Healthy Behaviors Research Articles

HUBUNGAN PENGETAHUAN DIABETES MELITUS DAN PENGETAHUAN ASUPAN GIZI PADA REMAJA DI SMK X SIDOARJO

The prevalence of diabetes mellitus (DM) in the world and nationally continues to increase. DM generally occurs in the age group >50 years; however, DM currently affects many young age groups. Adolescents affected by DM can continue to increase if they do not have good knowledge about DM and nutritional intake. This study aims to determine the level of DM knowledge and nutritional intake among high school adolescents in SMK X West Sidoarjo. This research method is descriptive-observational with prospective data collection. The research instrument used the DKQ-24 questionnaire and a valid nutritional intake questionnaire. The selected sample is in accordance with the research inclusion criteria, totaling 50 people The results showed that 76% did not know the causes of DM and diet rules; 78% people also did not know the importance of DM treatment to control blood sugar. Regarding knowledge of nutritional intake, most respondents (56%) did not know the calculation and value of BMI, 46% did not know the importance of fiber for controlling blood sugar, and 40% did not know the types of foods with a high glycemic index. The majority of respondents have good knowledge about diabetes (76%) and nutritional intake (70%). Chi-square analysis shows that there is a relationship between knowledge of DM and knowledge of nutritional intake, with a p value of 0.027. DM knowledge and nutritional intake are important to shape healthy lifestyle behaviors in an effort to prevent DM in adolescents

Integration of exercise professionals to help patients adopt and maintain healthy movement behaviour: What are we waiting for?

Integration of exercise professionals to help patients adopt and maintain healthy movement behaviour: What are we waiting for?

Effectiveness of colorectal cancer screening strategies: a review of current scientific evidence

Colorectal cancer is one of the most common malignancies in the world. Its incidence and mortality could be reduce through primary prevention activities, which include healthy lifestyle behavior and avoidance of risk factors, and through screening (secondary prevention). Understanding the strengths and weaknesses of different colorectal cancer screening strategies is within the scope of interest of different health professionals. Therefore, the aim of this review is to synthesis the current scientific evidence that addresses the issues of effectiveness of population-based colorectal cancer screening programs and new methods for its early diagnosis.

Development, usability, and preliminary efficacy of a virtual reality experience to promote healthy lifestyle behaviors in children: pilot randomized controlled trial.

Virtual reality (VR) shows promise for supporting behavior change in children. This study used user-centered design to translate key tenets of behavioral health interventions into VR for children aged 6-12 years and their caregivers and examined the feasibility, acceptability, and preliminary efficacy of the VR experience in a pilot parallel, two-group randomized controlled trial (RCT). The VR experience incorporates psychoeducational content from evidence-based behavioral health interventions using voiceover and an interactive go-kart game related to the concepts of "food as fuel" and nutrition guidelines. Study 1 involved usability testing with n=5 child-caregiver dyads, which informed technical and content refinements to the experience. Study 2 involved children aged 6-12 years with body mass index (BMI) ≥85th percentile for age and sex who were comfortable speaking English and their caregivers with BMI ≥25 kg/m2. After participants completed baseline assessments in lab on eating-related behavioral cognitions and behaviors, participants were randomly assigned to the 10-minute VR experience or a control condition (i.e., nutrition education video and mobile phone food game), and were unblinded to condition. Child and caregivers completed assessments immediately post-intervention (eating-related behavioral cognitions) and at 2-week follow-up (behaviors, caregiver readiness to change). The objectives were to evaluate the feasibility, usability, and acceptability of the VR experience, and examine the preliminary efficacy of VR compared to the control condition on the primary outcomes of child behavioral cognitions and behaviors. Non-parametric tests examined differences in change scores across conditions as well as overall and within-group changes in outcomes. Twenty-seven child-caregiver dyads (14 in VR, 13 in control) were enrolled (child mean age =10.4 years; 14 girls). Caregivers reported good usability and excellent immersion in the virtual environment. Children reported significantly greater acceptability of VR compared to control (P=0.02). Child self-efficacy for healthy eating, self-efficacy for physical activity, attitudes toward healthy eating, and behavioral intentions for healthy eating increased from pre- to post-test in both conditions. From baseline to 2-week follow-up, all children reported greater weekly vegetable servings and more active days in the past week. Children in the VR condition had greater change in attitudes towards healthy eating from pre- to post-test compared to children in the control condition [effect size r=0.44, 95% confidence interval (CI): 0.03-0.72]. Readiness to help child change significantly increased for caregivers in the VR condition from pre- to 2-week follow-up, but did not change for caregivers in the control condition. No adverse events were reported. A VR program to promote healthy eating among children shows high feasibility and acceptability, and high potential for improving child and caregiver behavioral cognitions in this pilot RCT. Future work should examine the impact of repeated exposure to the experience over time, and examine long-term effects. ClinicalTrials.gov Identifier: NCT04845568.

