Modalidades de administración de un cuestionario referido a hábitos de salud bucal: análisis de concordancia / Modalities for the administration of a questionnaire on oral health habits: a concordance analysis

Objetivo: Analizar las diferencias entre dos modali-dades de administración de un instrumento, autoad-ministrado o guiado por un investigador, aplicados a tutores legales de infantes de una institución educa-tiva. Materiales y Métodos: muestra de 130 tutores legales de niños/as (3 y 5 años) pertenecientes a un jardín de infantes municipal de Avellaneda. Se aplicó un instrumento de recolección de datos sobre hábi-tos de salud bucal constituido por 14 preguntas sim-ples, múltiples y cerradas. La entrega y devolución del instrumento fue a través de la institución. A los 2 meses se convocó a la misma población para comple-tar el mismo instrumento guiado por un investigador. Se evaluó: porcentajede concurrentes e instrumen-tos respondidos totalmente (modalidad autoadminis-trada), porcentaje de concurrentes que completaron el instrumento guiado y concordancia total y por res-puesta de las 2 modalidades. Se analizaron frecuen-cias y porcentajes. Para comparar la concordancia se utilizó Kappa global y Kappa de Cohen para cada pregunta. Resultados: 76,9% de tutores legales res-pondieron en la modalidad autoadministrada y 48,5% la guiada por el investigador. El 80,0% respondió la totalidad de las preguntas del instrumento autoad-ministrado. Al comparar las respuestas para ambas modalidades, no se observaron diferencias signifi-cativas en la totalidad de las mismas. Al analizar las respuestas solo 3 de las 14 preguntas tuvieron una concordancia menor (0,70). Conclusión: Para la po-blación estudiada, la forma autoadministrada tuvo mayor tasa de respuesta que la guiada por un inves-tigador, sin que se registren diferencias en las res-puestas de ambas formas de administración (AU)

Objective: Analyze the differences between two methods of administration of an instrument, self-administered or guided by a researcher, applied to legal guardians of infants in an educational institution. Materials and Methods: Population 130 legal guardians of children (3 and 5 years old) belonging to a municipal kindergarten in Avellaneda. A data collection instrument on oral health habits was applied, consisting of 14 simple, multiple, and closed questions. The delivery and return of the instrument was through the institution. After 2 months, the same population was called to complete the same instrument guided by a researcher. The following were evaluated: percentage of participants and instruments fully answered (self-administered mode), percentage of participants who completed the guided instrument. The total and response agreement of the 2 modalities was evaluated. Frequencies and percentages were analyzed. To compare agreement, global Kappa was used, and Cohen's Kappa was used for each question. Results: 76.9% of legal guardians responded to the self-administered modality and 48.5% to the one guided by the researcher. 80.0% answered all the questions of the self-administered instrument. When comparing the responses for both modalities, no significant differences were observed in all of them. When analyzing the answers, only 3 of the 14 questions had a lower agreement (0.70). Conclusion: For the population studied, the self-administered form had a higher response rate than the one guided by a researcher, with no differences recorded in the responses of both forms of administration (AU)

Mediating Effects of the COVID-19 Pandemic on the Associations between Physical Activity and Physical Fitness; Cross-Sectional Study among High School Adolescents.

The COVID-19 pandemic and the imposed social distancing measures caused negative changes in physical activity levels (PALs) and physical fitness (PF) among adolescents, but the potential mediating effect of the pandemic on the association between PAL and PF is unknown. This study aimed to evaluate gender-specific associations between objectively measured PAL and indices of PF among high school adolescents during the period of the COVID-19 pandemic. The participants were 150 adolescents (101 females) aged 14-18 years; their anthropometrics were evaluated, and they were tested on PF (cardiorespiratory fitness (CRF; beep test), power (broad jump), flexibility (sit-and-reach test), and abdominal strength (sit-ups)) and PAL (using a pedometer for 7 days) during the pandemic period. A T-test was calculated to determine differences between genders. Associations between variables were evaluated using Pearson correlations. Additionally, multivariate taxonomic classification was used to sort participants into homogenous groups (clusters) according to their PF, and then analysis of variance (ANOVA) was performed to differentiate them according to PAL. For the total sample, PAL was correlated with CRF only (R = 0.25, p < 0.05), while gender-stratified correlations showed that PAL was significantly associated with CRF among girls only (R = 0.29, p < 0.05), which was additionally confirmed with multivariate cluster analysis and subsequent ANOVA. No association between PAL and PF was found for boys. The relatively low association between PAL and PF is most likely related to the mediating effect of the change in life circumstances during the COVID-19 pandemic, and limited applicability of pedometers in evaluating high-intensity PAL. Further studies in other age groups and environments are warranted.

