Trends in adolescent sexual behavior, impact of information, and attitudes about HIV/AIDS in Portugal.

There is a recent decline in HIV in a significant number of countries due to the adoption of preventive sexual behaviors, which demonstrates that HIV reduction is possible. The goal of this research was to deepen knowledge of preventive sexual behavior in adolescents, including knowledge and attitudes about HIV/AIDS, and assessing whether they changed from 2002 to 2010. Data were collected through a self-administered questionnaire from the Portuguese sample of the Health Behavior in School-aged Children, a collaborative WHO study. The study provided national representative data of 10,587 Portuguese adolescents attending 8th and 10th grade. In terms of preventive behaviors, results showed an increasing trend regarding the percentage reporting first sexual intercourse at 14 years old or more and condom use at last intercourse and a stabilized trend concerning having had intercourse, contraceptive pill use at last intercourse and having had intercourse under the influence of alcohol or drugs. Nevertheless, results showed a systematic decreasing trend in terms of knowledge and attitudes. This suggested that sex education programs are still too limited to teaching sessions, strongly homogenized in their content and inadequate to enhance knowledge and attitudes regarding HIV, let alone personal and social skills of different target groups.

Portuguese adolescents: the importance of parents and peer groups in positive health.

The purpose of this study is to examine the influence of peer groups and parents on adolescents' health. It was examined how communication relationships with peer groups and parents affect youngsters life satisfaction, sadness, irritability, being nervous, fear and troubles in falling asleep. The sample was comprised of individuals that participated in the study in continental Portugal, integrating the European study HBSC - Health Behavior in School - aged Children. The study was made during January 2006 and included a total of 4,877 students attending the 6th, 8th and 10th grades from Portuguese public schools, with an average age of 14 years of age. The instrument used was the HBSC questionnaire. The results showed that adolescents' health is influenced by their relationship with their parents and peers. When the communication with both is easy, youngsters are more satisfied with life and have less health negative symptoms. When compared with peers, parents influence positively the adolescents' health.

PROTEIN AI Advisor: A Knowledge-Based Recommendation Framework Using Expert-Validated Meals for Healthy Diets.

AI-based software applications for personalized nutrition have recently gained increasing attention to help users follow a healthy lifestyle. In this paper, we present a knowledge-based recommendation framework that exploits an explicit dataset of expert-validated meals to offer highly accurate diet plans spanning across ten user groups of both healthy subjects and participants with health conditions. The proposed advisor is built on a novel architecture that includes (a) a qualitative layer for verifying ingredient appropriateness, and (b) a quantitative layer for synthesizing meal plans. The first layer is implemented as an expert system for fuzzy inference relying on an ontology of rules acquired by experts in Nutrition, while the second layer as an optimization method for generating daily meal plans based on target nutrient values and ranges. The system's effectiveness is evaluated through extensive experiments for establishing meal and meal plan appropriateness, meal variety, as well as system capacity for recommending meal plans. Evaluations involved synthetic data, including the generation of 3000 virtual user profiles and their weekly meal plans. Results reveal a high precision and recall for recommending appropriate ingredients in most user categories, while the meal plan generator achieved a total recommendation accuracy of 92% for all nutrient recommendations.

Users' Perspective on the AI-Based Smartphone PROTEIN App for Personalized Nutrition and Healthy Living: A Modified Technology Acceptance Model (mTAM) Approach.

The ubiquitous nature of smartphone ownership, its broad application and usage, along with its interactive delivery of timely feedback are appealing for health-related behavior change interventions via mobile apps. However, users' perspectives about such apps are vital in better bridging the gap between their design intention and effective practical usage. In this vein, a modified technology acceptance model (mTAM) is proposed here, to explain the relationship between users' perspectives when using an AI-based smartphone app for personalized nutrition and healthy living, namely, PROTEIN, and the mTAM constructs toward behavior change in their nutrition and physical activity habits. In particular, online survey data from 85 users of the PROTEIN app within a period of 2 months were subjected to confirmatory factor analysis (CFA) and regression analysis (RA) to reveal the relationship of the mTAM constructs, i.e., perceived usefulness (PU), perceived ease of use (PEoU), perceived novelty (PN), perceived personalization (PP), usage attitude (UA), and usage intention (UI) with the users' behavior change (BC), as expressed via the acceptance/rejection of six related hypotheses (H1-H6), respectively. The resulted CFA-related parameters, i.e., factor loading (FL) with the related p-value, average variance extracted (AVE), and composite reliability (CR), along with the RA results, have shown that all hypotheses H1-H6 can be accepted (p < 0.001). In particular, it was found that, in all cases, FL > 0.5, CR > 0.7, AVE > 0.5, indicating that the items/constructs within the mTAM framework have good convergent validity. Moreover, the adjusted coefficient of determination (R 2) was found within the range of 0.224-0.732, justifying the positive effect of PU, PEoU, PN, and PP on the UA, that in turn positively affects the UI, leading to the BC. Additionally, using a hierarchical RA, a significant change in the prediction of BC from UA when the UI is used as a mediating variable was identified. The explored mTAM framework provides the means for explaining the role of each construct in the functionality of the PROTEIN app as a supportive tool for the users to improve their healthy living by adopting behavior change in their dietary and physical activity habits. The findings herein offer insights and references for formulating new strategies and policies to improve the collaboration among app designers, developers, behavior scientists, nutritionists, physical activity/exercise physiology experts, and marketing experts for app design/development toward behavior change.

