Text Neck Epidemic: a Growing Problem for Smart Phone Users in Thailand

INTERNATIONAL JOURNAL OF THE COMPUTER, THE INTERNET AND MANAGEMENT

Senior Editor-in-Chief: Srisakdi Charmonman Editor-in-Chief: Pornphisud Mongkhonvanit

http://www.ijcim.th.org

Volume 23 Number 3 September - December 2015 ISSN 0858-7027

In this issue: - Applications of Internet of Things in E-Learning - A Survey of Apps for E-Learning 2015 - Wearable Technology and E-Learning - E-Learning via Social Media - BKK Management at Vocational School in Semarang - The Implementation of an Integrated Academic Information System (SIKADU) to Improve Academic Service

at the Faculty of Economics Semarang State University - School Accountability Based on E-Archives at Senior High School in Semarang - Text Neck Epidemic: a Growing Problem for Smart Phone Users in Thailand - A Development of Instructional Model in Op-Amp and Linear IC Course of Diploma Electronic Students Using

Distance Communication Technology and Information Technology - Values Judgment of the Top Executive toward National Security System Management in Thailand - Managing an Enterprise Resource in News Department for Thailand Digital Television Broadcasting Business

under Changing of Technology - Reform Direction of the Defense Information and Space Technology Department’s Strategic Management

and Organization Structure - The Solutions in Thai Herbal Development Collaboration - Curriculum Development of Building Inspectors According to Building Control Act (2522) Using Delphi Technique - The Achievements of Pesticide Policy Implementation - Hybrid Genetic Algorithms Feature Selection and Decision Trees Classifier for Student’s Computer Self-Efficacy - Model for Development of Professional Competencies of Physical Education Teacher in 21st Century in Educational

Innovation and Information Technology - Development of Student’s Research Skills Using Social Networks and Ubiquitous Learning in Flipped Classroom - Teaching Tool: Finite Element Analysis of 2D Truss Problem by VBA Program - The Use of Electronic Learning Management System to Enhance Learning and Achievement Case Study:

Course Analysis and Design Students of the Program Department of Computer Information Systems - The Effect of Blended Learning Approach Using Facebook and Learning Experiences Outside the Classroom on an

Inquiring Mind of Freshmen in Teacher Education Program at Institute of Physical Education, Chumphon Campus - Professional Development in Information Technology Competency for Teachers in Basic Education Schools - Internet Plagiarism in PhD Papers

Siam Technology Press, Siam Technology College The Computer Association of Thailand Under the Royal Patronage of HM the King,

The Interdisciplinary Network of the Royal Institute of Thailand Under the Royal Patronage of HRH Princess Maha Chakri Sirindhorn,

The Interdisciplinary Network Foundation for Research and Development, Srisakdi Charmonman Institute, Siam Technology College,

Thailand Chapter of the Internet Society, Thailand Internet Association, Thailand Chapter of the ACM, The Association of Thai Internet Industry,

Thailand Chapter of the Computer Society of the IEEE, Asia-Pacific eLearning Association, Prof. Dr. Srisakdi Charmonman Foundation,

The Internet Poll Association, The Association of Thai Federation of Information Processing.

vi

CONTENTS

Foreword iii

Applications of Internet of Things in E-Learning 1

By Prof. Dr. Srisakdi Charmonman, Pornphisud Mongkhonvanit (Thailand),

Vo Ngoc Dieu (Viet Nam), and Niek van der Linden (Netherlands)

A Survey of Apps for E-Learning 2015 5


and Myong-Jun Kim (Korea)

Wearable Technology and E-Learning 9


Mario Rodriguez (Mexico), Greg Bassani Oam (Australia),

and Sumit Sharma (Nepal)

E-Learning via Social Media 13

By Firouz Anaraki (Iran)

BKK Management at Vocational School in Semarang 18

By Joko Widodo, Murwatiningsih, Nina Oktarina, and Hengky Pramusinto

(Indonesia)

The Implementation of an Integrated Academic Information System (SIKADU) 21

to Improve Academic Service at the Faculty of Economics Semarang State

University

By Kardoyo, Hengky Pramusinto, and Nina Oktarina (Indonesia)