Health-promoting domains and lifestyle of a sample of Brazilian adolescents.

BACKGROUND: Reports indicate that the health habits of adults are strongly linked to the behaviors incorporated in adolescence. Therefore, it is essential to monitor the lifestyle of adolescents to promote their present and future health. This study aimed to identify differences in health-promoting domains according to demographic data and lifestyle behaviors, including physical activity, sedentary behavior, sleep duration, and food intake, in a sample of Brazilian adolescents. MATERIALS AND METHODS: Cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire was applied with structured questions to collect demographic data and lifestyle behaviors. To examine the health-promoting domains the Adolescent Health Promotion Scale (AHPS) was used. Data were analyzed using multivariate analysis. RESULTS: Scores attributed to each of the health-promoting domains showed substantial variations according to sex, age, year of study, parents' schooling, and family economic class. After adjustment for covariables, the adolescent who presented significantly higher scores equivalent to the overall index of health promotion reported being more physically active (F = 4.848; P = 0.009), sleeping 6-8 hours/night (F = 2.328; P = 0.046), consuming fruit/vegetable more frequently (F = 3.168; P = 0.024), while sedentary behavior and intake of sweetened products/soft drinks have not shown any significant effect. CONCLUSION: The findings confirmed the consistent positive influence of health-promoting domains assessed by AHPS on healthy lifestyle behaviors, suggesting in the intervention programs aimed at adopting healthy lifestyle approaches it is important enough to contemplate actions aimed at all the areas of health promotion with characteristics aimed at nutrition behavior, social support, health responsibility, life appreciation, exercise behavior, and stress management.

Impact of an Interdisciplinary Educational Programme on Students' Physical Activity and Fitness.

Educational initiatives and actions are needed to provide students with skills to create active habits and lifestyles in order to increase the physical activity and fitness levels of young people. The main objective of this study was to analyse the effects of a classroom-based physical activity and life skills programme on students' physical activity and fitness levels. The sample consisted of 65 students in the 6th grade of Primary Education, aged between 11 and 13 years (11.86 ± 0.53), divided into a control group (CG) and an experimental group (EG) for convenience and accessibility. This was a quasi-experimental, repeated measures, longitudinal cut-off research design. For 16 weeks, an interdisciplinary educational programme based on a combination of classroom-based physical activity and life skills was implemented. The results showed that the educational programme had a positive effect on students' physical activity levels during school hours, specifically on reducing sedentary time (p < 0.001) and increasing light (p < 0.001) and moderate-to-vigorous (p < 0.001) physical activity. Positive effects were also found on the variables of explosive strength (p < 0.05) and aerobic capacity (p < 0.05) related to physical fitness. In conclusion, interdisciplinary educational programmes based on the promotion of physical activity and life skills could contribute to the development of responsible daily physical activity habits in students to facilitate their transfer to other environments (social and family) outside school.

