Long-term Habits Research Articles

Graphic Medicine in Graduate Medical Education.

Medical residency is a transformational journey when residents and fellows develop long-term habits, attain professional competencies, grow their professional identities, and build relationships from shared experiences. It is also often a taxing time as residents may feel isolated and overwhelmed from cognitive overload and a stressful work environment. The challenge is how to incorporate opportunities for self-expression, creativity, and potential community building into residency education.Graphic medicine, a field at the intersection of comics and health care, can help faculty and trainees explore the triumphs and struggles of the residency experience. As an art form that combines words and images to sequentially tell a story, comics allow the reader—and author—to reconceptualize their experiences and thus may support a more affirming residency climate. This emphasis on storytelling distinguishes comics from other visual art. Comics can deliver information effectively and efficiently as well as address topics in a variety of genres (eg, fiction, nonfiction, memoir, reportage).In the context of medical education, comics serve as powerful communication tools for both receiving and delivering information. While there is growing literature on the use of comics in undergraduate medical education (UME), the use of comics in graduate medical education (GME) is not as well explored. Their use generally involves 2 types of activities: (1) reading and discussing medically relevant comics (receiving), and (2) drawing comics as a form of self-expression and to share experiences (delivering). For example, when comics were used to teach aspects of patient safety, residents in one study reported increased awareness of patient safety risks and greater enjoyment than with standard educational activities.1 In other work, comics were used to educate residents about neurological diseases, with outcomes of increased appreciation of the illness experience, deeper empathy, and willingness to explore new approaches to patient communication.2Comics also support self-expression, personal reflection, and communication. Even those without prior drawing experience can author comics to effectively share their experiences, emotions, and ideas in ways beyond that of written text.3 Comics creation has been used to gather feedback and to debrief with medical students.4 In general, using comics has been associated with self-reported improvements in empathy, communication, awareness of bias, and nonverbal cues.5

"What Questions Do You Have?": Teaching Medical Students to Use an Open-Ended Phrase for Eliciting Patients' Questions.

Patients frequently do not understand health information received in clinical settings, yet rates of question-asking by patients are low, particularly for patients with lower health literacy skills. Experts recommend that health care professionals attempt to elicit patients' questions by using an open-ended phrase, such as “What questions do you have?” as opposed to a closed-ended phrase like, “Do you have any questions?” We compared question-eliciting techniques used during video-recorded observed structured clinical examinations among medical students who had completed a mostly didactic curriculum on health literacy and clear communication (n = 46) to students who completed a newer longitudinal problem-based communication curriculum (n = 32). Students were not aware that they were being observed for specific communication skills. Compared to controls, students in the intervention group were more likely to spontaneously attempt to elicit questions from a standardized patient (65.2% vs. 84.4%, p = .06), and were significantly more likely to use an open-ended phrase to do so (6.7% vs. 51.9%, p = .0002). The longitudinal communication skills curriculum was successful in creating long-term patient-centered question-eliciting habits. Further research is needed to determine whether eliciting questions with an open-ended technique result in patients asking more or different clarifying questions during the closing phase of clinical encounters. [HLRP: Health Literacy Research and Practice. 2022;6(1):e12–e16.]

Flexibility and stability of habit learning depend on temporal signal variation.

The visual system can learn statistical regularities and form search habits that guide attention to a region where a target frequently appears. Although regularities in the real world can change over time, little is known about how such changes affect habit learning. Using a location probability learning task, we demonstrated that a constant target location probability resulted in a long-term habit-like attentional bias to the target-frequent location. However, when the target probability changed over time in any pattern, the same amount of learning induced only a short-term bias and disrupted the formation of long-term search habits. Moreover, although temporal changes in regularity during initial learning interfered with the acquisition of a search habit, they did not modulate the already consolidated bias. These results suggest that the stability and flexibility of habitual attention learning depend on when and how the statistical regularities in the environment change. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Improving Willingness to Try Fruits and Vegetables and Gross Motor Skills in Preschool Children in Guam.

