The relationship between cell phone use, physical activity, and sedentary behavior in adults aged 18–80

Passive sensing of smartphone use, physical activity and sedentary behavior among adolescents and young adults during the COVID-19 pandemic

The research that links excessive screen time to adverse health outcomes is based on self-reported screen use. Few studies have documented how passively-sensed smartphone and app use relate to health behaviors like activity and sitting. Furthermore, they have not considered that daily fluctuations in smartphone/app use may have different relationships to these behaviors than a person's usual smartphone/app use. This study evaluated whether physical activity or sedentary (sitting) behavior are associated with either smartphone screen time or specific smartphone app use by adolescents and young adults during the COVID-19 pandemic. Adolescents and young adults aged 13-29 years wore activPAL4 micro activity monitors while their smartphones logged daily screen time and app use durations for nine days. Data were collected in 2020-2021 and analyzed in 2022-2023. Participants (N = 125) had a mean (SD) age of 19.7 (4.3) years. Participants' usual smartphone screen time was negatively associated with daily step counts. Daily deviations in smartphone screen time were negatively associated with daily step counts and moderate-vigorous physical activity durations. Time spent on Instagram, YouTube and, to a lesser extent, TikTok were linked with reduced activity levels. Daily sedentary behavior was not associated with usual or daily screen time. Interventions to promote physical activity during the transition into adulthood may benefit from limiting excessive smartphone screen time. Specific intervention targets could include limiting use of apps with infinite scrolling feeds algorithmically tuned to maintain user engagement, such as Instagram, YouTube and TikTok.

Association between social jetlag and leisure-time physical activity and muscle strengthening exercise in young adults: findings from a nationally representative sample in South Korea

OBJECTIVES

Social jetlag (SJL), which is characterised by a misalignment between biological and social time, is associated with cardiometabolic risk factors. This study investigated the relationship between SJL, leisure-time physical activity (LTPA) and muscle strengthening exercise (MSE) in young adults.

STUDY DESIGN

This was a cross-sectional study.

METHODS

This cross-sectional study included a nationally representative sample of young adults aged 19-29 years (n = 2113). SJL was calculated as the difference in the midpoint of sleep onset and offset time between weekdays and weekends. The dependent variables were engagement in ≥150 min/week of moderate-to-vigorous LTPA and engagement in MSE ≥2 days/week based on guidelines provided by the World Health Organisation. Logistic regression analysis was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Non-linear relationships were estimated using restricted cubic spline regression.

RESULTS

The study population comprised 975 men and 1138 women. Among participants, 4.6% had <0 min, 41.9% had 0-59 min, 25.7% had 60-119 min and 27.7% had ≥120 min SJL. Those with ≥120 min SJL had a reduced likelihood of achieving the recommended level of LTPA (OR: 0.71, 95% CI: 0.52-0.95) and MSE (OR: 0.73, 95% CI: 0.55-0.97). In the non-linear model, an inverse U-shaped association was observed, wherein the highest probability of meeting the recommended level of LTPA and MSE was observed in those with 45 min SJL, decreasing after this threshold.

CONCLUSIONS

Individuals with ≥120 min SJL were less likely to engage in the recommended level of both aerobic and anaerobic exercise. Although future studies using a longitudinal design are required to elucidate the causal relationship between SJL and physical activity, the current findings suggest that physical inactivity during leisure time may play an important role in the increased risk of cardiometabolic abnormalities in young adults with SJL.

Exploring individual, social and environmental factors related to physical activity: a network analysis

Objectives

Insufficient physical activity (PA) has long been a global health issue, and a number of studies have explored correlates of PA to identify the mechanisms underlying inactive lifestyles. In the literature, dozens of correlates have been identified at different (eg, individual, environmental) levels, but there is little or no direct evidence for the mutual associations of these correlates. This study analysed 44 variables identified as theoretically and empirically relevant for PA to clarify the factors directly and indirectly associated with PA.

Methods

A cross-sectional survey dataset of 19 005 Japanese-speaking adults (mean age=53.50 years, SD=17.40; 9706 women) was analysed. The data encompassed demographic and anthropometric variables; self-reported PA levels; perceived social support and environments (eg, awareness of urban facilities for PA); psychological traits and health-behaviour characteristics (eg, personality, motivation, self-efficacy, decisional balance, process of change strategies); and technology use (eg, mobile health apps).

Results

Network analyses were performed to select meaningful associations (partial correlations) among variables, which identified nine variables directly positively associated with PA: job/employment status, self-efficacy, perceived social support, intrinsic motivation, stage of change, counter conditioning, self-reevaluation, environment and technology use. Indirect associations (two-step neighbourhood) were identified for 40 (out of 44) variables, implying that most of the known PA-correlates are associated with PA-at least indirectly.

Conclusion

These identified associations echo the importance of the multilevel perspective in understanding how people maintain (in)active lifestyles. Interventions for PA could have mixed-level targets, including intraindividual characteristics, social support and physical and digital environments.

Effects of Screen-Based Leisure Time on 24 Subsequent Health and Wellbeing Outcomes: A Longitudinal Outcome-Wide Analysis

BACKGROUND

Previous research has shown that screen-based leisure time is related to physical and mental health, relationships, and prosocial behaviors. However, it remains unclear whether screen-based leisure time causally affects wellbeing, as previous studies have relied on cross-sectional data, focused on one type of media use (e.g., social media, video games, or internet), or assessed a narrow set of outcomes.

METHOD

We used three waves (2016, 2017, 2019) of national longitudinal data from the New Zealand Attitudes and Values Study to investigate the effects of screen-based leisure time on 24 parameters of wellbeing (n = 11,085). We operationalized screen-based leisure as the sum of time spent browsing the internet, using social media, watching/reading the news, watching videos, and playing video games. We followed the outcome-wide analytic design for observational data by performing a series of multivariable regression models estimating the effect of screen-based leisure time on 24 wellbeing outcomes and assessed potential unmeasured confounding using sensitivity analyses.

