic screen time? | a) 5 hours, b) ≤2 hours, c) 4 hours, d) Unlimited | b | 227 | 51.6 |
3 | Poor posture can cause? | a) Acne, b) Spinal strain, c) Diabetes, d) Lung congestion | b | 360 | 81.8 |
4 | Best position for phone use? | a) Lying down, b) Eye level sitting, c) Standing slouched, d) Side-lying | b | 216 | 49.1 |
5 | Does stretching prevent spinal strain? | a) Yes, b) No, c) Sometimes, d) Rarely | a | 262 | 59.5 |
6 | Long-term sitting with bent neck causes? | a) Sleepiness, b) Good concentration, c) Spinal fatigue, d) Hunger | c | 283 | 64.3 |
7 | What helps relieve postural stress? | a) Sleeping longer, b) Drinking water, c) Watching videos, d) Taking breaks & moving | d | 198 | 45.0 |
8 | Best chair for long phone usage? | a) Back-supported, b) Plastic stool, c) Bean bag, d) Bed pillow | a | 241 | 54.8 |
9 | Spinal strain symptoms? | a) Sore throat, b) Cough, c) Neck stiffness, d) Eye infection | c | 259 | 58.9 |
10 | Ideal screen level for posture? | a) Waist level, b) Eye level, c) Below lap, d) Chest level | b | 244 | 55.5 |
11 | Mobile use in bed? | a) Safe, b) Harmful, c) Neutral, d) Necessary | b | 286 | 65.0 |
12 | Importance of taking screen breaks? | a) Not important, b) Crucial, c) Optional, d) Once a day | b | 238 | 54.1 |
13 | Spinal health improves with? | a) Ignoring pain, b) Heavy meals, c) Physical activity, d) No exercise | c | 277 | 62.9 |
14 | Which practice is ergonomic? | a) Hunched shoulders, b) Upright sitting, c) Cross-legged slouch, d) None | b | 269 | 61.1 |
15 | Can youth develop spinal problems? | a) Yes, b) No, c) Only elderly, d) Only athletes | a | 296 | 67.3 |
16 | Is posture linked to headaches? | a) Yes, b) Never, c) Only with dehydration, d) Sometimes | a | 219 | 49.8 |
17 | What is ‘tech neck’? | a) Fashion, b) Meditation, c) Postural strain, d) Muscle exercise | c | 241 | 54.8 |
18 | Best posture duration before break? | a) 1 hour, b) 3 hours, c) 30 mins, d) No break | c | 223 | 50.7 |
19 | Poor spinal posture can lead to? | a) Skin problems, b) Better mood, c) Long-term back pain, d) Digestive issues | c | 278 | 63.2 |
20 | Should posture education be taught in school? | a) No, b) Optional, c) Yes, d) Only in colleges | c | 318 | 72.3 |
Table 3: Knowledge Score Classification
Knowledge Level | Score Range | Frequency (n) | Percentage |
| Very Good | ≥80% | 128 | 29.1 |
| Good | 60–79% | 166 | 37.7 |
| Fair | 41–59% | 91 | 20.7 |
| Poor | <40% | 55 | 12.5 |
This study brings attention to a critical and rising issue among youth the risk of spinal strain associated with excessive and improper mobile device use. While general awareness exists in Kangra’s youth, there are still substantial gaps in practical knowledge and implementation of preventive behaviors. Structured and accessible posture education must be integrated into school curricula, community wellness campaigns and digital platforms. Proactive, community-driven interventions targeting adolescents especially in rural and underserved areas can ensure a healthier, posture-aware generation that thrives in the digital world without compromising musculoskeletal health.
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