Valoración del estilo de vida saludable adquirido en adultos españoles de 22 a 72 años de edad / Health-related lifestyle assessment among Spanish adults from 22 to 72 years

Objetivo: El objetivo de la presente investigación se ha centrado en evaluar el nivel del estilo de vida saludable adquirido en adultos españoles de las ciudades españolas de Albacete y Murcia, y analizar las diferencias existentes en función del sexo y la edad. Material y métodos: Sobre una muestra de 788 sujetos de edades comprendidas entre los 22 y 72 años de edad se aplicó la Escala de Valoración del Estilo de Vida Saludable Adquirido, formada por 52 ítems y estructurada en 7 dimensiones que explicaron una varianza total de 66,87% y un alfa de Cronbach de 0,894. Resultados: El 12% de los adultos encuestados tenía un estilo de vida saludable, el 53% tendente hacia la salud y el 35% nada o poco saludable. Las pruebas de χ2 de Pearson y análisis de residuos muestran una asociación positiva y significativa de las mujeres a la salud y una tendencia a la mejora significativa del estilo de vida con el transcurso de la edad. Los datos inferenciales (pruebas t de Student y ANOVA de un factor) confirman estas diferencias en función del sexo y la edad. Conclusiones: Es necesario promover programas preventivos para la mejora de la salud en los hábitos de la población, sobre todo en el 35% que posee un nivel poco o nada saludable en su estilo de vida.(AU)

Objective: The objective of this paper has focused on assessing the level of health-related lifestyle acquired in Spanish adults in the Spanish cities of Albacete and Murcia, and analyzing the existing differences according to sex and age. Material and methods: On a sample of 788 subjects aged between 22 and 72, the Health-related Lifestyle Assessment Scale was applied, consisting of 52 items and structured in 7 dimensions that explained a total variance of 66.87% and a Cronbach's alpha of 0.894. Results: A percentage of 12 of the adults surveyed have a healthy lifestyle, 53% show a trend to health and 35% poor or unhealthy. Pearson's χ2 tests show a positive and significant association of women with health and a trend of significant improvement in lifestyle with age. The inferential data (t-Student tests and one-factor ANOVA) confirm these differences according to gender and age. Conclusions: It is necessary to promote preventive programs to improve health in the habits of the population, especially in the 35% that show a poor or unhealthy level of lifestyle.(AU)

Association between age of first exposure and heavy internet use in a representative sample of 317,443 adolescents from 52 countries.

Internet usage among adolescents has increased substantially over the last years, concurrently with emerging concerns that an abusive use is associated with detrimental health outcomes. Our objective was to examine the association between age of first exposure and heavy Internet usage in different domains. Data from the 2018 wave of the Programme for International Student Assessment (PISA) were retrieved. This included a total of 317,443 participants (49.2% boys) aged 15 and 16 years from 52 countries. Data from both Internet use and age of first exposure were retrieved and used to conduct metanalyses with random effects. Adolescents reporting an age of first exposure of Internet usage at ≥ 13 years old had the lowest odds for heavy Internet use (> 2 h/day) (reference group: ≤ 9 years) during weekends (odds ratio, 0.41 [95% CI, 0.35-0.48]), weekdays (odds ratio, 0.45 [95% CI, 0.37-0.56]), and during school time (odds ratio (odds ratio, 0.86 [95% CI, 0.77-0.96]) even when adjusted for sex, socioeconomic status, and country. A stronger association was observed in adolescents from South and Central America and Eastern Mediterranean regions in the domain of weekends and weekdays. The results indicate that early internet exposure is associated with heavy Internet use, particularly during weekends and weekdays, regardless the geographical region, in a linear fashion. Further research should aim to examine if better education and parental control in specific areas may avoid excessive Internet use that possibly have a negative influence on both mental and physical health.

Health-related lifestyle assessment among Spanish adults from 22 to 72 years. / Valoración del estilo de vida saludable adquirido en adultos españoles de 22 a 72 años de edad.

OBJECTIVE: The objective of this paper has focused on assessing the level of health-related lifestyle acquired in Spanish adults in the Spanish cities of Albacete and Murcia, and analyzing the existing differences according to sex and age. MATERIAL AND METHODS: On a sample of 788 subjects aged between 22 and 72, the Health-related Lifestyle Assessment Scale was applied, consisting of 52 items and structured in 7 dimensions that explained a total variance of 66.87% and a Cronbach's alpha of 0.894. RESULTS: A percentage of 12 of the adults surveyed have a healthy lifestyle, 53% show a trend to health and 35% poor or unhealthy. Pearson's χ2 tests show a positive and significant association of women with health and a trend of significant improvement in lifestyle with age. The inferential data (t-Student tests and one-factor ANOVA) confirm these differences according to gender and age. CONCLUSIONS: It is necessary to promote preventive programs to improve health in the habits of the population, especially in the 35% that show a poor or unhealthy level of lifestyle.