RESULTS

In our primary analysis with the total sample, total screen-based leisure time was associated with a very modest decrease in body satisfaction and a very modest increase in body mass index. Possible evidence of associations was found with increases in number of hours spent exercising and volunteering each week, as well as decreases in number of average daily hours of sleep, self-control, and subjective health.

CONCLUSION

Screen-based leisure time has the potential to affect health and wellbeing. Results are discussed in light of the high prevalence of screen-based leisure time.

Enhancing physical activity participation among female employees: evaluating the effectiveness of an educational intervention

This paper evaluates the effectiveness of an educational intervention based on the transtheoretical model aimed at increasing physical activity (PA) participation among female employees in Bandar Abbas city (Iran) healthcare centers in December 2017 and August 2018. Using a semi-experimental interventional study design with a randomized and multi-stage method, 100 participants were included in both the intervention (n = 50) and control groups (n = 50). Data collection involved questionnaires assessing demographic information (age, gender, marital status and education), stages of change in PA behavior, Perceived Benefits, Barriers and Self-efficacy. The data were analyzed using SPSS-16, employing both descriptive (mean, SD, frequency, percentage) and inferential statistics (t-tests, chi-squared tests, etc.). Prior to the educational intervention, 19 participants (0.38%) in the intervention group engaged consistently in PA (stages 4-5). After 3 and 6 months of intervention, these numbers increased to 29 (0.58%) and 25 (0.50%), respectively. This improvement was statistically significant compared to the pre-intervention stage (P < 0.001). The findings highlight the importance of theory-based behavior change models and health education programs in promoting PA and combating sedentary lifestyles. Although focused on a specific population in Bandar Abbas, the intervention can serve as a model for similar programs targeting diverse social classes and populations.

Prevalence and determinants of non-communicable diseases and risk factors among adults in Lebanon: a multicentric cross-sectional study

OBJECTIVES

Evidence on non-communicable disease (NCD) prevalence and associated risk factors informs primary health care consolidation regarding prevention and treatment strategies. In Lebanon, the government and many international organisations are still working to decrease the burden of NCDs. The aim of this study was to assess the prevalence of selected NCDs and their risk factors among adults in Lebanon, and to investigate the relationship between these risk factors and NCDs.

STUDY DESIGN

A multicentric cross-sectional study was conducted over one year, from 1 June 2022 to 31 June 2023, across five Lebanese governorates.

METHODS

Participants aged ≥18 years were considered eligible for enrolment in the study. Data on the sociodemographic, behavioural and medical characteristics of participants were collected.

RESULTS

From the total study population (n = 4540), 52.4% reported one or more NCDs. The prevalence of most prominent NCDs were hypertension (32.8%), diabetes (26.8%), cardiovascular disease (16.1%), asthma (7.1%) and cancer (3.7%). Results showed a significant association between gender and smoking, high-fibre diet and asthma (P-value <0.05). Findings showed a highly significant association between age categories and smoking, high-fibre diet, physical activity, diagnosis with NCDs, hypertension, diabetes and cardiovascular disease (P-value <0.0001).

CONCLUSIONS

This study showed a high prevalence of NCDs among adults living in Lebanon. Prevention, treatment and control of NCDs and their risk factors are a public health priority in Lebanon, and resources are required to provide targeted interventions with a multisectoral approach.

Differences in Physical Activity, Sedentary Behavior, Health-Related Physical Performance Indices and Academic Achievement: A Comparative Study of Normal-Weight and Obese Children in Qatar

Background: The relationship between physical activity (PA), health-related physical performance (PP), and academic achievement (AA) plays an important role in childhood. This study examined the differences in PA, sedentary behavior, health-related PP, maturity status, and AA between normal-weight and obese school children in Qatar. Methods: Eighty schoolchildren were recruited (age: 12.1 ± 0.6 years). Based on age-specific BMI percentiles, the children were classified as normal weight (n = 40) or obese (n = 40). Moore's equations were used to estimate their maturity status (PHV). The measurements encompassed anthropometric data as well as PP tests (medicine ball throw, postural stability, handgrip strength). AA was assessed by reviewing school records for grade point average in Mathematics, Science, and Arabic courses. The total amount of time spent participating in PA each week was calculated using the International Physical Activity Questionnaire Short Form. Results: Handgrip strength was the only parameter that showed a relevant group difference (p < 0.001, ηp2 = 0.15; normal weight: 19.7 ± 3.46 N; obese: 21.7 ± 2.80 N). We found only one moderate correlation between PHV and handgrip strength (r = 0.59). Conclusions: The findings suggest that obesity status alone might not serve as a sufficient predictor of AA in school or PA levels.

Relationship between addictions and obesity, physical activity and vascular aging in young adults (EVA-Adic study): a research protocol of a cross-sectional study

Background

Behavioral and substance addictions are prevalent health problems that, alongside obesity, are linked to reduced physical activity and increased sedentary time. Similarly, arterial stiffness and vascular aging are processes that begin gradually at an early age and are closely associated with morbidity and mortality from cardiovascular diseases. The main objective of this study is to analyze how addictions are related to obesity and body fat distribution, physical activity, sedentary time, arterial stiffness and vascular aging, as well as sleep quality, cognitive function and gender differences in young adults aged between 18 and 34 years.

Methods

This cross-sectional descriptive observational study will analyze data from 500 subjects (250 men and 250 women) aged 18-34 without cardiovascular disease, selected by simple random sampling with replacement from the urban population of the city center of Salamanca (34,044 people aged 18-34, with 18,450 women and 15,594 men). Behavioral and substance addictions, as well as sleep quality and cognitive impairment will be assessed using questionnaires. The Pittisburg Sleep Quality Index (PSQI) will be used to measure sleep quality and the Ford questionnaire will be used to measure insomnia in response to stress. For obesity, weight, height, waist and hip circumference, body composition will be measured with the Inbody 230® impedance meter. For physical activity and sedentary time, we will use the Actigraph® accelerometer alongside the international physical activity questionnaire (IPAQ) and the Marshall questionnaire. The Sphygmocor System® will be used for pulse wave analysis and carotid-femoral pulse wave velocity (cfPWV), while the Vasera VS-2000® will measure cardio ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV). Vascular aging will be calculated with the 10th and 90th percentiles of cfPWV or baPWV. Demographic, analytical variables will be collected, as will data to assess vascular, cardiac, renal, and brain injury.

