Estimates Of Compliance Research Articles

Testing of New Drugs Approved From 2015 Through 2021 Under the US Pediatric Research Equity Act

This study uses public US Food and Drug Administration lists to identify new drugs approved from 2015 through 2021 to examine recent estimates of compliance with and timing of pediatric testing requirements after passage of the Pediatric Research Equity Act.

Muscle-Strengthening Activity among College Students: Who, What, Where, and Is It Enough?

ABSTRACT Introduction Muscle-strengthening activity (MSA) is recommended for all major muscle groups ≥2 d·wk−1. Assessment is often based on the number of days per week of MSA without determining if all major muscle groups are being used, precluding accurate determination of compliance with physical activity (PA) guidelines. Thus, characteristics of MSA remain inadequately characterized, especially among college students. Although it is known that males engage in more MSA than females across the lifespan, more detailed information regarding sex differences in this behavior is needed. The purpose of this study was to comprehensively describe MSA among male and female college students to a) characterize adherence to MSA guidelines according to frequency of MSA and number of muscle groups used, and b) explore sex differences in MSA. Methods College students (n = 651, 79.1% female, 20.3 ± 1.3 yr old) reported frequency of participation in MSA, muscle groups used, types of MSA performed, and location of MSA engagement via online questionnaires. The proportion of students meeting public health recommendations for MSA and characteristics of MSA participation were analyzed for the total sample and separately for male and female students. Results The proportion of students meeting MSA recommendations ranged from 9.8% to 52.7% depending on the minimum number of muscle groups required. Regardless of criteria, males were more likely to meet PA guidelines and reported more days of MSA, more muscle groups used, more types of MSA, and MSA at more locations than females (all P ≤ 0.05). Conclusions Estimates of compliance with MSA guidelines vary substantially depending upon the number of muscle groups required for compliance. Frequency of MSA and specific muscle groups worked should be included as part of MSA assessment to align with PA guidelines. Sex differences also influence MSA participation; thus, tailoring of messages and programming may improve MSA participation on college campuses.

Revisiting the OBS seafloor compliance signal removal with a stationarity and stacking-based approach: the BRUIT-FM toolbox

Summary This study focuses on improving the seafloor compliance noise removal method, which relies on estimates of the compliance transfer function frequency response (the deformation of the seafloor under long-period pressure waves). We first propose a new multi-scale deviation analysis of broadband ocean bottom seismometer data to evaluate stationarity properties that are key to the subsequent analysis. We then propose a new approach to removing the compliance noise from the vertical channel data, by stacking daily estimated transfer function frequency responses over a period of time. We also propose an automated transient event detection and data selection method based on a cross-correlation criterion. As an example, we apply the method to data from the Cascadia Initiative (network 7D2011). We find that the spectral extent of long-period forcing waves varies significantly over time so that standard daily transfer function calculation techniques poorly estimate the transfer function frequency response at the lowest frequencies, resulting in poor denoising performance. The proposed method more accurately removes noise at these lower frequencies, especially where coherence is low, reducing the mean deviation of the signal in our test case by 27 % or more. We also show that our calculated transfer functions can be transfered across time periods. The method should allow better estimates of seafloor compliance and help to remove compliance noise at stations with low pressure-acceleration coherence. Our results can be reproduced using the BRUIT-FM Python toolbox, available at https://gitlab.ifremer.fr/anr-bruitfm/bruit-fm-toolbox.

A simulation study of extrapolation uncertainty in exposure assessment – Use of pilot study results for site investigation

Accurate characterization of soil contaminant concentrations is often crucial for assessing risks to human and ecological health. However, fine-scale assessments of large tracts of land can be cost prohibitive due to the number of samples needed. One solution to this problem is to extrapolate sampling results from one area to another unsampled area. In the absence of a validated extrapolation methodology, regulatory agencies have employed policy-based techniques for large sites, but the likelihood of decision errors resulting from these extrapolations is largely unexplored. This study describes the results of a simulation study aimed at guiding environmental sampling for sites where extrapolation concepts are of interest. The objective of this study is to provide practical recommendations to regulatory agencies for extrapolating sampling results on large tracts of land while minimizing errors that are detrimental to human health. A variety of site investigation scenarios representative of environmental conditions and sampling schemes were tested using adaptive sampling when collecting discrete samples or applying incremental sampling methodology (ISM). These simulations address extrapolation uncertainty in cases where a Pilot Study might result in either false noncompliance or false compliance conclusions. A wide range of plausible scenarios were used that reflect the variety of heterogeneity seen at large sites. This simulation study demonstrates that ISM can be reliably applied in a Pilot Study for purposes of extrapolating the outcome to a large area site because it decreases the likelihood of false non-compliance errors while also providing reliable estimates of true compliance across unsampled areas. The results demonstrate how errors depend on the magnitude of the 95% upper confidence limit for the mean concentration (95UCL) relative to the applicable action level, and that error rates are highest when the 95UCL is within 10%–40% of the action level. The false compliance rate can be reduced to less than 5% when 30% or more of the site is characterized with ISM. False compliance error rates using ISM are insensitive to the fraction of the decision units (DUs) that are characterized with three replicates (with a minimum of 10 percent), so long as 95UCLs are calculated for the DUs with one replicate using the average coefficient of variation from the three replicate DUs.