Early childhood interventions have the potential to promote long-term healthy eating and physical activity habits to prevent obesity. However, research studies including indigenous young children are lacking. This study examined the effectiveness of the Food Friends®: Fun with New Foods™ and Get Movin’ with Mighty Moves™ (FFMM) curricula on willingness to try fruits and vegetables (FV) and gross motor (GM) skills among preschoolers in Guam. A pre-post community-based study included preschoolers from Head Start (HS), gifted and talented education (Pre-GATE), and Pre-Kindergarten programs during school years (SY) 2017–2018 and 2018–2019. In SY2017–2018, the intervention group had a significant increase in imported FV when compared with the other three groups. No significant differences between groups were found on the other FV scales. Regarding gross motor skills, no significant differences between groups were found. In SY2018–2019, the intervention group had a significant increase in all FV scales except imported FV when compared with the enhanced intervention group. With gross motor skills, no significant differences were found between groups on its progress. These results warrant FFMM adaptations for the prevention of obesity among Guam preschoolers.

Marketing and family-related factors affecting food label use: the mediating role of consumer knowledge

PurposeThis study investigated the influence of marketing- and family-related factors on consumers' in-store usage of different types of food label information. Furthermore, the authors determined the mediating role of consumers' knowledge about healthy foods between these factors and their label consultation.Design/methodology/approachThe authors conducted a survey among 223 purposively selected South African working female consumers via social media. Subjective and objective knowledge about healthy foods, the importance of marketing- and family-related factors and the extent of food label usage were determined. Structural equation modelling served to test the mediating effect of knowledge in the relationship of the marketing and family-related factors with food label usage.FindingsMarketing-related factors demonstrated a strong direct effect on food label usage. Subjective knowledge about healthy foods mediated the relationship between family members' dietary needs and food label usage. However, objective knowledge was not a mediator.Practical implicationsRespondents' firm reliance on marketing-related factors (instead of knowledge) during food label usage is not in the best interest of consumers' healthy food choices. Healthy food choices based on factual knowledge rather than marketing efforts are necessary to establish long-term healthy food habits, hence the need for retailers' response in supplying healthier food options. Role players in consumer education should focus on increasing consumers' healthy food knowledge.Originality/valueIn the context of rising awareness of public health concerns, healthy food choice among consumers is essential. This study contributes to the complexity of consumers' need to make healthy food choices within an economic-driven marketing environment.

World Gastroenterology Organisation Global Guidelines: Diet and the Gut.

World Gastroenterology Organisation Global Guidelines: Diet and the Gut.

INTERACTIVE METHODS OF TRAINING IN SUSTAINABLE WASTE MANAGEMENT

Environmental education addresses the most common and current environmental problems as they could lead to a serious ecological misbalance on Earth. One of them is associated with a huge amount of waste, the need for sustainable management and recovery. For this reason, the topic of sustainable waste management needs to be included in the process of environmental education, to be based on an interdisciplinary approach, to start from an early age and be embedded not only in school curricula but also in extra-curricular activities, to be conducted systematically and methodologically provided.
 This paper presents an interactive model for training in sustainable waste management through an activity approach that could be successfully applied in some extra-curricular activities. Didactic instruments have been developed in the course of a project funded by the University of Plovdiv, aiming to enhance the ecological competencies of both pupils (11-13 years’ age) and students (pre-teachers in Biology). The thematic content included four themes: Waste definition and classification, Waste treatment, the Recycling process, and the Composting process. Learning activities and the expected results of the training are defined for each theme. The innovative model of training in sustainable waste management includes four of the most popular interactive educational methods: research-based education, problem-based education, game-based education, and project learning. Worksheets have been developed for all activities, and the thematic content was structured following environmental topics, enabling environmental education through a proactive approach. In order to assess the effectiveness of the interactive methodology, two questionnaires (pre-test and post-test) were developed. Each one consisted of 15 questions allowing the analysis of the environmental competencies of pupils (knowledge, attitude and behavior construct), as well as the attitudes, habits and behavior of both children and their families to the problem of sustainable waste management. The first questionnaire was made before the training in order to determine the entry-level of knowledge and competencies, while the second one was conducted after the training in order to evaluate the competencies’ enhancement.
 The experimental trainings conducted (2019-2020) show that these models for training in sustainable waste management, based on the constructivist approach, lead to a significant increase of pro-ecological behavior and can be successfully implemented in the education process. According to the knowledge construct, we found that the working hypothesis was confirmed for 80.2% of the pupils (χ2 = 2.043, p <0.05). Based on the attitude construct, we found that the working hypothesis was confirmed for 46.7% of the pupils (χ2 = 1.205, p <0.05). In the behavior construct, the working hypothesis was confirmed for almost 23% of the pupils who had not had long-term habits for nature conservation and rational use of resources before the time of training (χ2 = 0.383, p <0.05). This was the construct with the lowest positive change from the three studied.