Discussion

Addictions are on the rise in today's society, affecting the mental health and well-being of those who suffer from them, generating important social problems such as job loss, family dysfunction, debt and social isolation. Together with obesity, they are prevalent health problems in young adults and are associated with lower physical activity and higher sedentary time. Meanwhile, arterial stiffness and vascular aging are processes that begin gradually at an early age and determine morbidity and mortality caused by cardiovascular diseases. The results of this project will allow us to understand the situation regarding behavioral and substance addictions in young adults. Better understanding of these addictions will in turn facilitate the development of more effective prevention strategies and intervention programs, which can then reduce the negative impact at both the individual and societal levels.

Clinical trial registration

[ClinicalTrials.gov], identifier [NCT05819840].

How physical exercise influences academic burnout among Chinese "Double Non" college students: the chain mediation role of mobile phone addiction and learning engagement

Background

With mental anxiety caused by the COVID-19 pandemic, the trend of "lying down" has become increasingly prevalent among Chinese college students such as not thinking ahead, decadent abandonment, and being weak daily. Particularly, Chinese "Double Non" college students are more likely to face academic burnout (AB) due to lower school satisfaction and after-degree employment ratio, in comparison to "Double First-Class" college students.

Objectives

In view of this, the present study examined the structural relationships of physical exercise (PE), mobile phone addiction (MPA), learning engagement (LE), and AB among Chinese "Double Non" college students, aiming at exploring corresponding mechanism to provide supportive guidance for alleviating potential AB.

Methods

This study adopted a cross-sectional survey approach among the sample of "Double Non" college students in China. We recruited 930 participants (272 men and 658 women) in the second half of the 2022-2023 academic year, all of whom completed questionnaires involving Physical Exercise Rating Scale, Mobile Phone Dependence Index Scale, Utrecht Work Engagement Scale-Student, and Maslach Burnout Inventory-Student Survey. A series of statistical analyses, including descriptive statistics, bivariate correlations, and direct and indirect effects among study variables, were proceeded based on the collected data.

Results

The results showed that PE can not only directly and negatively influence AB, but also indirectly and negatively influence AB through the mediation of MPA as well as the chain mediation of both MPA and LE. While PE had no significantly indirect effect on AB via LE.

Discussion

Physical exercise was proved to be an effective way to reduce MPA and then enhance LE, consequently leading to decreased AB in Chinese "Double Non" college students. The findings were discussed in light of related research, and implications and future directions were put forward for application in potential theoretical research and educational practice.

Effects of Smartphone Activities on Postural Balance in Adolescents with Intellectual Disabilities

Considering the rising prevalence of smartphone usage among adolescents with intellectual disabilities and their frequent motor challenges, understanding its impact on their physical well-being is important. This study aims to investigate the impact of smartphone activities on postural balance in adolescents with intellectual disabilities. Two groups of adolescents participated in the study: an intellectual disability group (IDG) (n = 16) and atypical development group (TDG) (n = 12). Static postural balance, using a stabilometric platform on firm and foam surfaces, and dynamic balance, using the Timed Up-and-Go Test (TUGT), were performed under various conditions, such as playing a game, watching videos, video calls, and listening to music. The center of pressure (CoP) values significantly increased (p < 0.05) during all smartphone activities (except listening to music) compared to the control condition in both groups, with the IDG demonstrated a more pronounced increase (p < 0.05) during playing video games and video calls on the firm surface. TUGT scores significantly increased (p < 0.05) during smartphone activities, with greater changes observed in the IDG (p < 0.05), and significantly decreased (p < 0.01) during listening to music in both groups. Our study suggests that adolescents with intellectual disabilities need special tools and guidance to ensure their safety and well-being when using smartphones.

Use of electronic devices in leisure time modifies the prevalence and factors associated with sedentary behavior derived exclusively from excessive television viewing among Brazilian adults

The growing interest in the study of sedentary behavior is justified by its increasing presence in people's daily lives, particularly in leisure time. The aim of this study was to compare the prevalence and factors associated with sedentary behavior derived exclusively from TV time and from its combination with the time spent using other electronic devices among Brazilian adults (n = 52,443). This cross-sectional study used data from the Vigitel survey (2019), which included subjects ≥ 18 years old who resided in the capitals of the 26 Brazilian states and Federal District. High TV time (≥ 4 h/day), and its combination with computer, tablet, or cell phone use (≥ 4 h/day), as well as sociodemographic, behavioral, and health characteristics were self-reported. Adjusted logistic regression was used to estimate odds ratios and 95% confidence intervals (95%CI). The prevalence of high sedentary behavior almost tripled when TV viewing was added to the time spent using other electronic devices (from 12.2%; 95%CI: 11.6; 12.8, to 34.7%; 95%CI: 33.8; 35.6), notably among the youngest (32.0 percentage points). Individuals living without a partner, who smoked, consumed alcohol and processed foods excessively, were physically inactive, and had hypertension were more likely to have both outcomes than their counterparts. Older and less educated individuals were more likely to spend excessive time watching TV and less likely to have high use of other electronic devices in addition to TV viewing than their peers. Including computer, tablet, or cell phone led to an increase in the prevalence of high sedentary behavior. The magnitude and direction of the associations of age and education with high sedentary behavior varied according to the method how high sedentary behavior was defined. Projects, programs, and policies must consider the different indicators of sedentary behavior in monitoring and promoting a healthier lifestyle.

Effects of smartphone addiction on cognitive function and physical activity in middle-school children: a cross-sectional study

Introduction

This study aimed to investigate the effects of smartphone addiction on cognitive function and physical activity in middle-school children.