Ehealth Interventions To Promote Healthy Movement Behaviors In Young Children: A Meta-analysis

Ehealth Interventions To Promote Healthy Movement Behaviors In Young Children: A Meta-analysis

Improving transitional care after acute myocardial infarction: A scoping review.

Cardiovascular disease remains the leading cause of morbidity and mortality, posing a significant challenge to healthcare systems worldwide. Transitional care interventions, which ensure coordination and continuity of care as patients move between different levels of healthcare, have been shown to reduce unnecessary healthcare utilization and improve patient outcomes. While much attention has been given to transitional care in heart failure, this review aims to map the interventions implemented for patients following an acute myocardial infarction (AMI). A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology, with literature searches performed in the Cochrane, CINAHL, MEDLINE, JBI, and SciELO databases, focusing on publications from 2013 onwards in both Portuguese and English. Seventy-five studies were included, with most combining multiple interventions that contributed to improved cardiovascular health outcomes, including increased adherence to healthy lifestyle behaviors, enhanced medication compliance, and better healthcare self-management. These interventions were effective in reducing cardiovascular-related Emergency Department visits, unplanned 30-day readmissions, and mortality following a first-time myocardial infarction. Key strategies identified included discharge planning, digital health solutions, outpatient care, and healthcare coordination. The findings of this review underscore the need for developing methodologies that enhance the transition of care from hospital to primary care following an AMI. There is an urgent need to design and implement new healthcare programs that integrate discharge interventions, digital health, outpatient care, and healthcare coordination to ensure continuity of care and optimize patient outcomes post-discharge.

Exploring How the Kidney BEAM Physical Activity Digital Health Intervention Improved Mental Health-Related Quality of Life for People Living With Kidney Disease: a Mixed Methods Approach

IntroductionThe Kidney BEAM randomised controlled trial reported clinically meaningful and statistically significant improvements in mental health-related quality of life (HRQoL), physical function (sit-to-stand-60, but not the physical component of HRQoL) and patient activation following a 12-week physical activity digital health intervention (DHI). This study explores factors that contributed to the effectiveness of Kidney BEAM through mixed methods analyses. MethodsQuantitative data analysis was taken from the recently published primary manuscript. Participants from the Kidney BEAM trial intervention group (n=30) completed individualized semi-structured interviews after the 12-week DHI. Interviews were analysed using the framework method with inductive and deductive coding. Quantitative and qualitative data collection and analyses occurred concurrently, and independently, before combining using a mixed methods analysis with joint displays to triangulate datasets and further explore the primary findings. ResultsThe integrated mixed methods analyses facilitated explanation of the primary findings. The Kidney BEAM intervention was shown to have mental and physical wellbeing benefits and enhanced self-management in this cohort of people living with CKD. Elements that contributed to the effectiveness of the intervention were reported, including the different functional levels and gradual progression of the program, shared lived experiences with other participants, self-monitoring, the sense of achievement, taking back control of their health, moving beyond medications and feeling safe and confident to exercise. ConclusionElements of the Kidney BEAM intervention that contributed to the main quantitative trial findings were identified. This will allow researchers and practitioners to maximize the effectiveness of DHI’s to enhance healthy behaviours in people living with CKD.

S393 Applying Narrative Theory to Raise Community Awareness and Support to Promote Healthy Behaviors and Cancer Screening in Baltimore

S393 Applying Narrative Theory to Raise Community Awareness and Support to Promote Healthy Behaviors and Cancer Screening in Baltimore

Accuracy of self-perceived cardiovascular disease risk and factors predicting risk underestimation in perimenopausal and postmenopausal women in Ismailia, Egypt.