Longitudinal Effects of Physical Activity Change on Hippocampal Volumes over up to 12Years in Middle and Older Age Community-Dwelling Individuals.

The objectives of this study were to investigate the long-term associations between changes in physical activity levels and hippocampal volumes over time, while considering the influence of age, sex, and APOE-ε4 genotype. We investigated the effects of change in physical activity on hippocampal volumes in 411 middle age (mean age = 47.2years) and 375 older age (mean age = 63.1years) adults followed up to 12years. An annual volume decrease was observed in the left (middle age: 0.46%; older age: 0.51%) but not in the right hippocampus. Each additional 10 metabolic equivalents (METs, ~2h of moderate exercise) increase in weekly physical activity was associated with 0.33% larger hippocampal volume in middle age (equivalent to ~1year of typical aging). In older age, each additional MET was associated with 0.05% larger hippocampal volume; however, the effects declined with time by 0.005% per year. For older age APOE-ε4 carriers, each additional MET was associated with a 0.10% increase in hippocampal volume. No sex effects of physical activity change were found. Increasing physical activity has long-term positive effects on hippocampal volumes and appears especially beneficial for older APOE-ε4 carriers. To optimize healthy brain aging, physical activity programs should focus on creating long-term exercise habits.

Change in physical activity and stress during COVID-19 in a sample of older adults with exercise habits

BACKGROUNDː The COVID-19 outbreak forced many states to introduce public health and social measures (PHSM), which may pose an obstacle to performing physical activity (PA).METHODS: This study investigated PA levels and their changes and perceived stress in a sample of 193 participants (aged 71.21 ± 4.87 years) engaged in exercise lessons prior to PSHM. Data were collected via an online survey distributed directly to the participants. The survey included two instruments: the International Physical Activity Questionnaire and the Perceived Stress Scale.RESULTS: The results indicate that sports habits may be a protective factor in staying active and meting PA recommendations. Nevertheless, there were no associations between the number of exercise lessons in the pre-COVID-19 period and PA level or the perceived change in PA during PSHM. Ability to replace the cancelled exercise lesson with PA of similar duration and intensity was negatively associated with PA levels and its change. The PSS-10 score suggests that the sample did not experience a significant increase in perceived stress, but the relationship of this outcome to PA is unclear.CONCLUSIONS: The promotion of alternative PA that could be performed during PHSM and building long-term exercise habits in older adults should be considered.

Travel-cost method for assessing the monetary value of recreational services in the Ömerli Catchment

Urban catchments in Istanbul, such as the Ömerli Catchment, are expected to receive more visitors in the future due to an increase in population, long-term recreational habits, and an insufficient amount of urban green spaces in the metropolitan area. Therefore, estimating the recreation's monetary value is crucial for developing sustainable spatial strategies for urban catchments that take cultural services and provisionary services into account. Although the Ömerli Catchment is a popular location for inhabitants' recreational demands, the previous studies primarily focused on provisioning and regulating services in the catchment. This study investigates the recreational potential and monetary value of this catchment using the random utility travel-cost method. We found that recreational visits depended on three significant factors: visitors' recreational habits, satisfaction and experience with nature, and urban environment. We also found that the consumer surplus is eight times greater than the average travel cost per person per year. This result shows visitors gain greater benefits from recreational visits than their cost to visit the catchment. We hope that decision-makers and practitioners will benefit from the results while developing spatial planning policies by considering urban catchments' recreational potentials.

Are dietary factors involved in the association of CDH4 methylation and breast cancer risk?