School Accountability Based on E-Archives at Senior High School in Semarang 24

By Nina Oktarina, Hengky Pramusinto, and Linda Agustina (Indonesia)

Text Neck Epidemic: a Growing Problem for Smart Phone Users in Thailand 27

By Poonsri Vate-U-Lan (Thailand)

A Development of Instructional Model in Op-Amp and Linear IC Course 33

of Diploma Electronic Students Using Distance Communication Technology

and Information Technology

By Pitipark Pinrod (Thailand)

Values Judgment of the Top Executive toward National Security System 37

Management in Thailand

By Uthai Shinawatra (Thailand)

Managing an Enterprise Resource in News Department for Thailand Digital 43

Television Broadcasting Business under Changing of Technology

By Phollapruet Ruangcharas (Thailand)

vii

Reform Direction of the Defense Information and Space Technology 48

Department’s Strategic Management and Organization Structure

By Thanyalak Prasertwit (Thailand)

The Solutions in Thai Herbal Development Collaboration 54

By Supapun Hoonchangtong (Thailand)

Curriculum Development of Building Inspectors According to Building 59

Control Act (2522) Using Delphi Technique

By Chanuan Uakarn, Uthai Shinawatra, Kajohnsak Chaokromthong,

Darran Yutthawonsuk, and Nittaya Sintao (Thailand)

The Achievements of Pesticide Policy Implementation 65

By Adisai Suttikeeree (Thailand)

Hybrid Genetic Algorithms Feature Selection and Decision Trees Classifier 70

for Student’s Computer Self-Efficacy

By Wanphen Wirojcharoenwong, Montean Rattanasiriwongwut,

and Monchai Tiantong (Thailand)

Model for Development of Professional Competencies of Physical Education 75

Teacher in 21st Century in Educational Innovation and Information Technology

By Pensri Srisawat, Naiyana Buppaworng, and Yuthana Wongwirat (Thailand)

Development of Student’s Research Skills Using Social Networks and Ubiquitous 81

Learning in Flipped Classroom

By Pathapong Pongpatrakant (Thailand)

Teaching Tool: Finite Element Analysis of 2D Truss Problem by VBA Program 89

By Supachard Krudtong (Thailand) and Saeed Moaveni (USA)

The Use of Electronic Learning Management System to Enhance Learning 92

and Achievement Case Study: Course Analysis and Design Students

of the Program Department of Computer Information Systems

By Somphong Wathanti and Anuchavadee Chaithongsri (Thailand)

The Effect of Blended Learning Approach Using Facebook and Learning 98

Experiences Outside the Classroom on an Inquiring Mind of Freshmen

in Teacher Education Program at Institute of Physical Education,

Chumphon Campus

By Narumon Rodniam (Thailand)

Professional Development in Information Technology Competency 105

for Teachers in Basic Education Schools

By Supinda Lertlit (Thailand)

Internet Plagiarism in PhD Papers 111

By Dararat Khampusaen (Thailand)

viii

Appendix A. Upcoming Conferences 118

Appendix B. About the Senior Editor-in-Chief 122

Appendix C. About the Editor-in-Chief 126

Appendix D. Call for Papers 129

Appendix E. Supporting Organizations 131

Appendix F. Editorial Board 134

Appendix G. Impact Factor 136

International Journal of the Computer, the Internet and Management Vol.23 No.3 (September-December, 2015) pp. 27-32

27

Text Neck Epidemic: a Growing Problem

for Smart Phone Users in Thailand

Poonsri Vate-U-Lan Graduate School of eLearning,

Assumption University of Thailand, Thailand

[email protected]

Abstract - This research study examined the

rapid changes in computer user behavior

among Thai internet users, and analyzed

differences in the computer health risk

between desktop users and mobile device

users. The emphasis is on “Text Neck”

which has become a global epidemic

affecting millions of people of all ages using

various computer devices. The purpose of

this study was to consider the incidence and

relationship between health problems, and

Thai Internet users’ behavior on computer

and smart devices. The main research

instrument was an internet-based survey

which yielded 642 responses. The research

findings reflected that the text neck health

problem in Thailand is growing. This

survey found that the smart phone device

was the most popular computer application

rather than desktop computers as almost

two thirds of Thais always have their smart

phones with them. The research isolated

other behaviors of Thai computer users that

contribute to health problems as the survey

found that almost two thirds of respondents

never wear glasses to protect their eyes

from the blue light that emanates from

computer screens (64.33%). Almost one

third of participants continuously worked

on the computer without a break (30.84%).