Cardiovascular disease (CVD) is the leading cause of death globally, with women at higher risk after menopause. This increased risk is attributed to both aging and hormonal changes. Prior research has established a link between CVD risk perception and adopting healthy behaviors to prevent CVD. This study aimed to assess the accuracy of self-perceived CVD risk in perimenopausal and postmenopausal women, and to identify factors that predict CVD risk underestimation among them. A cross-sectional study was conducted in the administrative sectors of Suez Canal University campus in Ismailia, Egypt, over a period of eight months starting in July 2022. A total of 390 eligible women (employees and workers) were randomly selected. Participants were interviewed to obtain data on demographics, medical history, self-perceived risk of CVD, self-perceived general health, awareness of factors that increase the risk of developing CVD, perceived stress, health literacy, numeracy, and self-perceived 10-year risk of developing major cardiovascular events. They also underwent measurements of blood pressure, weight, and height. The updated 2019 WHO/CVD risk non-laboratory-based prediction chart for the North Africa and Middle East Region was used to predict the 10-year risk of major cardiovascular events for the study participants. Risk accuracy was measured by comparing self-perceived CVD risk with predicted CVD risk. The ratio of self-perceived to predicted moderate/high CVD risk was 27.7% to 44.3%, respectively. The accuracy of CVD risk perception was 68.2%. Kappa analysis results showed fair and significant agreement between self-perceived and predicted CVD risk (kappa ± SE = 35.9 ± 4.1%, p < 0 .001). The proportion of women who underestimated their risks was 24.1%. Of those in the high-risk group, 93.3% underestimated their CVD risk, compared to 50.6% in the moderate-risk group. Factors that significantly predicted CVD risk underestimation included being married (aOR 14.5; 95% CI 1.4-149.9), low income (aOR 2.321; 95% CI 1.09-4.909), high BMI (aOR 4.78; 95% CI 1.9-11.9), hypertension (aOR 3.5; 95% CI 2-6.2), and old age (aOR 1.46; 95% CI 1.3-1.6). Approximately one-third of our study participants misperceived their CVD risk; of those who did, 75.8% underestimated it. Marital status, old age, low income, high BMI, and hypertension strongly predicted CVD risk underestimation. These findings identified the menopausal women subgroups that could benefit from targeted health interventions designed to reduce CVD risk underestimation and improve risk accuracy.

Dark patterns, dark nudges, sludge and misinformation: alcohol industry apps and digital tools.

Many alcohol-industry-funded (AIF) organizations disseminate eHealth/mHealth tools that claim to assist users in making health decisions by monitoring alcohol consumption, e.g. blood alcohol calculators, AUDIT scores, consumption trackers. Previously, AIF materials were found to contain health misinformation that could increase consumption (dark nudges) or make healthy behaviour change more difficult (sludge). The accuracy and functionality of AIF tools have never been analysed, and given the history of AIF materials it is possible they contain misinformation and function as covert marketing channels to promote alcohol-industry-friendly narratives on the causes and possible solutions of alcohol-related harms. We evaluated the information accuracy and framing, behaviour change techniques (BCTs), and functions of AIF digital tools (n = 15, from the UK, Ireland, the USA, Canada, New Zealand, Australia; including Drinkaware, Drinkwise, Educ'alcool and others), compared to a non-industry-funded independent sample (n = 10). We identified misinformation and 'dark patterns' (interface design strategies for influencing users against their interest) throughout AIF tools; significantly fewer provided accurate feedback (33% vs 100%), and significantly more omitted information on cancer (67% vs 10%) and cardiovascular disease (80% vs 30%) and promoted industry-friendly narratives (47% vs 0%). AIF tools encouraged consumption through priming nudges (53%) and social norming (40%). AIF tools utilized fewer BCTs, provided users with more limited pre-set options (54%), and fewer drink choices (mean 24 vs 275). Their input structure often impeded their ability to provide guideline advice. We conclude that AIF tools contain pro-industry misinformation strategies and dark patterns that misinform users about their consumption and could 'nudge' them towards continuing to drink alcohol-characteristics of 'Dark Apps' designs.

Achieving Work-Life Balance as an Organizational Leader: Strategies for Leaving Work at Work

This article explores research-backed strategies that organizational leaders can implement to effectively achieve work-life balance and integration. It discusses the importance of leaders setting clear expectations and boundaries around work hours and responsibilities through formal policies, communication of response times, and role modeling healthy behaviors. It also addresses the need for leaders to create intentional boundaries when using technology and shift to a "work to live" mindset. The article outlines techniques leaders can use to make time for rest and recharging, such as scheduling vacations and practicing daily decompression routines. It emphasizes the value of leaders showing empathy, understanding, flexibility, and distributing work equitably. Finally, the article encourages leaders to promote employees' well-being through benefits, on-site activities, and opportunities for volunteer/learning days and growth. The purpose is to provide guidance for optimizing sustainable work-life integration to benefit both individuals and organizations.