DNA methylation is one of the most important epigenetic modifications in breast cancer (BC) development, and long-term dietary habits can alter DNA methylation. Cadherin-4 (CDH4, a member of the cadherin family) encodes Ca2+-dependent cell-cell adhesion glycoproteins. We conducted a case-control study (380 newly diagnosed BC and 439 cancer-free controls) to explore the relationship of CDH4 methylation in peripheral blood leukocyte DNA (PBL DNA), as well as its combined and interactive effects with dietary factors on BC risk. A case-only study (335 newly diagnosed BC) was conducted to analyse the association between CDH4 methylation in breast tissue DNA and dietary factors. CDH4 methylation was detected using quantitative methylation-specific PCR. Unconditional logistic regressions were used to analyse the association of CDH4 methylation in PBL DNA and BC risk. Cross-over analysis and unconditional logistic regression were used to calculate the combined and interactive effects between CDH4 methylation in PBL DNA and dietary factors in BC. CDH4 hypermethylation was significantly associated with increased BC risk in PBL DNA (ORadjusted (ORadj) = 2·70, (95 % CI 1·90, 3·83), P < 0·001). CDH4 hypermethylation also showed significant combined effects with the consumption of vegetables (ORadj = 4·33, (95 % CI 2·63, 7·10)), allium vegetables (ORadj = 7·00, (95 % CI 4·17, 11·77)), fish (ORadj = 7·92, (95 % CI 3·79, 16·53)), milk (ORadj = 6·30, (95 % CI 3·41, 11·66)), overnight food (ORadj = 4·63, (95 % CI 2·69, 7·99)), pork (ORadj = 5·59, (95 % CI 2·94, 10·62)) and physical activity (ORadj = 4·72, (95 % CI 2·87, 7·76)). Moreover, consuming milk was significantly related with decreased risk of CDH4 methylation (OR = 0·61, (95 % CI 0·38, 0·99)) in breast tissue. Our findings may provide direct guidance on the dietary intake for specific methylated carriers to decrease their risk for developing BC.

Numerical Analysis of Concentrated Solar Heaters for Segmented Heat Accumulators

This presented paper focuses on the design and evaluation of the concept of concentrated solar heaters for segmental heat accumulators, which are designed to cover the energy needs of selected communities in terms of food preparation without the need for fossil fuels, which have a negative impact not only on the climate but especially on health. The proposed device is based on the traditional method of food preparation in the so-called earth oven; however, the fire-heated stones are replaced with heat accumulators heated by solar radiation. This approach eliminates the need to change common and long-term habits of food preparation for selected communities. The device connects solar vacuum heat pipes, a solar radiation concentrator, and heat accumulators. The concept was evaluated based on computational fluid dynamics (CFD) analysis with the use of a transient simulation of selected operating situations in three geographical locations. The results showed a significant temperature increase of the heat accumulators, where in the most effective case the temperature increased up to 227.23 °C. The concept was also evaluated based on a calorimetric analysis of the system consisting of heat accumulators and food. The resulting temperature in the considered case reached the pasteurization temperature necessary for safe and healthy food preparation.

Examining the effects of a temporary subway closure on cycling in Glasgow using bike-sharing data

This study takes the 39-day Glasgow Subway closure in July 2016 as a natural experiment to evaluate the effect of subway closure on bike-sharing trips. We find that bike-sharing trips increased by 20.7% for incoming trips and 20.1% for outgoing trips on average for each bike station in the proximity of subway station during the subway suspension. Some of this change persisted, with 12.4% of the increased bike-sharing trips remaining after the resumption of the subway service. Our findings suggest that first, subway and bike-sharing trips are substitutes; second, this temporary service disruption was not enough to break commuters’ long-term habits, and third, the diversion factors implied by our results are much lower than the recommended values for UK cities.

Cannabinoid Modulation of Dopamine Release During Motivation, Periodic Reinforcement, Exploratory Behavior, Habit Formation, and Attention.