On occasions, 62.3 percent of users

experienced pain in the neck and/or

shoulder regions when working on the

computer.

Keywords - Computer Users Behavior,

Computer Vision Syndrome, Health,

Survey, Text Neck

I. INTRODUCTION

People‟s contemporary lifestyle has become

much dominated by computer technology;

often overuse in digital tasks on handheld

mobile technology induces „Text Neck‟ [1, 2],

seemingly a world-wide health effect. The

term of „text neck‟, or another phrase „turtle

neck posture‟, can be described as a repeated

stress injury and pain sustained from excessive

watching or texting on handheld devices for

long periods of time [1, 3-5]. Text neck may

cause many harmful symptoms such as neck

pain, shoulder pain, upper back pain, chronic

headaches and increased curvature of the spine

[1-6]. Mobile device users frequently adopt

prolonged forward head posture while looking

down at the screens of mobile devices [1-6].

Text neck directly affects the spine while

flexing the head forward at varying degrees -

when the head tilts forward at 15 degrees, the

forces on the neck surge to 27 pounds, at 30

degrees 40 pounds, at 45 degrees 49 pounds

and at 60 degrees 60 pounds, then at 90

degrees the model prediction was not reliable

[5]. This issue is a major concern with

children, since their heads are larger in relation

to their body size than adults, and thus they are

have an increased risk for text neck given their

propensity to use mobile phones. Serious

permanent damage of untreated text neck can

be the result and be quite similar to

occupational overuse syndrome or repeated

stress/strain injuries [2].

II. LITERATURE REVIEW

Both text neck and Computer Vision

Syndrome (CVS) are parts of serious physical

computer-related illnesses [2]. According to

mailto:[email protected]

Text Neck Epidemic: a Growing Problem for Smart Phone Users in Thailand


28

health science research results, spending time

on computer longer than 2 hours a day

increases the risk by 90 per cent to develop

CVS [7-9]. Eye strain together with dryness

and irritation of the eyes, headache, blurred

vision, dry eyes, and neck and shoulder pain

are characteristic of CVS symptoms [7, 8, 10].

Many 10-15 years old children in Thailand

and other countries have used mobile devices

or touched screen monitors which has induced

CVS – their numbers have increased markedly

[7]. A case study in Thailand found that a Thai

14-year old teenager suffered from digital

eyestrain since the user performed almost

every activity (90%) such as social networking

and messaging on a mobile phone due to

lacking a computer desktop at home [7]. The

qualitative element in another survey in

Thailand detailed many Thai teenagers told

how they were addicted to the Internet and

faced many health problems, especially eye

strain [11].

The crisis of CVS and text neck, associated

with texting and general overuse of smart

devices, is reflected in research, which found

that American citizens peered down onto their

smart devices for web searching, communicating and

socializing for longer than 2.7 hours daily on

average [1]. Another study of a developed

country in Asia found that almost all people in

the Republic of Korea have smart mobile

phones (97.4%), spending an estimated 4.1

hours a day on the devices while the heavy

smart phone users spent even longer, reaching

around 5.4 hours daily [3]. Computer-related

illnesses are a concern warranting an added

focus as the research found that CVS may

decrease working productivity by up to 20 per

cent [8].

The text neck epidemic is a global

phenomena and problem. A U.S.A. survey of

university students revealed that forty per cent

of participants faced text neck or spinal pain

using mobile devices [12]. The group that

experienced frequent pain were found to have

higher levels of anxiety and/or depression

[12]. A report from the Republic of Korea

confirmed that the heavy smart phone users

affected by multiple stress on the cervical

spine, also experienced cervical curve and pain

threshold in the muscles around the neck [3].