Assistive HCI-Serious Games Co-design Insights: The Case Study of i-PROGNOSIS Personalized Game Suite for Parkinson's Disease.

Human-Computer Interaction (HCI) and games set a new domain in understanding people's motivations in gaming, behavioral implications of game play, game adaptation to player preferences and needs for increased engaging experiences in the context of HCI serious games (HCI-SGs). When the latter relate with people's health status, they can become a part of their daily life as assistive health status monitoring/enhancement systems. Co-designing HCI-SGs can be seen as a combination of art and science that involves a meticulous collaborative process. The design elements in assistive HCI-SGs for Parkinson's Disease (PD) patients, in particular, are explored in the present work. Within this context, the Game-Based Learning (GBL) design framework is adopted here and its main game-design parameters are explored for the Exergames, Dietarygames, Emotional games, Handwriting games, and Voice games design, drawn from the PD-related i-PROGNOSIS Personalized Game Suite (PGS) (www.i-prognosis.eu) holistic approach. Two main data sources were involved in the study. In particular, the first one includes qualitative data from semi-structured interviews, involving 10 PD patients and four clinicians in the co-creation process of the game design, whereas the second one relates with data from an online questionnaire addressed by 104 participants spanning the whole related spectrum, i.e., PD patients, physicians, software/game developers. Linear regression analysis was employed to identify an adapted GBL framework with the most significant game-design parameters, which efficiently predict the transferability of the PGS beneficial effect to real-life, addressing functional PD symptoms. The findings of this work can assist HCI-SG designers for designing PD-related HCI-SGs, as the most significant game-design factors were identified, in terms of adding value to the role of HCI-SGs in increasing PD patients' quality of life, optimizing the interaction with personalized HCI-SGs and, hence, fostering a collaborative human-computer symbiosis.

Body image and subjective well-being in Portuguese adolescents.

The study examines the impact of body image in adolescents' well-being. Well-being was assessed with the scale Kidscreen10, with the Cantril ladder for satisfaction with life and with an ad hoc happiness scale. The study presents data on adolescent health from the Health Behavior in School-aged Children (HBSC)/World Health Organization study in Portugal (2006), with a sample of 4,877 adolescents, average age of 14 years old and gender distribution at 49,6% males. Portuguese adolescents showed differences between gender and age group regarding their body image-related satisfaction/dissatisfaction and self-perceived body image, being that both components have a direct impact on the levels of well-being. The male gender has better results in the perception of body image and, consequently, well-being. The largest inter-gender differences for well-being is at 15 years of age. The main predictors of well-being are the look and body satisfaction/dissatisfaction, with greater importance on the affective component. This research highlights the importance of body image for adolescents' well-being, as well as to prepare educational strategies adapted to adolescents' age and gender, by helping them to develop skills concerning self-knowledge and caring for their look.

How can peer group influence the behavior of adolescents: explanatory model.

The current work aims to study both the peer group and family influence on adolescent behaviour. In order to achieve the aforementioned objective, an explanatory model based on the Structural Equations Modelling (SEM) was proposed. The sample used was the group of adolescents that participated in the Portuguese survey of the European study Health Behaviour in School-aged Children (HBSC). The Portuguese survey included students from grades 6, 8 and 10 within the public education system, with an average age of 14 years old (SD=1.89). The total sample of the HBSC study carried out in 2006 was 4,877; however with the use of the SEM, 1,238 participants were lost out of the total sample. The results show that peers have a direct influence in adolescents' risk behaviours. The relationship with parents did not demonstrate the expected mediation effect, with the exception of the following elements: relation between type of friends and risk behaviour; and communication with parent and lesser involvement in violence behaviours and increased well-being. The negative influence of the peer group is more connected to the involvement in risk behaviours, whilst the positive influence is more connected with protective behaviours.

Information and attitudes about HIV/AIDS in Portuguese adolescents: state of art and changes in a four year period.