Motivational and attentional processes energize action sequences to facilitate evolutionary competition and promote behavioral fitness. Decades of neuropharmacology, electrophysiology and electrochemistry research indicate that the mesocorticolimbic DA pathway modulates both motivation and attention. More recently, it was realized that mesocorticolimbic DA function is tightly regulated by the brain’s endocannabinoid system and greatly influenced by exogenous cannabinoids—which have been harnessed by humanity for medicinal, ritualistic, and recreational uses for 12,000 years. Exogenous cannabinoids, like the primary psychoactive component of cannabis, delta-9-tetrahydrocannabinol, produce their effects by acting at binding sites for naturally occurring endocannabinoids. The brain’s endocannabinoid system consists of two G-protein coupled receptors, endogenous lipid ligands for these receptor targets, and several synthetic and metabolic enzymes involved in their production and degradation. Emerging evidence indicates that the endocannabinoid 2-arachidonoylglycerol is necessary to observe concurrent increases in DA release and motivated behavior. And the historical pharmacology literature indicates a role for cannabinoid signaling in both motivational and attentional processes. While both types of behaviors have been scrutinized under manipulation by either DA or cannabinoid agents, there is considerably less insight into prospective interactions between these two important signaling systems. This review attempts to summate the relevance of cannabinoid modulation of DA release during operant tasks designed to investigate either motivational or attentional control of behavior. We first describe how cannabinoids influence DA release and goal-directed action under a variety of reinforcement contingencies. Then we consider the role that endocannabinoids might play in switching an animal’s motivation from a goal-directed action to the search for an alternative outcome, in addition to the formation of long-term habits. Finally, dissociable features of attentional behavior using both the 5-choice serial reaction time task and the attentional set-shifting task are discussed along with their distinct influences by DA and cannabinoids. We end with discussing potential targets for further research regarding DA-cannabinoid interactions within key substrates involved in motivation and attention.

Research on the Characteristics of College Students’ Physical Fitness Database in Mathematical Statistics

With the rapid advancement of database theory, this paper uses mathematical algorithm modeling methods, and derives the mathematical XXX derivation. In combination with Android system optimization, the performance is improved through the use of Java language and MySQL database, and XXX empirical formulas are used. Finally, after AP ’ s continuous dynamic interactive communication and tracking statistical comparative analysis, it proves that the physical fitness database algorithm has significant effects. It shows that the real-time health information and exercise effect of the college student’s physical fitness database can help college students develop long-term exercise habits and health. Plays a positive role.

Long‐term exposure to cigarette smoke influences characteristics in human gingival fibroblasts

Periodontal disease is a chronic inflammatory disease caused by periodontopathic bacteria accumulated in the gingival sulcus and periodontal pocket. Cigarette smoking is a well-established risk factor for periodontal disease, and periodontal tissues in smokers are chronically exposed to cigarette smoke on a long-term basis. In this study, we investigated the effects of long-term exposure to nicotine or cigarette smoke condensate (CSC) on cellular functions of human gingival fibroblasts (HGFs). In vitro-maintained HGFs were divided into two groups. The HGFs of the short-term and the long-term culture groups were cultured for 4 and 25days, respectively, in the presence or absence of nicotine, which is one of the main components of cigarette smoke, or CSC. The cellular proliferation and migration capacities of HGFs exposed to nicotine or CSC were evaluated by WST-1 and wound healing assays. The effects of exposure to nicotine or CSC on the expression of various extracellular matrix (ECM) components, inflammatory cytokines, and senescence-related genes were examined by real-time polymerase chain reaction and enzyme-linked immunosorbent assay. The cellular senescence of HGFs exposed to nicotine or CSC was detected by the senescence-associated β-galactosidase (SA-β-gal) assay. To explore the senescence-associated microRNA (miRNA), we extracted miRNA from the HGFs and the expression profiles were examined by miRNA array. In short-term culture, no significant changes were observed. Long-term exposure of HGFs to nicotine or CSC significantly suppressed their cellular proliferation and migration and upregulated type Ⅰ collagen, type Ⅲ collagen, interleukin (IL)-6, IL-8, p16, p21, and p53mRNA expression, and IL-6 and IL-8 protein expression. Furthermore, long-term nicotine or CSC exposure significantly increased the percentage of SA-β-gal-positive HGFs. In addition, long-term nicotine or CSC exposure reduced miR-29b and miR-199a expression to less than 50% of that in the unstimulated HGFs. These data suggest that long-term smoking habits may reduce wound healing ability, modulate ECM protein homeostasis, stimulate the inflammatory response, and accelerate cellular senescence in HGFs, and consequently accelerate the progression of periodontal diseases.