The association between loneliness and frailty among community-dwelling older adults in five European countries: a longitudinal study.

Loneliness is described as the subjective experience of unfulfilled personal and social needs, with emotional and social domains. Frailty is a state of vulnerability to stressors, which is often characterised by impairment in the physical, psychological and/or social domain. This study aims to examine the bidirectional association between loneliness and frailty across the different domains. The study included 1735 older adults from the Urban Health Centres Europe project. Loneliness was assessed using the six-item De Jong Gierveld Loneliness Scale. Frailty was assessed by the Tilburg Frailty Indicator. Multivariate linear regression and cross-lagged panel models were used to explore the associations between the social and emotional loneliness dimensions and overall, physical, psychological and social frailty. A bidirectional association existed between overall loneliness and overall frailty (loneliness to frailty: β = 0.09, 95% CI: 0.03, 0.15; frailty to loneliness: β = 0.05, 95% CI: 0.004, 0.10). Higher levels of overall loneliness at baseline were associated with higher levels of psychological frailty at follow-up (β = 0.05, 95% CI: 0.00, 0.10). The reverse association was not significant. A bidirectional association existed between overall loneliness and social frailty (loneliness to social frailty: β = 0.05, 95% CI: 0.01, 0.10; social frailty to loneliness: β = 0.05, 95% CI: 0.00, 0.09). This study confirms the importance of addressing loneliness among older adults. Interventions that increase social support, exercise engagement and promote healthy behaviours may be effective in reducing the risk of frailty among older adults and simultaneously preventing loneliness.

Strengthening the Tourism Village Program: Educational Tourism on Waste Bank and Clean and Healthy Living Behavior

Sawahan Village, Watulimo Subdistrict, Trenggalek Regency, is one of the tourist village areas developed by the local community. Several tourism programs have been established by the local tourism awareness groups, including durian forest tourism. In 2023, a chlorine diffuser technology was implemented to support the development of the tourist village, ensuring access to clean water. This appropriate technology is not only designed to produce clean water but also serves as a strategy to meet the requirements of Clean and Healthy Behavior (CHB). In 2024, community service has focused more on waste management through a waste bank. The methods employed include Focus Group Discussions (FGD) on educational tourism through waste banks, education on the separation of organic and inorganic waste, and community assistance with Clean and Healthy Behavior (CHB). The activities conducted resulted in increased community knowledge about waste banks, from 10 people (10%) to 48 people (96%). Not only did the community's knowledge improve, but their behavior also changed, with the creation of separate waste containers for organic and inorganic waste increasing from 3 people (6%) to 38 people (76%). Additionally, the community's behavior regarding clean and healthy living improved, with handwashing facilities available in every home and throughout the tourist area, reaching 50 people (100%). These changes in knowledge and behavior indicate that community service activities can only succeed with the community's willingness and ability to achieve sustainability and self-sufficiency.

Associations of Patient Activation with Outcomes Among Patients on Chronic Hemodialysis: A Retrospective, Longitudinal, Observational Study.

Patient activation, defined as an individual's readiness, willingness, and ability to manage their own health and health care, is associated with healthy behaviors and improved outcomes. Patients undergoing in-center hemodialysis (HD) have low activation, but the association of patient activation with clinical outcomes among dialysis patients is unclear. We investigated the association between patient activation and outcomes in HD patients. This cohort included 925 prevalent, in-center HD patients among 10 facilities in a mid-sized dialysis provider. All patients who completed the Patient Activation Measure 13-item (PAM-13) survey during a previous study were included, and their records were cross-referenced with data from the electronic heath system. Patients were followed for 180 days after completion of the survey for the primary outcomes of time to (1) death and (2) time to hospitalization. Markers of non-adherence during the month before and the month after completion of the PAM survey were examined as secondary outcomes, including (1) serum potassium >5.0 mEq/L; (2) serum phosphorus >5.5 mg/dL; (3) missed dialysis treatment due to absence (not hospitalization); and (4) interdialytic weight gain >4.0%. Univariate and adjusted regression models were fit to estimate associations of a 3-point increment in PAM-13 score with the outcomes of interest; adjustment factors comprised age, sex, dialysis vintage, serum albumin, diabetes, and hospitalization history. A 3-point increment in PAM score was associated with lower hazard of death (univariate HR=0.89, 95% CI: 0.84-0.94; adjusted HR=0.90, 95% CI: 0.85-0.96), but not with hospitalization (univariate HR=0.99, 95% CI: 0.96-1.02; adjusted HR=0.99, 95% CI: 0.96-1.02). Higher scores were associated with increased odds of having high phosphorus levels in the unadjusted analysis, but this was attenuated and not significant in adjusted models. There were no significant relationships between a 3-point increment in PAM score and any of the other secondary outcomes in univariate and adjusted analyses. In a cohort of prevalent, in-center HD patients, low activation was associated with mortality but not with hospitalization or measures of non-adherence.

