S-FAME: a low-threshold municipal social services intervention for digital media-related family difficulties in...

Problematic gaming and broader digital media-related family difficulties are increasingly encountered not only in specialist mental health services but also in everyday municipal support services. Sweden's new Social Services Act strengthens municipalities' responsibility to provide early, accessible, and knowledge-based support, creating both an opportunity and an obligation to evaluate whether structured, family-centered programs can be delivered effectively in this setting. The present protocol therefore addresses whether S-FAME, a social-services adaptation of the FAME model, can be implemented and evaluated as a low-threshold, preventive support within Swedish municipal social services. This randomized controlled trial aims to evaluate the effectiveness, implementation feasibility, acceptability, and health economic consequences of S-FAME. Specifically, the trial will test whether S-FAME reduces child screen-related problems and improves parent-child relationship outcomes compared with treatment as usual followed by access to a brief parent-focused digital intervention, and will examine whether changes in parenting behaviors mediate changes in child outcomes.

Families with children aged 10-14 years who seek municipal social services support because of digital media use (including gaming and excessive social media use) or related family conflict will be recruited from participating municipalities. Atleast176 families will be randomized in a 1:1 ratio to immediate S-FAME or a condition consisting of regular support from social services during the study period and subsequent access to P-FAME, a three-session online intervention for parents. S-FAME is delivered by trained municipal staff and retains selected family-centered principles from FAME while adapting content, referral pathways, risk management, and implementation procedures to preventive social services. Quantitative outcomes will be collected at baseline, postintervention, and 1-month follow-up. Qualitative interviews and focus groups will explore family and staff experiences, implementation fit, and the balance between fidelity and local adaptation. A health economic evaluation will estimate implementation costs and potential cost-effectiveness from municipal and broader societal perspectives.

Recruitment is planned to begin in February 2026 and end in December 2026. Final analyses of trial outcomes, qualitative implementation data, and health economic data are planned for the first quarter of 2027.

ClinicalTrials.gov NCT07245862 approval date April 20, 2026 (ongoing trial).