Development of a Protocol for Objectively Measuring Digital Device Use in Youth.

INTRODUCTION: Screen time is predominantly measured using questionnaires assessing a limited range of activities. This project aimed to develop a coding protocol that reliably identified screen time, including device type and specific screen behaviors, from video-camera footage. METHODS: Screen use was captured from wearable and stationary PatrolEyes video cameras in 43 participants (aged 10-14 years) within the home environment (May-December 2021, coding in 2022, statistical analysis in 2023). After extensive piloting, the inter-rater reliability of the final protocol was determined in 4 coders using 600 minutes of footage from 18 participants who spent unstructured time on digital devices. Coders independently annotated all footage to determine 8 device types (e.g., phone, TV) and 9 screen activities (e.g., social media, video gaming) using Observer XT (behavioral coding software). Reliability was calculated using weighted Cohen's κ for duration per sequence (meets criteria for total time in each category) and frequency per sequence (meets criteria for total time in each category and order of use) for every coder pair on a per-participant and footage type basis. RESULTS: Overall reliability of the full protocol was excellent (≥0.8) for both duration per sequence (κ=0.89-0.93) and the more conservative frequency per sequence (κ=0.83-0.86) analyses. This protocol reliably differentiates between different device types (κ=0.92-0.94) and screen behaviors (κ=0.81-0.87). Coder agreement ranged from 91.7% to 98.8% across 28.6-107.3 different instances of screen use. CONCLUSIONS: This protocol reliably codes screen activities in adolescents, offering promise for improving the understanding of the impact of different screen activities on health.

Initial Evidence of Variation by Ethnicity in the Relationship between Vitamin C Status and Mental States in Young Adults.

Higher fruit and vegetable intake has been associated with improved mood, greater vitality, and lower stress. Although the nutrients driving these benefits are not specifically identified, one potentially important micronutrient is vitamin C, an important co-factor for the production of peptide hormones, carnitine and neurotransmitters that are involved in regulation of physical energy and mood. The aim of our study was to investigate the cross-sectional relationship between blood plasma vitamin C status and mood, vitality and perceived stress. A sample of 419 university students (aged 18 to 35; 67.8% female) of various ethnicities (49.2% European, 16.2% East Asian, 8.1% Southeast/Other Asian, 9.1% Maori/Pasifika, 11.5% Other) provided a fasting blood sample to determine vitamin C status and completed psychological measures consisting of the Profile of Mood States Short Form (POMS-SF), the vitality subscale of the Rand 36-Item Short Form (SF-36), and the Perceived Stress Scale (PSS). Participants were screened for prescription medication, smoking history, vitamin C supplementation, fruit/juice and vegetable consumption, kiwifruit allergies, excessive alcohol consumption and serious health issues, and provided age, gender, ethnicity, and socioeconomic status information, which served as covariates. There were no significant associations between vitamin C status and the psychological measures for the sample overall. However, associations varied by ethnicity. Among Maori/Pasifika participants, higher vitamin C was associated with greater vitality and lower stress, whereas among Southeast Asian participants, higher vitamin C was associated with greater confusion on the POMS-SF subscale. These novel findings demonstrate potential ethnicity-linked differences in the relationship between vitamin C and mental states. Further research is required to determine whether genetic variation or cultural factors are driving these ethnicity differences.

The Big Three Health Behaviors and Mental Health and Well-Being Among Young Adults: A Cross-Sectional Investigation of Sleep, Exercise, and Diet.

BACKGROUND: Sleep, physical activity, and diet have been associated with mental health and well-being individually in young adults. However, which of these "big three" health behaviors most strongly predicts mental health and well-being, and their higher-order relationships in predictive models, is less known. This study investigated the differential and higher-order associations between sleep, physical activity, and dietary factors as predictors of mental health and well-being in young adults. METHOD: In a cross-sectional survey design, 1,111 young adults (28.4% men) ages 18-25 from New Zealand and the United States answered an online survey measuring typical sleep quantity and quality; physical activity; and consumption of raw and processed fruit and vegetables, fast food, sweets, and soda, along with extensive covariates (including demographics, socioeconomic status, body mass index, alcohol use, smoking, and health conditions) and the outcome measures of depressive symptoms [measured by the Center for Epidemiological Depression Scale (CES-D)] and well-being (measured by the Flourishing Scale). RESULTS: Controlling for covariates, sleep quality was the strongest predictor of depressive symptoms and well-being, followed by sleep quantity and physical activity. Only one dietary factor-raw fruit and vegetable consumption-predicted greater well-being but not depressive symptoms when controlling for covariates. There were some higher-order interactions among health behaviors in predicting the outcomes, but these did not survive cross-validation. CONCLUSION: Sleep quality is an important predictor of mental health and well-being in young adults, whereas physical activity and diet are secondary but still significant factors. Although strictly correlational, these patterns suggest that future interventions could prioritize sleep quality to maximize mental health and well-being in young adults.