Esophageal balloon catheter system identification to improve respiratory effort time features and amplitude determination

Objective. Understanding a patient’s respiratory effort and mechanics is essential for the provision of individualized care during mechanical ventilation. However, measurement of transpulmonary pressure (the difference between airway and pleural pressures) is not easily performed in practice. While airway pressures are available on most mechanical ventilators, pleural pressures are measured indirectly by an esophageal balloon catheter. In many cases, esophageal pressure readings take other phenomena into account and are not a reliable measure of pleural pressure. Approach. A system identification approach was applied to provide accurate pleural measures from esophageal pressure readings. First, we used a closed pressurized chamber to stimulate an esophageal balloon and model its dynamics. Second, we created a simplified version of an artificial lung and tried the model with different ventilation configurations. For validation, data from 11 patients (five male and six female) were used to estimate respiratory effort profile and patient mechanics. Main results. After correcting the dynamic response of the balloon catheter, the estimates of resistance and compliance and the corresponding respiratory effort waveform were improved when compared with the adjusted quantities in the test bench. The performance of the estimated model was evaluated using the respiratory pause/occlusion maneuver, demonstrating improved agreement between the airway and esophageal pressure waveforms when using the normalized mean squared error metric. Using the corrected muscle pressure waveform, we detected start and peak times 130 ± 50 ms earlier and a peak amplitude 2.04 ± 1.46 cmH2O higher than the corresponding estimates from esophageal catheter readings. Significance. Compensating the acquired measurements with system identification techniques makes the readings more accurate, possibly better portraying the patient’s situation for individualization of ventilation therapy.

The rationale behind updates to ambient ozone guidelines and standards.

Although air quality has gradually improved in recent years, as shown by the decrease in PM2.5 concentration, the problem of rising ambient ozone has become increasingly serious. To reduce hazards to human health and environmental welfare exposure to ozone, scientists and government regulators have developed ozone guidelines and standards. These answer the questions of which levels of exposure are hazardous to human health and the environment, and how can ambient ozone exposure be guaranteed, respectively. So what are the basis for the ozone guidelines and standards? This paper reviews in detail the process of revising ozone guidelines and standards by the World Health Organization (WHO) and the United States Environmental Protection Agency (EPA). The present study attempts to explore and analyze the scientific basis and empirical methods for updating guidelines and standards, in a view to guide the future revision process and provide directions for further scientific research. We found many epidemiological and toxicological studies and exposure-response relationships provided strong support for developing and revising the ozone guidelines. When setting standards, ozone exposure has been effectively considered, and the economic costs, health, and indirect economic benefits of standard compliance were reasonably estimated. Accordingly, epidemiological and toxicological studies and the establishment of exposure-response relationships, as well as exposure and risk assessment and benefit-cost estimates of standards compliance should be strengthened for the further update of guidelines and standards. In addition, with the increasing prominence of combined air pollution led by ozone and PM2.5, more joint exposure scientific research related to ozone guidelines and standards should be undertaken.

Estimates of compliance with Canada's guidelines for low and moderate risk alcohol consumption: the importance of adjustment for underreporting in self-report surveys.