Sensing of joint and spinal bending or stretching via a retractable and wearable badge reel

Human motions, such as joint/spinal bending or stretching, often contain information that is useful for orthopedic/neural disease diagnosis, rehabilitation, and prevention. Here, we show a badge-reel-like stretch sensing device with a grating-structured triboelectric nanogenerator exhibiting a stretching sensitivity of 8 V mm−1, a minimum resolution of 0.6 mm, a low hysteresis, and a high durability (over 120 thousand cycles). Experimental and theoretical investigations are performed to define the key features of the device. Studies from human natural daily activities and exercise demonstrate the functionality of the sensor for real-time recording of knee/arm bending, neck/waist twisting, and so on. We also used the device in a spinal laboratory, monitoring human subjects’ spine motions, and validated the measurements using the commercial inclinometer and hunchback instrument. We anticipate that the lightweight, precise and durable stretch sensor applied to spinal monitoring could help mitigate the risk of long-term abnormal postural habits induced diseases.

Healthy habits and Instagram: A Cross - Sectional study.

Social media could be considered as an interesting complementary tool to the public health domain. Although the literature has studied in detail the efficacy of some of these platforms, it is unclear whether Instagram® can play a role in the adoption of long-term healthy habits. A healthy food Instagram account called the "ChefTaste" was created to assess both the impact of this platform and the time needed for it to exert influence on its followers. After six months, a cross-sectional study was conducted. Out of 493 candidates, 171 did not follow any healthy food account, 204 followed "ChefTaste" account and 118 fol-lowed other healthy food accounts. Users who followed any healthy food account had a higher probability of not just eating better [OR=1.50 (1.03,2.18) p=0.036] but also indulging in more exercise [OR=1.46 (1.00,2.13) p=0.048] and were more cautious about what they were eating [OR=1.67 (1.13, 2.46) p=0.01]. Furthermore, on comparing the results of "ChefTaste" followers with those of other healthy accounts, we found there were no statistically significant differences with respect to healthy eating and weekly exercise. These findings demonstrate the effectiveness of Instagram® which could be explained by its social support and simplicity. Authors, therefore, believe that Instagram® could play a potential tool in improving the lifestyle of individuals.

Digipõlvkonnast sotsiaalmeedia põlvkonnaks. Põlvkondlikku enesemääratlust kujundavad trendid Eesti noorte internetikasutuses / From the digital generation to the social media generation: the main internet usage trends among Estonian young people leading t