The suggestion was to limit the time hunched

over a mobile phone on a daily basis and move

the whole screen content upwards until the

user returns to a good head posture or look at

the screen with a neutral spine [4, 13].

According to research conducted with Saudi

female nursing students, almost all of whom

own mobile phones and portable devices

(95.9% and 92.4 % respectively) [14], almost a

third spent time on computers and mobile

devices longer than three hours daily, with two

fifths experiencing mild headaches (39.2%)

thus representing a correlation between visual

content use and headaches [14].

The 20-20-20 rule which means every 20

minutes take a 20 second break and focus the

eyes on something at least 20 feet away is

recommended to practice in order to avoid the

health problems of CVS. Mobile applications

provide a capacity to replace many activities in

game consoles, e-readers, media players,

digital camera, and video recorders by

enabling all of these functions to be performed

on one hand-held device, thus restricting

human movement [1]. Given these

circumstances, the American Chiropractic

Association has advised to control text neck by

avoiding and limiting activities on mobile

“gadgets” by replying to emails on a desktop

computer and making a telephone call instead

of texting long messages [15]. The correct

posture to prevent text neck syndrome is the

ears be aligned with the shoulders and the

shoulder blades, retracted so this proper bodily

alignment diminishes spinal stress [5].

An awareness campaign aimed at mobile

phone users is needed to thwart problems from

text neck and CVS. An innovative mobile

application would be useful to alert users if

they are holding their smart phones in an „at-

risk‟ position along the lines of the „The Text

Neck Indicator‟ [1]. The application would

likely trigger the user to adopt a risk-free

operation. The group of Japanese researchers

involved in this type of ergonomic research

pertaining to smart phones have also created an

Poonsri Vate-U-Lan


29

application to blur the device‟s screen if it

detects that users did not blink for a given

period of time (8 seconds in the demo system)

[13]. The application tracked the head angle

and mobile device movement using the build-

in accelerometer [13]. The application also

allows users to continue watching the screen

content after they adjusted their heads to a

better angle [13]. This research group also

designed and embedded a function of tracking

reading activities in order to perform simple

eye gestures while interacting with the

computer screen on „computer glasses‟ that

normally filtered blue light [13].

Referring to possibilities to alleviate

problems as outlined above, it is necessary to

explore the potential correlation between

health problems and Thai Internet users‟

behavior on computer and smart devices.

Therefore, this research employed the online

self-administered survey as the main research

instrument to explore the problem and

comment on possible solutions.

III. RESEARCH METHODOLOGY

An online self-administered survey was

employed in this current research as the most

appropriate instrument to elicit information

from the target population, who are Internet

users in Thailand. The questionnaire included

20 questions which explored details pertaining

to computer users‟ behavior. The researcher

selected only four questions related to text

neck and CVS to discuss in this article. Each

question format was a simple multiple-choice

item. The invitation to fill in the questionnaire

was declared on the researcher‟s timeline on a

Facebook and on a web forum in Thai.

Participation was fully voluntary without

incentives offered.

IV. RESEARCH FINDING

AND DISCUSSION

The first question aimed to know the type

of devices that users favored: “What kind of

computer do you most often use?” The

question offered three options: I. Desktop

computer, II. Mobile device and III. Laptop,

tablet or similar (see Fig. 1). Almost two fifths

(39.1%, n=251) of respondents chose „Mobile

phone‟, about one third (34.27%, n=220) chose

desktop computer and about one quarter

(26.6%, n=171) chose tablets, laptop or

similar. This can be interpreted that mobile

devices or smart phones were more popular

devices than desktop computers since

approximately two thirds of Thai Internet users

(65.73%, n=422) selected mobile phone or

tablets. This trend was the same as in Republic

of Korea, Saudi Arabia and the U.S.A. [4, 12,

14].

Fig 1. Type of Computer most often used

The second question asked about behavior:

“Do you wear glasses to protect you from the

computer light?” The question offered three

options to choose: I. Yes, I do. II. No, I do not

and III. Sometimes. Fig. 2 reveals the findings

which presents both desktop and smart phone

users. The majority of respondents (64.33%)

did not wear glasses to protect the computer

light (45.02% of smart phone users and

19.31% of desktop users).