Participants stories about long-term achievement 60-months after attending a Healthy Life Centre programme (the VEND-RISK study) - a qualitative study.

BACKGROUND: Experiences of long-term achievement in participants attending programs for changing health habits including diet and physical activity interventions aiming for weight reduction is lacking. This study aimed to explore how participants experienced their own achievement of healthy habits 60 months after attending a Healthy Life Centre programme in the Norwegian primary healthcare. METHODS: An explorative qualitative design with an inductive approach was employed. Individual semi-structured interviews were performed with 20 participants attending a Healthy Life Centre programme 60 months ago. They were aged 30-72 years, and 55% were females. Interviews were transcribed verbatim and analysed thematically using systematic text condensation. RESULTS: Two main themes emerged from the interviews with three subthemes each. The first theme "Changes over time" includes "Nutritional changes", "Physical activities adjusted to own presumptions" and "Health habits incorporated into life with manageable goals". The second theme "Barriers to fulfil changes" includes "Life circumstances with health issues influences the continuity to adjust to changes", "a busy everyday life" and "a lack of external drive when not having commitment to the Healthy Life Centre". CONCLUSIONS: Focusing on changes adjusted to participants' own everyday lives and having an approach with small goals can facilitate long-term changes in health habits.

Introduction of a conversation starter tool to improve health habits in young children.

BACKGROUND: Childhood overweight and obesity rates in the United States continue to climb. Providers must identify feasible interventions to improve health habits to prevent and treat obesity in children. METHODS: Parents (n = 91) of four-to eight-year-old children were recruited and surveyed regarding their child's current health habits and perception of their child's weight status. A conversation starter tool was developed and utilized to improve health habits in children ages four-to-eight over a period of four-to-six weeks. FINDINGS: Health habits in children improved in the comparison and intervention groups. There was a 42% improvement in health habits in the intervention group who chose a specific goal to work on compared to 30% improvement in the comparison group. There was no statistically significant relationship between health habit adherence and the assigned group when assessing the health habits individually. DISCUSSION: Overall, 42% of the selected goals were met, according to parent report at the follow-up survey; however, use of the conversation starter tool did not demonstrate statistically significant improvement in health habits. Parental perception of children's weight status remained unchanged. Health habits in children improved in the comparison and intervention groups. Further studies should enroll a larger sample to assess differences between these two groups. APPLICATION TO PRACTICE: The conversation starter tool was designed to be implemented into practice without the need for any specific training. The tool can be used on all children to promote improved health habits.

Attitudes towards Tattoos among Spanish Health Science Students.

(1) Background: The aim is to ascertain health science students' attitudes towards tattoos and their association with healthy lifestyles and socio-demographic variables. (2) Methods: Descriptive study conducted on pharmacy, medical and nursing students (n = 423). To ascertain attitudes towards tattoos, we used the Attitudes Towards Tattoos Scale. Other variables were physical activity, healthy diet, harmful habits and socio-demographic variables. (3) Results: A total of 12.6% (95% CI 9.1−16.2) of students reported having a tattoo; 58.9% did not regard tattoos as a health risk. In terms of attitudes, the mean score in the range of 7−35 (7­most unfavourable to 35­most favourable) was 22.6 (SD 5.2; 95% CI: 22.0−23.2). Scores were higher (p < 0.05) among women (23.1; SD: 5.3), persons aged <20 years (23.6; SD: 5.0) and smokers (23.9; SD: 4.6). Attitudes were found to be more favourable (p < 0.05) in nursing students than in pharmacy or medical students. No relationship was observed with physical activity, healthy diet or drug use. (4) Conclusions: The attitude to tattoos is most favourable among women, persons aged under 20 years and nursing students. In terms of health habits, attitudes are more favourable among smokers, regardless of their level of physical activity, compliance with healthy eating guidelines or consumption of alcohol or other drugs.