Alcohol is a leading cause of premature mortality; however, awareness of this and of some specific risks is low. Survey-based estimates of drinking at risk levels suffer from substantial underreporting. We show that alcohol use reported in the 2019 Canadian Alcohol and Drug Survey (CADS) accounted for just 38.06% of recorded alcohol consumption. This contributes to alcohol's risks being minimized, by researchers, the public, and policymakers. The new Canada's Guidance on Alcohol and Health (CGAH) defines "moderate risk" as 3 to 6 drinks/week for men and women. Employing published methods to correct for underreporting in the CADS, we estimate that in 2019 the proportion of drinkers at moderate risk of long-term harm to be 50.43% (up from 23.34% without adjustment). We further estimate that, collectively, these drinkers consumed 90.17% of all drinks consumed that year. Similarly, 92.82% of drinks were consumed on days when upper limits for short-term harm (2 drinks/day) were exceeded (up from 65.02% without adjustment). We conclude that adjustments for underreporting of alcohol use in Canada need to be incorporated routinely in public health monitoring. This might help mitigate the widespread underestimation of risky alcohol use as well as the neglect of this public health issue by policymakers.

Monitoring variability in parameter estimates for lumped parameter models of the systemic circulation using longitudinal hemodynamic measurements

BackgroundPhysics-based cardiovascular models are only recently being considered for disease diagnosis or prognosis in clinical settings. These models depend on parameters representing the physical and physiological properties of the modeled system. Personalizing these parameters may give insight into the specific state of the individual and etiology of disease. We applied a relatively fast model optimization scheme based on common local optimization methods to two model formulations of the left ventricle and systemic circulation. One closed-loop model and one open-loop model were applied. Intermittently collected hemodynamic data from an exercise motivation study were used to personalize these models for data from 25 participants. The hemodynamic data were collected for each participant at the start, middle and end of the trial. We constructed two data sets for the participants, both consisting of systolic and diastolic brachial pressure, stroke volume, and left-ventricular outflow tract velocity traces paired with either the finger arterial pressure waveform or the carotid pressure waveform.ResultsWe examined the feasibility of separating parameter estimates for the individual from population estimates by assessing the variability of estimates using the interquartile range. We found that the estimated parameter values were similar for the two model formulations, but that the systemic arterial compliance was significantly different (p < 10^{-6}) depending on choice of pressure waveform. The estimates of systemic arterial compliance were on average higher when using the finger artery pressure waveform as compared to the carotid waveform.ConclusionsWe found that for the majority of participants, the variability of parameter estimates for a given participant on any measurement day was lower than the variability both across all measurement days combined for one participant, and for the population. This indicates that it is possible to identify individuals from the population, and that we can distinguish different measurement days for the individual participant by parameter values using the presented optimization method.

Unmasking the truth: Experimental evidence of facemask compliance in Bangladesh, Kenya, and Nigeria during the COVID-19 pandemic.

High levels of compliance with public health measures are critical to ensure a successful response to the COVID-19 pandemic and other public health emergencies. However, most data on compliance are self-reported and the tendency to overreport due to social desirability could yield biased estimates of actual compliance. A list experiment is a widely used method to estimate social desirability bias in self-reported estimates of sensitive behaviours. We estimate rates of compliance with facemask mandates in Kenya, Nigeria, and Bangladesh using data from phone surveys conducted in March-April 2021. Data on compliance were collected from two different survey modules: a self-reported compliance module (stated) and a list experiment (elicited). We find large gaps between stated and elicited rates of facemask wearing for different groups depending on specific country contexts and high levels of overreporting of facemask compliance in self-reported surveys: there was an almost 40 percentage point gap in Kenya, 30 percentage points in Nigeria, and 20 percentage points in Bangladesh. We also observe differences in rates of self-reported facemask wearing among key groups but not using the elicited responses from the list experiment, which suggest that social desirability bias may vary by demographics. Data collected from self-reported surveys may not be reliable to monitor ongoing compliance with public health measures. Moreover, elicited compliance rates indicate levels of mask wearing are likely much lower than those estimated using self-reported data.

Quality of prescription writing in Brazilian primary health care.

To evaluate the quality of prescription writing in the context of public primary health care. Prescription errors are one of the leading patient safety problems in primary care and can be caused by errors in therapeutic decisions or in the quality of prescription writing. Cross-sectional observational study conducted in a municipality in Northeastern Brazil. The assessment instrument (including 13 indicators and one composite indicator) was applied to a representative sample of drug prescriptions from the 24 Family Health Teams providing Primary Health Care in the municipality, dispensed in January 2021. Estimates of compliance and their 95% confidence intervals and graphical analysis of frequencies are assessed globally and stratified by dispensing units and prescribers. The average composite prescription writing quality on a 0-100 scale was 60.2 (95% CI 57.8-62.6). No quality criteria had 100% compliance. The highest compliance rates were found for 'frequency of administration' (98.9%) and 'identification of the prescriber' (98.9%). On the other hand, 'recorded information on allergy' (0.0%), 'patient's date of birth' (1.7%), 'nonpharmacological recommendations' (1.7%), and 'guidance on the use of the drug' (25%) were the indicators with lower compliance, contributing to 69% of the noncompliances found. The type and frequency of the errors in the quality of prescription writing uncovered in this study confirm the continuing need to tackle this problem to improve patient safety. The results identify priority aspects for interventions and further studies on the quality of prescription writing in the context of Primary Health Care in Brazil.