Methods

A population of 196 children (boys and girls) from middle schools were recruited for this study with an average age of 12.99 ± 0.81 years, a height of 153.86 ± 6.50 meters, a weight of 48.07 ± 7.31 kilograms, and a body mass index of 20.22 ± 2.08 kg/m2. Smartphone addiction was determined using Arabic versions of the Smartphone Addiction Scale-Short Version, and physical activity levels were assessed by a physical activity questionnaire for older children. The working memory and selective attention domains of cognitive function were evaluated using a laptop screen's digital version of the memory automaticity and Flanker tasks, respectively. A one-way MANOVA was conducted to determine the differences in working memory between the smartphone-addicted and non-addicted groups. The relationship between smartphone addiction and physical activity was analyzed using Pearson's chi-squared test.

Results

The cognitive function-attention domain accuracy component showed a statistically significant difference between the groups, with a p-value of 0.05). The reaction time between smartphone-addicted and non-addicted children showed no statistically significant difference (p = 0.817). The relationship between smartphone addiction and physical activity was statistically significant (p < 0.001).

Discussion

The interaction effects between physical activity and smartphone addiction on reaction times showed statistically insignificant (p = 0.25) differences, showing that physical activity's effect on reaction times did not depend on smartphone addiction levels. The non-addicted children had significantly higher physical activity levels than the addicted children, indicating that smartphone addiction reduced physical activity.

Correlation of Socio-Economic Factors, Diet, and Ownership of Consumer Electronics with Body Mass Index in Women of Childbearing Age: Insights from the 2016 South African Demographic Health Survey

The available evidence indicates a correlation between owning consumer electronics, such as cellphones and televisions, and a higher risk of obesity and increased adiposity. However, such studies are sparse in South Africa. Thus, the aim of this study is to examine the dietary and sociodemographic factors associated with various BMI categories, including the possession of consumer electronics, among women of reproductive age in South Africa. This is a secondary study of a population registry that includes dietary, BMI, and digital use items among women of reproductive age. The data is from the South Africa Demographic Health Survey (SADHS, 2016). Of the 3363 participants included in the analysis, women of normal weight were (35.5%), pre-obese (34.5%), obese (27.1%) and underweight (2.9%). Age was found to be significantly associated with pre-obesity at a <0.05 confidence interval. Owning a cellphone was significantly associated with being underweight and had 55% increased odds (1–0.45) (OR = 0.45; 95% CI 0.26–0.77, p = 0.004). Using internet almost daily was statistically significant with being underweight and had 55% (1–0.45) increased odds of being underweight (OR = 0.45; 95% CI 0.20–1.01, p = 0.054). Owning a cellphone and internet use was found to be significantly associated with being underweight. More research is needed to understand why cellphone ownership and using internet almost daily are significantly associated with being underweight.

Physical activity, sedentary behavior, and cardiovascular disease risk in Korea: a trajectory analysis

OBJECTIVES

To identify the distinct trajectories of sedentary behavior (SB) and explore whether reduced cardiovascular disease (CVD) risk was associated with a distinct trajectory of physical activity (PA).

METHODS

We analyzed data from 6,425 people who participated in the Korean Health Panel Survey over a period of 10 years. The participants' self-reported SB and PA were assessed annually, and trajectory groups were identified using a group-based trajectory model for longitudinal data analysis. Logistic regression analysis was performed to assess the association between CVD risk (10-year cumulative incidence) and the trajectories of SB and PA. The adjusted variables included socio-demographic factors, the predisposing diseases of CVD, and baseline health behaviors.

RESULTS

Trajectory analysis identified 4 SB trajectory groups: SB group 1 (low and slightly increasing trend, 53.1%), SB group 2 (high and rapidly decreasing trend, 14.7%), SB group 3 (high and slightly decreasing trend, 9.9%), and SB group 4 (low and rapidly increasing trend, 22.2%). The 3 PA trajectory groups were PA group 1 (moderate and slightly decreasing trend, 32.1%), PA group 2 (low and slightly decreasing trend, 57.3%), and PA group 3 (maintained inactivity, 10.7%). By the 10-year follow-up, 577 cases of incident CVD had occurred. We also noted a 50% reduction in the risk of CVD when SB group 4 was accompanied by PA group 1 (odds ratio, 0.50; 95% confidence interval, 0.28 to 0.90).

CONCLUSIONS

Despite increased time spent in SB, maintaining PA about 2 days to 3 days per week reduced the occurrence of CVD.

The Relationship Between Physical Activity and Mobile Phone Addiction Among Adolescents and Young Adults: Systematic Review and Meta-analysis of Observational Studies

BACKGROUND

Previous studies have reported a potential negative correlation between physical activity (PA) and mobile phone addiction (MPA) among adolescents and young adults. To date, the strength of this correlation has not been well characterized.

OBJECTIVE

This review and meta-analysis aimed to synthesize available empirical studies to examine the correlations between PA and MPA among adolescents and young adults. We also explored several potential moderators, including time of data collection, country or region, and type of population, associated with the relationship between PA and MPA.

METHODS

Four electronic databases (PubMed, Scopus, PsycINFO, and Web of Science) were searched from database inception to March 2022 to identify relevant studies. The pooled Pearson correlation coefficients and their corresponding 95% CIs for the relationship between PA and MPA were calculated using the inverse variance method. The methodological quality of the included cross-sectional studies was determined based on the Joanna Briggs Institute appraisal checklist. The study conformed to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-analyses) guidelines.