Fig 2. Wearing Glasses to Protect Computer Light



30

The computer users who were most safe

since they wore glasses to protect from the

computer light was the smallest group or

16.82 percent (8.10% of smart phone users and

8.72% of desktop users). This finding

highlighted how the majority of Thai Internet

users, especially mobile device users, were at

risk of being CVS since they did not protect

their eyes from computer light.

The third question also focused on

computer user behavior: “While you are using

the computer, do you break away from the

computer, let your eyes relax by looking at a

green object?” The question offered three

options to choose: I. No break, II. Break every

20 minutes and III. Break every 1 hr. Fig. 3

presents the findings which are separated into

desktop and smart phone users. The computers

users having a break appropriately or every 20

minutes is the smallest group which was about

one quarter of users (26.08% in total 19.16%

of smart phone users and 6.85% of desktop

users). All the rest or about three quarters of

users were at risk of having CVS problems,

especially 30.84 percent (20.72% of smart

phone users and 10.12% of desktop users) that

had no break while working continuously on a

computer.

Fig 3. Taking a Break while Using Computer

The fourth question inquired about the

symptoms of text neck: “When you are

working on the computer for a long time, do

you have neck or shoulder pain?” The question

offered three options: I. It is con-tinuing, II.

No, I don‟t and III. Just happens sometimes.

Fig. 4 presents the results showing desktop and

smart phone users. The research finding found

that 15.11 percent of users already suffered

from text neck - mobile phone users were

higher than desktop users (10.44% and 4.67%

respectively). The biggest proportion or 63.3

per cent (42.21% of smart phone users and

20.09% of desktop users) were at the initial

stage of experiencing text neck.

Fig 4. Feeling Pain on Neck or Shoulder

when Working on the Computer

Demographic informat ion of 642

respondents who participated in the survey can

be described by gender, place of living, age,

occupation, and education. Approximately

three fifths (59.5%) were females and the rest

(40.5%) were males. The majority of users

resided in rural areas (61.21%) and the rest in

urban areas (38.79%). Fig. 5 shows the age

profile of respondents, the red column

representing smart phone users and the blue

column desktop users. The majority of

part icipants were 11-20 years old

(total=45.33%, smart phone=33.64% and

desktop=11.68%) followed by 21-30 years old

(total=27.73% smart phone= 18.69% and

desktop=9.03%). The rest of participants were

over 30 years of age (26.94 %). According to

this figure, the smart phone users are a bigger

group from 11-40 years old.

Fig 5. Age of Respondents

Poonsri Vate-U-Lan


31

Fig. 6 presents the occupational profile,

with a similar trend in the majority of

occupations but university students and

secondary school students have higher

proportions of smart phones (red line shows

34.11% and 14.49% respectively).

Fig 6. Occupation and Education of Respondents

The right graph in Fig. 6 above is revealing

as education attainment levels of respondents

can be described that mobile devices are more

popular than desktop computers for users

whose education is lower than bachelor degree

or at bachelor degree level.

V. CONCLUSIONS

This current online self-administered

questionnaire finding reflected how CVS and

text neck has become a real problem for

Internet users in Thailand. The trends of Thai

computer users‟ behavior were similar to other

countries because the mobile device was more

popular than the computer desktop [4, 7, 8, 12,

14]. The Thai computer users were at high risk

of developing CVS and text neck since the

majority showed a lack of concern to wear

glasses to protect their eyes from computer

light, or use 20-20-20 rules. Only a small

group did not feel pain in their necks and

shoulders. A future campaign to educate users

to recognize the correct gesture and computer

user behavior needs to be directed to Thai

Internet users in order to prevent and increase

awareness of CVS and text neck. The mobile

application to reduce CVS and text neck

problems should be introduced to Thai Internet

users since prevention is better than cure.

REFERENCES

(Arranged in the order of citation in the

same fashion as the case of Footnotes.)

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[15] The American Chiropractic Association

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4

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