Passive acoustics as a tool to quantify/characterize vessel activity at fish spawning aggregation sites

The vulnerability of fish spawning aggregations (FSA) to fishing pressure has led to seasonal fishing bans for certain aggregating reef-fish species and seasonal or permanent closures of known FSA sites throughout the Caribbean. While discerning the degree of compliance with fisheries regulations is essential in evaluating their success, this information can be scarce when opportunistic surveillance from enforcement vessels is minimal or absent. We used passive acoustic recorders to determine the temporal patterns of vessel activity at three red hind, Epinephelus guttatus, spawning aggregation sites off western Puerto Rico with varying levels of protection (Buoy 4: no regulation, Abrir la Sierra (ALS): seasonal closure, and Mona: permanent closure) during the closed (January and February) and open (March) periods for the capture of red hind. We proposed that dynamic vessel sounds (e.g., gear shifting, sudden changes in speed) at known FSA sites and during aggregating periods could be indicative of fishing activity. A band-limited energy detector was used to detect vessel sounds, with detections grouped into discreate vessel events and classified as having only constant vessel sounds or containing dynamic vessel sounds. While most of the vessel events consisted of constant vessel sounds at all sites, events with dynamic vessel sounds were greatest at Buoy 4, followed by ALS and only one detected at Mona. Average events with dynamic vessel sounds were greater during the closed than the open period at Buoy 4, while the opposite was found at ALS, and red hind calling activity was significantly correlated with vessel detections during 3 years at Buoy 4. Results suggest fishers may have been targeting red hind at Buoy 4 despite red hind's seasonal closure, and the site-specific regulations at ALS may have served as a deterrent and divert fishing effort towards other areas. Acoustic records can reveal high-resolution temporal patterns of vessel activity and of events with dynamic vessel sounds, which could be used to infer about fishing activities and complement other surveys to provide estimates of compliance.

Prevention of Fetal Neural Tube Defect with Folic Acid Supplementation

Prevention of Fetal Neural Tube Defect with Folic Acid Supplementation

Application of a proposed reliability analysis multivariate capability index on manufacturing processes

n the manufacturing process of any product intervene several factors associated with the monitored quality characteristics. These factors must be examined with adequate Statistical Quality Control tools to provide estimates of product specification compliance. For this purpose, Process Capability Indices are commonly applied to manufacturing processes, assuming that the quality variables are independent, and the data is normally distributed. Additionally, an increasingly prominent quality characteristic across manufacturing industries is product reliability. This paper explores the advantages of using multivariate capability indices that include product reliability as a key quality criterion.

Estimates of Individual Fracture Compliances Along Boreholes From Full‐Waveform Sonic Log Data

AbstractAn important seismic attenuation mechanism in fractured environments is related to energy conversion into reflected and transmitted waves at fracture interfaces. Using full‐waveform sonic (FWS) log data, we show that it is possible to quantify transmission losses across a set of fractures from time delays and amplitude differences of the critically refracted P‐wave as compared to intact sections along the borehole. In the presence of fractures, the transmission coefficient associated with a given fracture is obtained by combining information on transmission losses from multiple receivers and source positions into a linear system of equations for all fractures intersecting the borehole. Fracture compliance is computed from the inferred transmission coefficient based on a linear slip model. For validation, we use synthetic FWS log data obtained from numerical simulations of wave propagation in a water‐filled borehole surrounded by low‐permeability rocks with discrete fractures. The methodology is then applied to field data acquired along boreholes penetrating multiple fractures in a granodioritic host rock. We show that our estimations of mechanical compliance are consistent with previously reported values, which were estimated for individual fractures intersecting one of the boreholes with a related method valid only for isolated single fractures. Comparison between our estimates of fracture compliance and transmissivity profiles from previous hydraulic characterizations of the fractures suggests that the proposed method may also allow to locate the most permeable fractures along a borehole, which, in turn, opens the perspective of enhancing the design and effectiveness of subsequent hydraulic testing and fracturing experiments.

