Internet Addiction Among School Children: Cross-Sectional Analytical Study.

Internet use is rapidly increasing in Sri Lanka. Excessive use can lead to addiction with significant consequences, particularly among adolescents. While internet addiction has been documented worldwide, data from Sri Lanka remain limited. A validated local tool is required to assess the prevalence and associated factors in this population. This study aimed to translate and validate the Young Internet Addiction Test (IAT) into Sinhala, assess the prevalence of internet addiction among school-going adolescents aged 15 to 19 years in the Western Province of Sri Lanka, and identify demographic and behavioral characteristics associated with internet addiction. We conducted a 2-phase cross-sectional analytical study in Colombo and Gampaha districts. Phase 1 involved translation and validation of the Sinhala IAT using confirmatory factor analysis (n=200) and test-retest reliability assessment (n=40). Phase 2 involved multistage stratified cluster sampling to recruit 2835 students. Participants completed self-administered questionnaires assessing demographics, internet use patterns, and internet addiction. The Sinhala IAT demonstrated excellent internal consistency (Cronbach α=0.98) and strong test-retest reliability (r=0.95; P<.001). Among 2835 students with complete data, 1803 (63.6%) were current internet users. The overall prevalence of internet addiction among internet users was 12.6% (227/1803; 95% CI 11.2%-14.0%), including mild addiction at 8.2% (147/1803; 95% CI 6.9%-9.5%), moderate addiction at 3.5% (64/1803; 95% CI 2.7%-4.5%), and severe addiction at 0.9% (16/1803; 95% CI 0.4%-1.4%). No significant associations were found with sex (male and female; odds ratio 1.13, 95% CI 0.86-1.49; P=.14), age group (P=.23), or parental education (P=.34). The most common online activities were entertainment (1522/1803, 84.4%), gaming (1251/1803, 69.4%), and social media use (1127/1803, 62.5%). Mean daily use was 2.1 (SD 1.8) hours, with 10.0% (180/1803) reporting single sessions of ≥6 hours. This study provides the first systematic evidence of internet addiction in adolescents in Sri Lanka. The predominance of mild to moderate severity suggests an opportunity for early intervention.