RESULTS

In total, 892 relevant articles were identified, of which 22 were selected based on the inclusion and exclusion criteria. The final meta-analysis included 17 of the 22 studies. Results of random effects modeling revealed a moderate correlation between PA and MPA among adolescents and young adults (summary r=-0.243, P<.001). Sensitivity and publication bias analyses further demonstrated the robustness of our results. All the included studies were scored as high quality with a low risk of bias. Subgroup analysis further indicated that none of the hypothesized moderators (time of data collection, country or region, and type of population) significantly affected the relationship between PA and MPA, as confirmed by the mixed effects analysis. In addition, in the data collection subgroups, medium effect sizes were obtained for data collected before COVID-19 (r=-0.333, P<.001) and data collected during COVID-19 (r=-0.207, P<.001). In subgroup analyses for country or region, the correlation coefficient for China and other developing regions showed a similarly moderate effect size (r=-0.201, P<.001 and r= -0.217, P<.001, respectively). However, the effect sizes for developed regions were not significant (r=-0.446, P=.39). In a subgroup analysis based on the type of population, we found that the effect size for young adults was moderate (r=-0.250, P<.001). However, that of adolescents was not significant (r=-0.129, P=.24).

CONCLUSIONS

Our results demonstrate a moderately negative relationship between PA and MPA among young adults. The strength of this relationship was not influenced by the time of data collection, country or region, or type of population.

Cascading bidirectional influences of digital media use and mental health in adolescence

A substantial portion of critical adolescent development is occurring within digital environments. However, certain individual differences may lead adolescents to use digital media in diverse ways. In this chapter we suggest that the way teens use digital media influences how digital media affects their mental health. Further, we propose a model in which these influences, in the context of ongoing development, may have feedback effects on how digital media is subsequently used, thus resulting in a self-perpetuating cycle. Our model suggests that certain developmental risk/protective factors and maladaptive/adaptive digital media behaviors likely perpetuate each other in a cyclical manner each serving to maintain and/or escalate the other. We discuss existing evidence of these processes in psychosocial, identity, incentive processing, and physical health development. Future research focusing on individual differences and self-reinforcing digital media behaviors that manifest these feedback loops may portray a more complete picture of cascading digital media influences across adolescent development.

Smartphone Usage Patterns and Dietary Risk Factors in Adolescents

BACKGROUND

Whereas earlier studies have shown that traditional screen time such as TV watching influences dietary behaviors in adolescents, little is known about the effects of modern screen time such as smartphone use.

OBJECTIVES

We examined the associations of smartphone usage duration and content type with dietary risk factors among adolescents.

METHODS

We conducted a cross-sectional analysis using a nationally representative sample of 54,601 middle- and high-school students (aged 12-18 y; 26,928 boys and 27,673 girls) in the Korea Youth Risk Behavior Web-Based Survey 2017. Smartphone use (average duration and most frequently used content type) and dietary intakes [frequent breakfast skipping; less frequent intakes of fruits and vegetables; more frequent intakes of instant noodles, fast food, chips/crackers, and sugar-sweetened beverages (SSBs)] were self-reported via an online-based questionnaire. Multivariable logistic regression was performed to estimate ORs and 95% CIs for the associations of smartphone usage duration and content type with prevalence of dietary risk factors, adjusting for potential confounders. All analyses accounted for complex survey sampling.

RESULTS

Prolonged smartphone use (≥300 compared with 1-59 min/d) was associated with (OR; 95% CI) higher prevalence of frequent breakfast skipping (1.60; 1.45, 1.76); frequent intakes of instant noodles (1.65; 1.47, 1.84), fast food (1.36; 1.20, 1.53), and SSBs (1.92; 1.75, 2.11); and less frequent intakes of fruits (1.44; 1.30, 1.59) and vegetables (1.32; 1.18, 1.47). Adjusting for usage duration, using smartphones mainly for messenger/e-mail, social networking service (SNS)/forum, and games were associated with less frequent intakes of fruits (OR: 1.21; 95% CI: 1.12, 1.31; OR: 1.28; 95% CI: 1.17, 1.40; and OR: 1.20; 95% CI: 1.10, 1.32, respectively) and vegetables (OR: 1.24; 95% CI: 1.12, 1.37; OR: 1.26; 95% CI: 1.13, 1.40; and OR: 1.25; 95% CI: 1.12, 1.40, respectively) than was using smartphones for education/information search. Using smartphones mainly for messenger/e-mail (OR: 1.24; 95% CI: 1.14, 1.35) and SNS/forum (OR: 1.18; 95% CI: 1.08, 1.29) were also associated with more frequent intake of SSBs.

CONCLUSIONS

Our data suggest that both duration and content type of smartphone use are independently associated with dietary risk factors among adolescents.

The Impact of Smartphone Addiction on Chinese University Students' Physical Activity: Exploring the Role of Motivation and Self-Efficacy

Background

Previous studies showed that smartphone addiction (SA) can lead to reduced physical activity (PA), but only a few studies have explored the impact of SA from psychological perspective closely related to PA. This study aimed to examine the extrinsic and partial psychological factors leading to decrease in PA using structural equation modelling analysis.

Methods

We conducted an online survey on 628 males and 1159 female students from 10 universities in Henan Province, China, through a questionnaire survey application “Questionnaire Star”. This study used three models to test the mediating effects of three types of motives (intrinsic motives, body-related motives, and social motives) and self-efficacy, respectively, in the relationship between smartphone addiction and physical activities.

Results

Our result confirmed that smartphone addiction leads to lower physical activities. Secondly, self-efficacy mediates smartphone addiction and physical activities, but the mediating effect of all three types of motivation is not significant. Thirdly, smartphone addiction did not affect intrinsic motivation and body-related motivation, but positively affects social motivation. Finally, as the motivation type changes from internal to external, the mediating effect of self-efficacy becomes stronger.

Conclusion

This study showed that smartphone addiction lead to increase social motivation and decreased self-efficacy, and is a potential barrier to personal participation in physical activities. Our findings provide a new perspective for future design physical activities interventions in China and worldwide especially among university students where smartphone addiction is a problem.