Do they really wash their hands? Prevalence estimates for personal hygiene behaviour during the COVID-19 pandemic based on indirect questions

BackgroundDuring the COVID-19 pandemic, billions of people have to change their behaviours to slow down the spreading of the virus. Protective measures include self-isolation, social (physical) distancing and compliance with personal hygiene rules, particularly regular and thorough hand washing. Prevalence estimates for the compliance with the COVID-19 measures are often based on direct self-reports. However, during a health crisis there is strong public pressure to comply with health and safety regulations so that people’s responding in direct self-reports may be seriously compromised by social desirability.MethodsIn an online survey, an indirect questioning technique was used to test whether the prevalence of hygiene practices may be lower than in conventional surveys when confidentiality of responding is guaranteed. The Extended Crosswise Model is an indirect questioning technique that guarantees the confidentiality of responding. To the degree that direct self-reports are biased by social desirability, prevalence estimates of hygiene practices such as thorough hand washing based on the Extended Crosswise Model should be lower than those based on direct self-reports.ResultsWe analysed data of 1434 participants. In the direct questioning group 94.5% of the participants claimed to practice proper hand hygiene; in the indirect questioning group a significantly lower estimate of only 78.1% was observed.ConclusionsThese results indicate that estimates of the degree of commitment to measures designed to counter the spread of the disease may be significantly inflated by social desirability in direct self-reports. Indirect questioning techniques with higher levels of confidentiality seem helpful in obtaining more realistic estimates of the degree to which people follow the recommended personal hygiene measures. More realistic estimates of compliance can help to inform and to adjust public information campaigns on COVID-19 hygiene recommendations.

Empathy and expectations of others' willingness to help

Researchers have linked trait empathy to an individual's willingness to help others. We examine whether trait empathy also predicts people's expectations that others will help them. We posit that highly empathic people are more attuned to the emotional drivers of others' prosocial behavior—an intrinsic desire to help and the discomfort of refusing a help request. Such insight should make empathic people more optimistic that their own requests for help will be granted. In two studies of US-based MTurk survey respondents, we found some support for the predicted association between empathy and estimates of compliance with help requests. Study 1 (N = 207; 40.1% Female; MAge = 30.1; 77.8% White) provided initial evidence for this relationship, and Study 2 (N = 404; 44.5% Female; MAge = 38.2; 69.3% White) replicated this association in a pre-registered, higher-powered study. Mediation analyses suggest this association may result from highly empathic individuals' awareness of others' desire to help. Limitations are discussed.

Do Survey Estimates of the Public’s Compliance with COVID-19 Regulations Suffer from Social Desirability Bias?

The COVID-19 pandemic has led governments to instate a large number of restrictions on and recommendations for citizens’ behavior. One widely used tool for measuring compliance with these strictures are nationally representative surveys that ask citizens to self-report their behavior. But if respondents avoid disclosing socially undesirable behaviors, such as not complying with government strictures in a public health crisis, estimates of compliance will be biased upwards. To assess the magnitude of this problem, this study compares measures of compliance from direct questions to those estimated from list-experiments - a response technique that allows respondents to report illicit behaviors without individual-level detection. Implementing the list-experiment in two separate surveys of Danish citizens (n&gt;5,000), we find no evidence that citizens under-report non-compliant behavior. We therefore conclude that survey estimates of compliance with COVID-19 regulations do not suffer from social desirability bias.

Vascular Decoupling in Septic Shock: The Combined Role of Autonomic Nervous System, Arterial Stiffness, and Peripheral Vascular Tone.

