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Updated: Aug 5, 2026

Smartphone Fundus Photography
Published on: July 6, 2017
A cross-over feasibility trial of smartphone grayscale mode in medical students
James Hagerty1, Shrey Saretha1, Brenton Phung1
1Department of Medical Education, The California University of Science and Medicine, Colton, CA, United States.
Background:
Smartphones are central to digital health environments, yet their color-rich interfaces may increase visual salience and habitual engagement. Grayscale mode removes color saturation, potentially reducing attentional capture during digital task use.
Methods:
We conducted a cross-over feasibility trial involving first-year medical students at an allopathic medical school. Participants were assigned in a 1:1 alternating sequence based on order of enrollment to use either grayscale screen settings or standard color display for one week, followed by a crossover to the alternate condition for a second week. Participants recorded daily screen time using their smartphone's built-in tracking feature and completed end-of-week surveys assessing attitudes regarding sleep quality and productivity. Linear mixed-effects models were used to analyze differences in screen time between conditions.
Results:
Fifty-one participants completed the study. Grayscale mode was associated with a statistically significant reduction in mean daily screen time compared to color display (mean reduction 28 min per day; p < 0.05). The effect was consistent across intervention order. Qualitative comments suggested reduced habitual engagement alongside usability challenges for certain tasks.
Conclusions:
Grayscale mode represents a low-cost, scalable interface-level intervention associated with reduced smartphone screen time. These findings provide preliminary evidence that modifying visual features of widely available consumer technology may influence digital engagement patterns in high-demand learning environments.