Service Learning Experience on Health Habits in High School Students Conducted by Nursing Students: A Qualitative Design.

Service learning is a teaching methodology that combines learning and service to the community in the same well-articulated project, where the participants are trained to improve and work on the real needs of the environment. This paper aimed to explore learning about healthy habits and standards of nursing professional practice through a service learning activity between nursing students and high school students. Data of participants (N = 127 high school students and N = 12 nursing students) were collected by the high school students' healthy habits mind map and with the help of the nursing students' reflective journals. A generic qualitative design using content analysis was performed. After the activity, high school students identified which habits they should improve, such as diet, physical activity, resting time, and emotional health. By performing the activity, nursing students increased their knowledge about health habits, as well as their communication skills, confidence in public speaking, and awareness about community nurses' tasks. Service learning activity on health habits conducted by nursing students in a high school has a positive effect on the knowledge of healthy habits for both participants, nursing and high school students. Participating in an activity of service learning improves communication skills among first-year nursing students and narrows the gap between university theory and nursing practice.

Adherence to Combined Healthy Movement Behavior Guidelines among Adolescents: Effects on Cardiometabolic Health Markers.

BACKGROUND: The combined movement behavior guidelines for adolescents recommend ≥60 min of moderate to vigorous physical activity, ≤2 h of screen time, and 8-10 h of sleep. Considering that the information available on this topic in the young Latin American population is rare, this study aimed to identify the proportion of a sample of Brazilian adolescents meeting individual guidelines as well as the combination of the three healthy movement behavior guidelines. In addition, another objective of the study was to examine the effects of compliance with these guidelines on cardiometabolic health markers. METHODS: This is a cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire with structured questions was applied to collect data on physical activity, screen time, and sleep duration. Cardiometabolic health was assessed by the calculation of a continuous risk score, including twelve markers related to body fat, blood pressure, plasma lipids and lipoproteins, glycemia, and insulin. RESULTS: Only 4.8% (4.3-5.4) of the adolescents met the three healthy movement behavior guidelines, while 9.3% (8.4-10.4) of the sample did not meet any of the guidelines. No significant difference between sexes was found in the simultaneous compliance of the three movement guidelines. Adolescents who did not meet any of the movement guidelines were twice as likely to have higher cardiometabolic risk (OR = 2.05 (1.41-3.17)) than their peers who met all three guidelines. CONCLUSIONS: Considering the high proportion of adolescents who did not meet the movement behavior guidelines and the negative effects on cardiometabolic health, it is suggested that future policies and interventions should consider an integrated and holistic approach aimed at simultaneous actions of maximizing physical activity, minimizing screen time, and ensuring sufficient sleep duration.

HABIT (Health visitors delivering Advice in Britain on Infant Toothbrushing): a qualitative exploration of the acceptability of a complex oral health intervention.

BACKGROUND: To explore the acceptability of the oral health intervention, HABIT (Health visitors delivering Advice in Britain on Infant Toothbrushing) to parents with young children aged 9-12 months and health visitors. METHODS: Following the delivery of the universal oral health intervention called HABIT, qualitative semi-structured interviews with parents and focus groups with health visitors were undertaken. Interviews were audio-recorded and transcribed. Health visitors completed self-reported diaries after delivering the HABIT intervention with parents. The qualitative data was analysed using framework analysis (guided by a theoretical framework of acceptability). RESULTS: Seventeen parents were interviewed, and five health visitors and three nursery nurses participated in two focus groups. Parents reported health visitors to be 'trusted' and valued the reassurance provided during the HABIT visit. Health visitors found the HABIT training and resources useful and valued the consistency and increased confidence in undertaking oral health conversations. There were, however, challenges in changing behaviour where families faced competing demands on time and resources. Both health visitors and parents described the importance of the intervention's timing and suggested that multiple visits may be needed to support optimal oral health habits. CONCLUSION: The HABIT intervention was acceptable to parents and health visitors. Health visitors would welcome a further refinement to enhance intervention delivery that specifically achieves a balance between using a guided script and retaining the flexibility to adapt the conversation to suit the needs of individual families. This, in turn, will maximise impact and enable parents of young children to adopt and maintain optimal home-based oral health behaviours for their child.