BackgroundAcute inflammation and sepsis are known to induce changes in vascular properties, leading to increased arterial stiffness; at the same time, the autonomic nervous system (ANS) also affects vascular properties by modulating the arterial smooth muscle tone, and it is widely reported that sepsis and septic shock severely impair ANS activity. Currently, clinical guidelines are mainly concerned to resuscitate septic shock patients from hypotension, hypovolemia, and hypoperfusion; however, if the current resuscitation maneuvers have a beneficial effect also on vascular properties and autonomic functionality is still unclear. The objective of this work is to assess the effects of standard resuscitation at vascular level and to verify if there is any association between alterations in vascular properties and ANS activity.MethodsSix pigs underwent a protocol of polymicrobial septic shock and resuscitation (fluids and noradrenaline). The arterial blood pressure (ABP) waveform was recorded in the central aorta and in the peripheral radial and femoral artery. The characteristic arterial time constant was computed at the three arterial sites based on the two-element Windkessel model, to characterize the overall arterial vascular tree. Moreover, independent estimates of total arterial compliance (AC) and total peripheral resistance (TPR) were performed. Baroreflex sensitivity (BRS), low frequency (LF, 0.04–0.15 Hz) spectral power of diastolic blood pressure, and indices of heart rate variability (HRV) were computed to assess ANS functionality.ResultsSeptic shock induced a severe vascular disarray, decoupling the usual pressure wave propagation from central to peripheral sites; this phenomenon appeared as an inversion of the physiological pulse pressure (PP) amplification, with a higher PP in the central aorta than in the peripheral arteries. The time constant was decreased, together with AC and TPR. ANS dysfunction was described by a reduced BRS, decreased LF power, and suppressed HRV. This compromised condition was not resolved by administration of fluids and noradrenaline. Thus, a persistent vascular and autonomic dysfunction were reported also in the resuscitated animals, and they were found to be significantly correlated.ConclusionMeasures of vascular function and ANS activity could add information to standard hemodynamic and clinical markers, and the current resuscitation strategies could benefit from the adjunction of these additional functional indices.

Reducing tachycardia in septic shock patients: do esmolol and ivabradine have a chronotropic effect only?

An elevated heart rate (HR) often persists in resuscitated septic shock patients, increasing the risk of mortality. Several drugs for HR control, such as esmolol and ivabradine, have been tested in the recent years, but their benefit on the overall cardiovascular system is still under investigation. The aim of this study is to investigate the hemodynamic effects of the two drugs in a protocol of polymicrobial septic shock and resuscitation, mainly focusing on the vascular function. Twelve pigs were divided into three experimental groups: the esmolol-treated group (n=4), the ivabradine-treated group (n=5) and the control group (n=3). The characteristic arterial time constant τ was computed on aortic arterial pressure (AoP), together with estimates of total arterial compliance and peripheral resistance. Power spectral analysis of aortic and radial diastolic BP oscillations was performed to estimate the sympathetic autonomic control of vascular tone. Septic shock induced a severe cardiac and vascular disarray, only partially resolved by resuscitation. The administration of esmolol, but not ivabradine, was beneficial both for cardiac and vascular function, thereby its adjunction to standard therapies could help to improve patient's condition and optimize the resuscitation strategies.Clinical Relevance-This study shows a potential beneficial effect of esmolol on the arterial tree.

Operationalization Of The Youth Physical Activity Guidelines Using The International Children’s Accelerometry Database (ICAD)

PURPOSE: Use data from the International Children’s Accelerometry Database to explore how different methods of operationalizing the youth physical activity (PA) guidelines influence: (i) the proportion of youth deemed compliant with the guidelines, and (ii) associations between guideline compliance and health indicators. METHODS: Accelerometer data for 21,612 youth (5-18y, 62.4% female) was used to explore PA guideline compliance defined by four operationalization METHODS: daily method (DM; ≥60 minutes moderate-vigorous PA [MVPA] on every day of the measurement period), average method (AM; average of ≥60 minutes MVPA per day over the measurement period), AM5 (compliance with AM and ≥5 minutes of vigorous PA [VPA] on ≥3 days), AM15 (compliance with AM and ≥15 minutes VPA on ≥3 days). Relationships between guideline compliance and health indicators (e.g., BMI z-score, cholesterol levels, blood pressure) were examined for all operationalization methods. Descriptive statistics and McNemar’s tests were used to compare compliance estimates for the four methods. Multivariate regression models were used to test associations between compliance and health indicators. RESULTS: Operationalization method influenced estimates of compliance with the youth PA guidelines: 5.3% using DM, 29.9% using AM, 29.4% using AM5, 23.7% using AM15. Associations between guideline compliance and health indicators were similar for the AM, AM5 and AM15 methods, for example, BMI z-score: AM compliance (coefficient -0.28, 95% CI: -0.33,-0.23), AM5 compliance (coefficient -0.28, 95% CI: -0.33,-0.23), AM15 compliance (coefficient -0.30, 95% CI: -0.35,-0.25). Compliance with the DM method demonstrated similar or weaker associations with health indicators, potentially due to a small number of participants that complied with DM and also had health indicator data (n=250-1,127). CONCLUSION: Operationalization method influences estimates of the proportion of youth meeting the PA guidelines. This finding adds to the PA data processing decisions that researchers need to consider. While operationalization method appears to have a minor influence on associations between guideline compliance and health indicators, further research with a larger sample of DM-compliant participants with health data is needed to confirm this finding.