Meediakasutust puudutavad isiksuseomadused on kujunenud olulisteks põlvkondliku enesemääratluse ja identiteedi osisteks. Artiklis tutvustatakse meediapõlvkondade kultuurilisest käsitlusest lähtuvat lähenemist, mis näeb tänapäeva lapsi ja noori sotsiaalmeedia põlvkonnana. Mitmete empiiriliste uuringute tulemustele tuginevalt antakse artiklis ülevaade peamistest Eesti noortele omastest internetikasutuse harjumustest ja internetitegevustest. Millisena tajuvad sotsiaalmeedia põlvkonna esindajad sotsiaalmeedia rolli enda igapäevaelus, näitavad viieks päevaks sotsiaalmeedia kasutamisest loobunud noorte kogemuspäevikute sissekanded.&#x0D; &#x0D; Scholars argue that the sense of belonging to a generation has proven to be one of the most important prerequisites for the formation of media habits and for the ways people consume various media. Especially the experience with media and technologies during the formative years, which helps to shape long-term media habits, is noted to be relevant in defining generations and their media consumption cultures. Younger generations, in particular, tend to build their generational identity around the devices that they use, perceiving that the specificity of the self-definition of their generation is anchored in the use of such technology. For example, a variety of labels – “digital generation”, “Net generation”, “digital natives”, etc. have been coined to signify the media preferences and supposed common media habits of present-day young people.&#x0D; Relying on various recent quantitative (e.g. EU Kids Online survey) and qualitative studies, the present article aims to give an overview of the main trends surrounding Estonian children’s (9–17 year olds) internet use (e.g. access to the internet, time spent online, online activities, using the internet for schoolwork, digital skills). Furthermore, relying upon the findings of a qualitative study where young adults (n = 42, 18–23 year olds), who were asked to refrain from using any social media platforms for five consecutive days, reflect in their detox diaries upon the role social media plays in their daily lives.&#x0D; The findings of EU Kids Online survey (n = 1020) from 2018 indicate that the internet has become an integral part of the daily lives of Estonian young people. The findings illustrate that 97 % of Estonian children (9–17 year olds) access internet through at least one device (most commonly a mobile or a smart phone) on a daily basis and tend to spend a significant amount of their waking hours on the internet. During the ongoing COVID-19 pandemic, children’s screen time has increased even more. Furthermore, the present-day pandemic has also revealed a digital stratification trend, which was not as strikingly evident in 2018 – in many households (34 %) children need to share devices for accessing remote learning platforms, as smart phones are not as user friendly.&#x0D; Estonian young people claim to be versatile internet users, although entertainment and communication-related activities tend to prevail. Although children’s self-assessment of their digital skills is very good, children’s engagement in creative and participatory online activities, which also require more digital skills, is still rather uncommon. Findings of qualitative studies indicate that young people’s modest digital participation can be explained by their lack of motivation on the one hand, and the lack of polite and reasoned communication culture, on the other hand.&#x0D; Due to the variety of affordances social media platforms provide, many children and young adults in Estonia have become habitual users of social media. The analysis of social media detox diaries revealed that for many young people social media is invisibly present in most of their daily activities (e.g. while eating, waiting to catch a bus, attending a lecture, taking a bath, etc.). Furthermore, the communicative interactions the young people engaged in, as well as the maintenance of both personal and professional relationships, had become increasingly mediated through various social media platforms. Thus, many young persons described their experience of feeling anxiety and FOMO (fear of missing out) during the social media detox. Thus, they experienced a need to find alternatives to their previously established media diets. In fact, in some of the participants, social media detox also triggered technostalgia for pre-digital forms of communication and “older” ways of communicating (e. g. face-to-face contacts, speaking on the phone).

Web-Based Lifestyle Interventions for Prostate Cancer Survivors: Qualitative Study.

BackgroundExercise and a healthy diet can improve the quality of life and prognosis of prostate cancer survivors, but there have been limited studies on the feasibility of web-based lifestyle interventions in this population.ObjectiveThis study aims to develop a data-driven grounded theory of web-based engagement by prostate cancer survivors based on their experience in the Community of Wellness, a 12-week randomized clinical trial designed to support healthy diet and exercise habits.MethodsTrueNTH’s Community of Wellness was a four-arm pilot study of men with prostate cancer (N=202) who received progressive levels of behavioral support (level 1: website; level 2: website with individualized diet and exercise recommendations; level 3: website with individualized diet and exercise recommendations, Fitbit, and text messages; and level 4: website with individualized diet and exercise recommendations, Fitbit and text messages, and separate phone calls with an exercise trainer and a registered dietitian). The primary aim of the study is to determine the feasibility and estimate the effects on behaviors (results reported in a separate paper). Following the 12-week intervention, we invited participants to participate in 4 focus groups, one for each intervention level. In this report, we used grounded theory analyses including open, axial, and selective coding to generate codes and themes from the focus group transcripts. Categories were refined across levels using embodied categorization and constant comparative methods.ResultsIn total, 20 men with prostate cancer participated in the focus groups: 5, 4, 5, and 6 men in levels 1, 2, 3, and 4, respectively. Participants converged on 5 common factors influencing engagement with the intervention: environment (home environment, competing priorities, and other lifestyle programs), motivation (accountability and discordance experienced within the health care system), preparedness (technology literacy, health literacy, trust, and readiness to change), program design (communication, materials, and customization), and program support (education, ally, and community). Each of these factors influenced the survivors’ long-term impressions and habits. We proposed a grounded theory associating these constructs to describe the components contributing to the intuitiveness of a web-based lifestyle intervention.ConclusionsThese analyses suggest that web-based lifestyle interventions are more intuitive when we optimize participants’ technology and health literacy; tailor interface design, content, and feedback; and leverage key motivators (ie, health care providers, family members, web-based coach) and environmental factors (ie, familiarity with other lifestyle programs). Together, these grounded theory–based efforts may improve engagement with web-based interventions designed to support prostate cancer survivorship.