A Comparative Cross-Sectional Study of the Consequences of the COVID-19 Lockdown on Women's Health Behaviors in Spain.

Changes in health habits were observed during the COVID-19 pandemic. An unequal distribution of responsibilities may have generated unequal levels of stress in men and women, and, therefore, this may have led to different impacts on their health habits during lockdown. This study aimed to analyze the changes in eating habits, physical activity, sleep, and body weight in women, compared to men, because of lockdown. A comparative cross-sectional study was carried out. 2834 Spanish volunteers aged 19 to 76 completed an online survey on health habits. Descriptive and inferential analyses were performed using a cross-sectional methodology to explore gender differences. Results showed that men maintained their health habits to a greater extent, performing the same physical activity, while maintaining the quantity and quality of sleep, the quality of the diet, the quantity of the intake, and their mealtimes and body weight, whereas women's eating habits changed in relation to the quality of their diet and mealtimes, as their food intake and weight increased, and their sleep was poorer in quality and duration than it was before lockdown. This could be due to the higher levels of anxiety experienced by women as a result of working on essential jobs in addition to taking on more unpaid work associated with care and housework.

Resilience in late adolescence/young adulthood: Rising to the occasion?

The developmental period of late adolescence/young adulthood is characterized by transitioning to an independent individual with a self-identity, established health habits and the components of resilience: (1) confidence in one's abilities (personal competence) and (2) the ability to adapt to changes (acceptance of self and life). This two-wave, prospective study examines the associations among self-identity, health habits and resilience in 18 year olds (n = 149) before military service and six months afterward. The questionnaire included validated scales of resilience and self-identity, as well as instruments measuring health habits, family environment and demographic characteristics. Cross-sectional findings indicated that resilience at baseline was associated with gender-male (p < .05), lower distress (p < .001) and higher identity-affirmation/belonging (p < .05). Longitudinal findings showed that resilience was associated with changes of distress (p < .05) and the resilience component of personal competence (p < .001). Cross-sectional and longitudinal perspectives on 18-year-old military recruits portrayed different pictures. The cross-sectional findings showed that resilience was associated with lower distress and higher feelings of affirmation/belonging (self-identity); however, longitudinal findings showed that resilience was predicted by the ability to adapt to changes under stress. Resilient 18 year olds demonstrated the ability to adapt to stressful situations, but psychological distress may impede the development of self-identity.

COVID-19 Confinement and Sexual Activity in Spain: A Cross-Sectional Study.

Restrictions of free movement have been proven effective in tackling the spread of COVID-19 disease. However, sensitive populations submitted to longer periods of restrictions may experience detrimental effects in significant areas of their lifestyle, such as sexual activity. This study examines sexual activity during the COVID-19 confinement in Spain. A survey distributed through an institutional social media profile served to collect data, whereas chi-squared tests, t-tests, analyses of variance, and multiple logistic regression analysis were used to assess differences among sample subgroups. A total of 71.3% adults (N = 536) (72.8% female) reported engaging in sexual activity with a weekly average of 2.39 times (SD = 1.80), with significant differences favoring males, middle age, married/in a domestic relationship (p < 0.001), employed (p < 0.005), medium-high annual household income, living outside the Iberian Peninsula, and smoking and alcohol consumption. Analyses adjusted for the complete set of control variables showed significant odds for a lower prevalence of weekly sexual activity in women (OR = 0.44, 95% CI 0.27-0.72). Interventions to promote sexual activity in confined Spanish adults may focus on groups with lower sexual activity.

Physical Sports Activities and Exercise Addiction during Lockdown in the Spanish Population.