Physical Exercise and Undergraduate Students’ Subjective Well-Being: Mediating Roles of Basic Psychological Need Satisfaction and Sleep Quality

This study aimed to examine the association between physical exercise and subjective well-being among undergraduate students, as well as its underlying mechanism—the potential mediating roles of basic psychological need satisfaction and sleep quality—from the perspective of self-determination theory. A sample of 770 undergraduate students (mean age was 19.90 ± 1.15 years old; 464 women) were recruited voluntarily to complete a set of measures examining physical exercise habits, psychological need satisfaction in exercise, sleep quality, and subjective well-being. The results indicated that (1) physical exercise was positively associated with undergraduate students’ subjective well-being; (2) psychological need satisfaction and sleep quality could significantly mediate this relation, which contained three pathways—the independent mediating effects of sleep quality and basic psychological need satisfaction and the sequential mediating effect of them. These findings not only reveal the mediating mechanism underlying the relation between physical exercise and subjective well-being by integrating the psychological and physical factors together but also provide an empirical basis for formulating prevention and intervention programs aimed at promoting the health and subjective well-being of undergraduate students.

Correlations between Physical Fitness and Body Composition among Boys Aged 14-18-Conclusions of a Case Study to Reverse the Worsening Secular Trend in Fitness among Urban Youth Due to Sedentary Lifestyles

A secular trend can be observed throughout the world with an increase in childhood obesity and a decrease in fitness. The research aimed to examine the results of tests measuring the conditional abilities of young boys aged 14-18 in fitness tests and their correlations with body composition indicators. That was supported by research that has been prepared in Hungary so far. This research focuses on the results of fitness tests conducted on 14- to 18-year-old boys, presented along with body composition data. The authors sought to describe the development of the fitness profiles of males at a Budapest secondary school participating in the research, based on the results of the Hungarian National Student Fitness Test (NETFIT®), and also how their physical characteristics affect the results of NETFIT® tests in the sample measured. A total of 735 male high school students at a Budapest secondary school (14-18 years old) (mean ± SD, 16.05 ± 1.18 years) participated in the survey. The data were collected in the 2018/2019 academic year, and it was compared with the national data. The correlation between the performance indicators of the NETFIT® tests and the physical characteristic indicators was analyzed using the two-block Partial Least Squares method. In the resulting groups, Kruskal-Wallis variance analysis was performed to investigate the differences in performance. In contrast, pairs of group differences were tested with the Mann-Whitney test. Boys with a short physique were at some advantage in trunk-lifts and push-ups, compared to taller boys. It was also obvious that being overweight is a hindrance regarding the PACER test or the standing broad jump. The handgrip in the left and right hand was mostly of similar strength or weakness. Tall-heavy children performed better in this test. The grip strength of tall-thin students was also strong, but not as strong as in the tall-heavy group. Reducing the percentage of body fat (PBF) and creating the optimal BMI index is important for the younger age group, as our results have clearly demonstrated that overweight is a hindrance in the PACER, VO2 max, standing broad jump, back-saver sit-and-reach, and push-up tests.

Prolonged Sitting Causes Leg Discomfort in Middle Aged Adults: Evaluation of Shear Wave Velocity, Calf Circumference, and Discomfort Questionaries

Introduction: Prolonged sitting causes leg discomfort. We evaluated shear wave velocity (SWV) of leg muscles, leg circumference, and leg discomfort associated with 2 h sitting. Methods: Twenty-one middle-aged men and 19 middle-aged women participated in the study. SWV and leg circumference was measured just after sitting, 60 min, 120 min, and after 3 min of leg raising. Leg discomfort was assessed before sitting and 120 min. Results: SWV was significantly greater in men than women and increased over time, and decreased with leg raising. The percentage increase in lower leg circumference was significantly greater in women than in men, and it increased over time. Leg discomfort significantly increased after 120 min in both men and women. Discussions: Because SWV is proportional to an increase in intramuscular compartment pressure in the lower leg, intramuscular compartment pressure increased over time with sitting and decreased with leg raising. Considering the changes in SWV and leg circumference, it was inferred that prolonged sitting causes an increase in intramuscular compartment pressure and intravascular blood volume, as well as an increase in water content in the leg subcutaneous tissue. Leg discomfort was estimated to be due to increased intra-leg fluid. Brief leg raising may resolve leg edema and discomfort.

Validation of a Modified Version of the German Sedentary Behavior Questionnaire

Background: Physical inactivity and excessive sedentary behavior (SB) are growing public health issues that require surveillance, guidelines, and targeted interventions. In addition to a variety of sophisticated technical methods, questionnaires are still an attractive method for quick, easy, comprehensive, and cost-effective estimation of SB. The aim of this study was to validate a modified version of the widely used Sedentary Behavior Questionnaire (SBQ) compared to waist-worn accelerometers as an objective measurement. Contemporary explanations covering the use of smart devices have been added to the original instrument, and sitting while handwriting was explicated in more detail. Methods: Cross-sectional data from an adult sample (n = 64, 20−85 y, 25 m, 39 f) were used in this first validation study. Based on prior investigations of the SBQ, analyses were conducted in a gender-specific manner. Criterion validity was assessed using Spearman’s Rho coefficients. The Bland−Altman method was used to test the agreement between self-reported and accelerometer-measured SB time. Results: Using the modified SBQ (mSBQ), a significant gender difference in weekly sedentary time was found. Women estimated their sedentary time to be almost 50% higher than men (median 74.5 h vs. 51.0 h). No correlation was found between the questionnaire and accelerometer data for both subgroups (rho ≤ 0.281, p ≥ 0.174). Individual differences in daily SB estimation between both methods (in relation to accelerometry) were +3.82 h ± 4.36 h for women and +0.48 h ± 2.58 h for men (p < 0.001). Conclusion: The modifications to the SBQ did not improve the correlation between self-assessment of SB and objective determination. The reasons for the presented gender-specific overestimation of the participants’ own sedentary time, which contradicts the findings of other studies, remain unclear and need to be investigated further.

Gender Differences in the Associations Between Physical Activity, Smartphone Use, and Weight Stigma

Background

Physical activity (PA) is important for health. However, there is little evidence on how weight stigma, time spent on sedentary activities (including smartphone, social media, online learning), time spent on outdoor activity, and nomophobia associate with PA among Chinese individuals with consideration of gender. The present study examined the aforementioned associations in the COVID-19 pandemic era.