The incidence of infection with HIV/AIDS among the heterosexual population has been increasing in young adults. The goal of this research was to deepen knowledge of preventive sexual behavior in Portuguese adolescents, including knowledge and attitudes about HIV/AIDS, and assessing whether they changed from 2002 to 2006. Data were collected through a self-administered questionnaire from the Portuguese sample of the Health Behavior in School-aged Children (HBSC), a collaborative WHO study. The study provides national representative data of 7093 Portuguese adolescents, randomly chosen from those attending 8th and 10th grade of high school. Results showed there was an increase in the age of first sexual intercourse and a decrease in the number of teenagers who reported having had sexual intercourse, also in the level of information regarding HIV/AIDS transmission/prevention and in positive attitudes towards people with HIV/AIDS. In general, adolescents have good knowledge about how to protect themselves from becoming infected. However, comparing to 2002, there was a reduction of knowledge and consequent increase in the doubts regarding HIV/AIDS. Given the incipient state of sex education in 2006, the results cannot be attributed to sex education, but they will be relevant for comparison with the 2010 HBSC results.

Processo adolescente e saúde positiva: âmbitos afectivo e cognitivo / Adolescent process and positive health: affective and cognitive scope

Os adolescentes portugueses percepcionam-se prevalentemente como saudáveis. Questiona-se se nesta percepção tem mais relevo a componente afectivo-emocional ou a componente cognitiva da saúde positiva. Este estudo fixou-se nas medidas sobre a auto-percepção da qualidade de vida relacionada com a saúde, sobre a satisfação com a vida e sobre a felicidade, enquanto variáveis de cariz afectivo-emocional e de índole cognitiva. Procurou-se perceber a influência do género, da idade, do nível socioeconómico e do nível de instrução da família nos índices da saúde positiva dos adolescentes portugueses. Utilizaram-se dados da amostra portuguesa do estudo Health Behaviour in School-Aged Children 2006 constituída por 4877 adolescentes, com uma média de idade de 14 anos, 49,6 por cento do género masculino e 50,4 por cento do género feminino. Após análise estatística descritiva, procedeu-se à comparação de médias entre grupos e à regressão linear para delinear os factores preditores de cada variável. Em todos os âmbitos do estudo observa-se uma maior relevância da dimensão afectivo-emocional na percepção do índice de saúde positiva dos adolescentes portugueses.

Portuguese adolescents perceive themselves prevailingly as healthy subjects. It is questioned whether, in this perception, the affective-emotional component or the cognitive component of the positive health has more relevance. This study focused on the measures of quality of life self-perception related to health, satisfaction with life and happiness as variables of cognitive and affective-emotional nature. It was sought to perceive the influence of gender, age, socio-economic and family instruction level on the index of positive health of the Portuguese adolescents. Data from the Portuguese sample of the study on Health Behavior in School-Aged Children 2006 were used. The sample is made up by 4877 adolescents, with an average age of 14 years old, 49.6 percent male and 50.4 percent female. After analyzing the descriptive statistics, it was proceeded the comparison of averages between the groups and the linear regression to design the predictor factors of each variable. In all the scopes of the study, it was observed a particular distinctness in the perception of the index of positive health by the Portuguese adolescent.

A influência da comunicação com a família e grupo de pares no bem-estar e nos comportamentos de risco nos adolescentes Portugueses / The influence of communication with family and peer group on well-being and risky behavior of Portuguese adolescents

O objectivo do presente estudo foi analisar a influência e o impacto dos pais e do grupo de pares nos comportamentos de saúde e risco dos adolescentes portugueses. Para isso, estudou-se o tipo de comunicação que os adolescentes mantêm com os pais e com os pares. A amostra foi constituída pelos sujeitos participantes no estudo realizado em Portugal Continental, que integra o estudo Europeu HBSC-Health Beaviour in School-aged Children. O estudo incluiu um total de 4877 estudantes do 6º, 8º e 10º ano de escolaridade de escolas públicas portuguesas, com média de idades igual a 14 anos. Os resultados revelaram que uma boa comunicação com os pais tem um maior efeito protector sobre os comportamentos de risco do que uma boa comunicação com os amigos. Adolescentes com boa comunicação com os pais e amigos revelaram serem mais felizes e satisfeitos com a vida. Os resultados encontrados salientam a importância da comunicação e do relacionamento positivo com os pais e com os pares simultaneamente.

The purpose of this study was to analyze the influence of parents and peer group on health and risky behaviors of Portuguese adolescents. It was studied the type of communication that adolescents have with their parents and with peers. The sample consisted of subjects who participated in a study performed in Portugal, which incorporates the European HBSC-Health Behavior in School-aged Children study. The study included a total of 4.877 students in 6th, 8th and 10th grades of public school in Portugal, with an average age of 14 years old. The overall results revealed that good communication with parents has a more protective effect on adolescents' risky behavior than good communication with friends. Adolescents with closer and better communication with their parents and friends have also revealed to have a happier and more pleased life. The results highlight the importance of communication and positive relationship simultaneously with parents and peers.