Fit Effect of Health Regulatory Focus on Exercise and Healthy Diet: Asymmetric Moderating Role of Scarcity Mindset.

Health is an intrinsic goal strongly related to individuals's well-being. Many individuals make efforts to achieve their health goals through different means. Based on the health regulatory focus theory, we proposed a health regulatory fit effect to understand individuals's health behaviors, and further examined the moderating role of scarcity mindset on these relationships. Using a two-wave longitudinal design, our research recruited a sample of 453 adult participants (350 Women, Age = 20.39 ± 2.30 Years) from China via an online survey platform. The results indicated that health individuals with health promotion-focus were more likely to exercise, whereas those with health prevention-focus were more inclined to prefer a healthy diet. Notably, such effect was moderated by scarcity mindset. Specifically, individuals with low promotion-focus were more susceptible to the impact of scarcity mindset, thus exhibiting less health-promoting behaviors. This research suggested a health regulatory fit effect for two health behaviors. Intriguingly, our findings reveal an asymmetric impact of the scarcity mindset on this fit effect. These results hold significant implications for developing health promotion strategies to mitigate the negative impact of scarcity mindset on healthy behaviors.

The Impact of School-Based Caries Prevention Programs on DMFT Scores and Oral Health Behaviors in School Children

Oral health promotion is recognized as one of the fundamental components of health-promoting schools. However, few studies have demonstrated the efficacy of supportive school environments for school children’s Oral health. This systematic review evaluates the impact of school-based caries prevention programs on DMFT scores and Oral health behaviours in school children. Objective: To evaluate the impact of school-based caries prevention programs on DMFT Scores and Oral Health Behaviors in school children. Methods: Databases like PubMed, Google Scholar, Cochrane Library, Springer, and Science Direct were searched from January 2009 to February 2024. Prisma guidelines were followed; 1, 950 studies were identified on the first search, titles, and abstracts of 500 papers were screened, 500 full-text papers were screened for eligibility, and 25 studies meeting the inclusion criteria were evaluated, relevant information was extracted, and a systematic review was conducted. Twenty-five studies were included in the systematic review. Results: These results indicate the significant role of SCPP among school-going children. Children with school-based caries prevention programs compared to those with no school-based caries prevention programs showed improved DMFT scores, reduced caries increment, healthy oral health behaviours, consistent Oral health hygienic habits, frequent use of flossing, fluoride toothpaste and mouth rinsing, and increased caries prevention knowledge. Conclusions: It was concluded that based on the pooled results, school-based caries prevention programs provide better, easily accessible, and sustainable caries prevention activities to school children to improve DMFT scores and Oral health behaviours.

Understanding Online Gaming Habits and Attitudes among Youth: A FGD Study of Gaming Behaviours, Social Interactions, and Psychological Effects

Asia has one of the highest incidences of online gaming, making it a favourite pastime among youth worldwide. However, research shows that excessive gaming can have detrimental effects on one's health, academic performance, and social development, and the economic relevance of the online gaming industry emphasizes the need to understand the attitudes and behaviours of youth towards online gaming. Therefore, this study aimed to explore the attitudes and habits of youth towards online gaming to develop strategies that promote healthy gaming behaviour. The study used a focus group discussion with three groups of youth, totalling 16 participants. The study found that the participants engaged in prolonged online gaming sessions, and individuals had different motivations for playing games, including relaxation, stress relief, escapism, and achievement. The findings demonstrated the varied ways in which gaming can impact socialization and psychological, both positively and negatively. While gaming can provide relaxation and social connection, it can also lead to negative impacts, such as distraction and addiction. Additionally, the data from the participants in this study reveal a range of potential psychological issues associated with online gaming, including anger management, the conflict between parents and children, addiction, risky behaviours, and compulsive behaviour. The findings of this study can help Malaysian politicians, educators, and parents create measures to encourage healthy gaming behaviours and lessen the harmful effects of excessive gaming. Keywords: Online gaming, gaming behaviours, social interactions, psychological effects, online gaming habits.