Methods

University students (N = 3,135; 1,798 females, 1,337 males) with a mean age of 19.65 years (SD = 2.38) years completed an online survey from November to December, 2021. The online survey assessed weight stigma (using the Perceived Weight Stigma Scale and Weight Bias Internalization Scale), PA (using the International Physical Activity Questionnaire Short Form), time spent on different activities (using self-designed items for time on smartphone, outdoor activity, social media, and online learning), and nomophobia (using the Nomophobia Questionnaire). Parallel mediation models were constructed (dependent variable: PA; mediators: perceived weight stigma, weight-related self-stigma, time spent on smartphone, time spent on outdoor activity, time spent on social media, and time spent online learning; independent variable: nomophobia) and evaluated using Hayes' Process Macro Model 4 (IBM SPSS 20.0).

Results

Weight-related self-stigma (β = −0.06; p = 0.03), time spent on outdoor activity (β = 0.21; p < 0.001), time spent on social media (β = 0.07; p = 0.02), time spent on online learning (β = 0.06; p = 0.03), and nomophobia (β = −0.07; p = 0.01) were all significant factors explaining the PA among female participants. Perceived weight stigma (β = −0.07; p = 0.01), time spent on outdoor activity (β = 0.27; p < 0.001), and time spent on online learning (β = 0.10; p = 0.002) were all significant factors explaining PA among male participants.

Conclusion

Chinese healthcare providers should design programs on weight stigma reduction and outdoor activity improvement to enhance PA among university students.

Trends in television viewing and overweight /obesity among Nepalese women: Findings from 2006, 2011 and 2016 Nepal Demographic and Health Surveys

BACKGROUND AND AIMS

Associations between overweight/obesity and television (TV) viewing have been identified in high-income countries, but little evidence is available from low- and middle-income countries. This study examined the trends and correlates of television viewing and overweight/obesity among Nepalese women between 2006 and 2016.

METHODS AND RESULTS

We analysed the data from 22,161 women aged 15-49 years who took part in Nepal Demographic Health Surveys 2006 (n = 10,115), 2011 (n = 5,881) or 2016 (n = 6,165). Trained staff collected data on TV viewing and sociodemographic attributes from a face-to-face survey while height and weight were measured objectively to determine body mass index. Around 38% of the study participants watched TV at least once a week in 2006, which increased to 49% in 2011 and 46% in 2016. The prevalence of overweight and obesity increased from 8% in 2006 to 14.6% in 2011 and 19.8% in 2016. Compared to those who did not watch TV at all, those watching it at least once a week were at 1.54 (95% CI: 1.02-2.33), 1.79 (95% CI: 1.23-2.60) and 1.46 (95% CI: 1.13-1.88) times higher odds of being overweight/obese in 2006, 2011 and 2016 respectively.

CONCLUSION

The prevalence of TV viewing rose among women in Nepal between 2006 and 2016 and was associated with overweight/obesity, which also increased dramatically over this period. Future studies examining the use of multiple screen devices, daily usage duration and content viewed are recommended to understand better the health impacts of transitions to more sedentary living in Nepal and similar settings.

Age, gender, peers, life skills and quality of life influence risk of cell phone addiction among college teachers in Karnataka, India : a state level epidemiological analysis

BACKGROUND

Cell phones are an integral part of modern day life and have become companions for individuals irrespective of age, gender and socio-economic status. In this study, we assessed the factors affecting risk of cell phone addiction among teachers attending Life Skills Training and Counselling Services (LSTCS) program in Karnataka.

METHODS

This cross sectional secondary data analysis utilised data from baseline assessment of trainees attending a Life Skills Training and Counselling Services program (LSTCP). Various factors hypothesised to be affecting risk of cell phone addiction (outcome) was analysed using univariate and multivariable logistic regression analysis. All the analysis was done using STATA 12.0 software.

RESULTS

Multivariable logistic regression analysis was conducted with risk of cell phone addiction as outcome. A conceptual framework of hypothesized exposure variables was developed based on expert consultation and literature review. Overall, data of 1981 participants was utilized. Gender (AOR=1.91; 95% CI=1.27-2.77), number of peers (AOR=1.01; 95 CI=1-1.008) and social quality of life (AOR=1.01; 95% CI=1.00-1.03) were associated with increased risk of cell phone addiction. Age (AOR=0.98; 95%CI=0.96-1.00), empathy (AOR=0.96;95%;CI=0.93-0.99), communication skills(AOR=0.92, 95%;CI=0.88-0.96) and physical quality of life (AOR=0.96; 95% CI=0.95-0.98) were associated with reduced risk of cell phone addiction.

CONCLUSIONS

This study on precursors of risk of cell phone addiction, conducted mostly among apparently healthy individuals, provide important insights into interventions to reduce risk of cell phone addiction. The complexity of associations between peers, gender, quality of life and risk of cell phone addiction needs further exploration.

The Importance of Physical Activity to Augment Mood during COVID-19 Lockdown

The purpose of this study was to assess the effect of COVID-19 lockdown on mood and objective physical activity. A sample of 78 college students in Spain completed an assessment of mood using the valid Profile of Mood State (POMS) questionnaire and had their physical activity tracked objectively using a validated wrist-worn accelerometer (Xiaomi Mi Band 2) for one week before being under COVID-19 lockdown (T1) and for one week during COVID-19 lockdown (T2). Paired samples t-tests revealed significantly greater (p = 0.027) POMS Total Mood Disturbance (TMD) Score T2 (mean ± SD) (22.6 ± 28.0) compared to T1 (17.7 ± 22.6) (lower score represents better mood) and significantly lower (p ≤ 0.001) POMS Vigor Score T2 (14.1 ± 5.0) compared to T1 (18.2 ± 4.5) (lower vigor score represents lower mental and physical energy levels). Additionally, Total Objective Steps was significantly less (p ≤ 0.001) lT2 (15,841.9 ± 17,253.2 steps) compared to T1 (64,607.0 ± 50,525.2 steps). Regression analyses demonstrated significant negative relationships of Total Objective Steps and POMS Depression (p = 0.014, Beta = -0.277, t = -2.511), POMS Anger (p = 0.040, Beta = -0.233, t = -2.091), and POMS TMD (p = 0.007, Beta = -0.302, t = -2.754) T2. The regressions also revealed a significant positive relationship (p = 0.012, Beta = 0.283, t = 2.57) of Total Objective Steps and POMS Vigor T2. These data suggest that being in a lockdown due to a pandemic may have negative physical and mental health-related consequences and that engaging in physical activity may reduce these deleterious mental health-related consequences during lockdowns and quarantines.