The coronavirus disease 2019 (COVID-19) pandemic has led to the paralysis of the worldwide economy caused by the population's lockdown to stop the virus spreading, making it difficult to do exercise. The aim of this study is to analyse the commitment to and feeling of insecurity related to practising sport, sports habits and the profile of the Spanish population during lockdown according to the level of addiction to exercise. The sample consisted of 1019 subjects with a mean age of 35 years old. The variables analysed were exercise addiction, commitment to and feeling of insecurity related to sport, and sport habits. Three groups were identified according to their addiction level to exercise: asymptomatic (n = 202), symptomatic (n = 756), and at risk of addiction (n = 61). The main results indicated that a higher addiction level was associated with a higher number of days and time spent on exercise per week. Six percent of the subjects were at addiction risk, and they had a lower feeling of insecurity towards sport. These findings provide information to governments on the need to promote physical activity programmes at home to promote adequate fitness and mental wellbeing in the population.

The value of Bayesian predictive projection for variable selection: an example of selecting lifestyle predictors of young adult well-being.

BACKGROUND: Variable selection is an important issue in many fields such as public health and psychology. Researchers often gather data on many variables of interest and then are faced with two challenging goals: building an accurate model with few predictors, and making probabilistic statements (inference) about this model. Unfortunately, it is currently difficult to attain these goals with the two most popular methods for variable selection methods: stepwise selection and LASSO. The aim of the present study was to demonstrate the use predictive projection feature selection - a novel Bayesian variable selection method that delivers both predictive power and inference. We apply predictive projection to a sample of New Zealand young adults, use it to build a compact model for predicting well-being, and compare it to other variable selection methods. METHODS: The sample consisted of 791 young adults (ages 18 to 25, 71.7% female) living in Dunedin, New Zealand who had taken part in the Daily Life Study in 2013-2014. Participants completed a 13-day online daily diary assessment of their well-being and a range of lifestyle variables (e.g., sleep, physical activity, diet variables). The participants' diary data was averaged across days and analyzed cross-sectionally to identify predictors of average flourishing. Predictive projection was used to select as few predictors as necessary to approximate the predictive accuracy of a reference model with all 28 predictors. Predictive projection was also compared to other variable selection methods, including stepwise selection and LASSO. RESULTS: Three predictors were sufficient to approximate the predictions of the reference model: higher sleep quality, less trouble concentrating, and more servings of fruit. The performance of the projected submodel generalized well. Compared to other variable selection methods, predictive projection produced models with either matching or slightly worse performance; however, this performance was achieved with much fewer predictors. CONCLUSION: Predictive projection was used to efficiently arrive at a compact model with good predictive accuracy. The predictors selected into the submodel - felt refreshed after waking up, had less trouble concentrating, and ate more servings of fruit - were all theoretically meaningful. Our findings showcase the utility of predictive projection in a practical variable selection problem.

Exploring use of activity monitors for patients with obesity during weight-loss treatment - a qualitative study.

BACKGROUND: Obesity is a major health concern in western countries. In Norway, patients with obesity can attend weight-loss programmes, which focus on changes in dietary and physical activity habits. Use of self-monitoring is advocated when changing dietary and physical activity habits for adults with obesity. This study aimed to explore the experiences of patients with obesity who used activity monitors while attending a weight-loss programme. METHODS: Patients with body mass index (BMI) > 35 kg/m2 with weight related comorbidities or a BMI > 40 kg/m2 referred to an intermittent weight-loss programme were recruited into this study. They were introduced to one of three different activity monitors, Fitbit Zip™, Mio Fuse™, or Mio Slice™. Semi-structured interviews were performed with patients six months into the weight-loss programme. Thematic analysis was applied when analysing the data. RESULTS: Of the 29 informants (aged 21 to 66 years) interviewed, 59% were female. Their experience with activity monitors was related to their adherence to the weight-loss programme. Two main themes emerged from the informants stories: 1. "Activity monitors visualize proof of effort or failure to change health habits". 2. "Activity monitors act as a positive or negative enforcer when incorporating change". CONCLUSIONS: Using activity monitors either strengthens or undermines patients' attempts to change health habits when attending a weight-loss program. Our findings suggest a need for more individualized weight-loss programmes for patients with obesity.