Level of Cardiovascular Disease Risk and Associated Factors among Clients on Highly Active Antiretroviral Therapy in Vihiga County, Kenya

Context: HIV/AIDS is still a public health concern globally, especially in sub-Saharan Africa and Kenya. HIV-positive clients are initiated on highly active antiretroviral therapy (HAART) to reduce the multiplication of HIV and improve their immunity. These clients are at an increased cardiovascular disease risk due to a complex interplay of factors, including traditional cardiovascular risk factors such as smoking cigarettes, obesity due to inactivity, and diabetes. Aim: This study sought to determine the level of cardiovascular disease (CVD) risk factors among people living with HIV (PLHIV) on highly active antiretroviral therapy (HAART) in Vihiga County, Kenya. Methods: The study employed a cross-sectional survey design to report baseline survey data for an interventional study on the level of CVD risk factors. The study involved a systematic sample of 211 patients on HAART in six health facilities purposively selected from Vihiga County. Data was collected using the WHO STEPWISE questionnaire from six comprehensive care clinics in Vihiga County from March to July 2022. The World Health Organization-International Society of Hypertension (WHO-ISH) tool AFRI E CHART was used to estimate the cardiovascular risk. Results: The majority (96.68%) of PLWHIV on HAART in Vihiga county had low overall cardiovascular risk as predicted WHO/ISH score. Age (OR = 1.199, 95% CI [1.031, 1.394], p = 0.018) and smoking status (OR = 0.115, 95% CI [0.024, 0.558], p = 0.007) exhibited a significant association with the level of cardiovascular risk. Conclusion: The majority of PLHIV have a low estimated CVD risk. There is a need to prioritize weight management in HIV care, integrating healthy lifestyle behaviors and nutritional support while conducting regular cardiovascular risk assessments, focusing on modifiable factors like smoking. Age-specific interventions can also help mitigate the risk across the different age groups.

Factors related to the uncontrolled fasting blood sugar among type 2 diabetic patients attending Kopang Health Center, Central Lombok Regency, Indonesia

Background: Prevalence of DMT2 is increasing every year, becoming a significant global health problem. Many DMT2 sufferers are not well controlled, prone to serious complications such as heart, kidney, and nervous system. Purpose: To determine Blood Sugar fluctuations in Diabetes Mellitus Type-2 (DMT2) to improve knowledge, positive attitudes, and healthy behaviors to achieve optimal blood sugar control. Method: Quantitative observational analytical research with Cross Sectional design. The population is 349 people with a sample of 186 respondents which is determined by simple random side. Data collection uses interview guidelines/questionnaires that have been tested for validity and reliability. Bivariate data analysis used Chi Square and Multivariate analysis multiple logistic regression. Results: P value of knowledge 0.000 &lt; 0.05, had a significant effect. The p-value of attitude was 0.002 &lt; 0.05, Positive attitude had a significant effect on stabilizing blood sugar. An optimistic, confident, and highly motivated attitude is important to control diabetes. The behavioral p value of 0.003 &lt; 0.05 had a stabilizing effect on blood sugar. Conclusion: Good knowledge has a significant effect on stabilizing blood sugar. An important understanding affects diabetes control. Accurate information empowers informed long-term health decisions. A positive attitude greatly affects blood sugar control. Optimistic, high spirits achieve better health control. Decisions of the right actions stabilize blood sugar is important for DMT2 health, prevent complications improve quality of life.

Does Stress Affect Adolescent Anxiety by Mediating Sleep Time?

Background: Health is essential for the sustainable well-being, yet high stress, anxiety, and lack of sleep among Korean adolescents have become significant social concerns.Methods: This study examined the impact of stress on anxiety and investigated whether sleep time mediates this relationship in 46,870 male and female adolescents, ranging from first-year of middle school students to third-year high school students. Data were obtained from the "18th Korea Youth Risk Behavior Survey" conducted by the Korea Disease Control and Prevention Agency.Results: The analysis showed that increased stress was associated with reduced sleep time and higher anxiety levels, stress was found to heighten anxiety, partly by reducing sleep time.Conclusions: Based on these findings, the study recommends: ① developing mental health indicators to quickly identify adolescents at risk for mental health issues, ② encouraging cooperation between schools, government agencies, healthcare providers to enhance access to mental health programs for adolescents, and ③ implementing policies that promote healthy behaviors, ensure adequate sleep, and improve overall well-being.