The relationship between internet addiction and risky health behaviors in university students: A cross-sectional study in Turkey

PURPOSE

The study was carried out to determine the relationship between internet addiction and risky health behaviors in university students.

DESIGN AND METHODS

The study, which is cross-sectional research, was conducted with 606 university students in the 2019-2020 academic year and used face-to-face interviews.

FINDINGS

It was determined that 7.15% of the students had internet addiction with limited symptoms. A positive and significant relationship was found between internet addiction and risky health behaviors (p < 0.05).

PRACTICE IMPLICATIONS

To reduce internet addiction and risky health behaviors, counseling, planning peer education programs, and creating an environment where students can express themselves should be provided. It is also recommended that students develop relationships with their social environment and participate in social activities.

Is the relationship between problematic mobile phone use and mental health problems mediated by fear of missing out and escapism?

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Higher level of problematic mobile phone use was associated with higher level of mental health problems, Fear of Missing Out (FoMO) and escapism.

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Higher level of mental health problems was associated with higher level of FoMO.

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Higher level of FoMO and worry was associated with higher level of escapism.

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The association between problematic mobile phone use and mental health problems was not mediated by FoMO and escapism.

Introduction

Individuals with problematic mobile phone use often report mental health problems, however, little is known about factors which mediate this association. Therefore, the aim of this study was to examine the mediating role of fear of missing out (FoMO) and escapism in an attempt to explain the relationship between problematic mobile phone use and mental health problems.

Method

A total of 235 undergraduate students in Turkey participated in this study. These participants completed a set of questionnaires to measure fear of missing out, problematic mobile phone use, escapism, depression, anxiety, stress, and worry severity.

Results

Participants with a high level of problematic mobile phone use also had a high level of mental health problems, FoMO, and escapism. The association between problematic mobile phone use and mental health problems was not mediated by FoMO and escapism.

Conclusion

Personal characteristics such as emotional regulation and self-regulation need to be examined in future studies in order to determine their potential mediating role in explaining the association between problematic mobile phone use and mental health problems.

Mobile health apps to reduce sedentary behavior: a scoping review

Given the continued increase in mobile health applications (apps) aimed at healthcare and the recognition of sedentary behavior (SB) as a public health problem, the goal of this scoping review study was to summarize the effects of interventions based on mobile health apps designed to reduce SB in adults, with a specific focus on SB. The electronic databases PubMed, PsycINFO, SportDISCUS, Web of Science, and manual searches in reference lists were conducted on papers published up to September 2020. Nine out of the 897 studies researched were included and composed the descriptive synthesis. The investigations found in the present study showed a decrease in time spent on television viewing and in total time spent sitting, as well as an increase in the number of SB breaks after interventions based on mobile health apps. In conclusion, despite the growing interest in intervention programs in SB, only nine studies have used smartphone apps as a strategy to reduce SB in adults. Mobile health apps were proved to be effective in SB reduction, as assessed by different parameters, and should be encouraged. However, further studies are needed to verify the long-term effects of the utilization of such applications.

Reducing sedentary time using an innovative mHealth intervention among patients with total knee replacement: Rationale and study protocol

INTRODUCTION

Although knee replacement is effective for improving pain and physical function, subsequent improvements in physical activity typically do not follow. As a result, many patients spend most of their day engaged in sedentary behavior, which may put them at higher risk of experiencing poor function and disability. Intervening on sedentary time, rather than physical activity, may be a more feasible first-step approach for modifying activity-related behaviors in adults who received knee replacement.

OBJECTIVE

The purpose of this study is to examine the use of a mobile health (mHealth) intervention to reduce sedentary time among adults who received a knee replacement at 3 and 6 months after surgery.

METHODS

Patients (n = 92) scheduled for knee replacement will be recruited and at 4 weeks after surgery, they will be randomized to either NEAT!2 or Control. NEAT!2 participants will use the NEAT!2 smartphone app, which provides a vibration and/or audible tone to interrupt prolonged bouts of sitting detected from the smartphone's internal accelerometer, until 3 months after surgery. NEAT!2 participants will receive biweekly coaching calls between 4 and 12 weeks after surgery. Control participants will receive an education control app and receive non-intervention calls to assess general surgery recovery. Both groups will receive 3 retention calls between 3 and 6 months. Data collection will occur pre-operatively and at 3 and 6 months after surgery.

DISCUSSION

The results of this study will help to determine whether an innovative remotely-delivered, mHealth sedentary reduction intervention can decrease sedentary time in adults after knee replacement.

The Effect of Containment Measures during the Covid-19 Pandemic to Sedentary Behavior of Thai Adults: Evidence from Thailand's Surveillance on Physical Activity 2019-2020

Measures to contain the spread of coronavirus disease 2019 (Covid-19) imposed by governments have undoubtedly impacted on preventing its spread but may have also produced longer periods of sedentary living across all segments of society. To examine this phenomenon, this study compared the sedentary behavior (SB) of Thai adults before and during the Covid-19 pandemic. The 2019 and 2020 datasets of Thailand's Surveillance on Physical Activity (SPA) were employed. A total of 5379 (SPA2019) and 6531 (SPA202020) persons age 18-64 years who had access to the Internet were included in the analysis. Measures imposed to contain the spread of Covid-19 infection were significantly associated with lower opportunity of Thai adults for work-related physical movement, and that increased their SB, particularly with the shift from onsite to online working platforms. Cumulative SB increased from 824 (before the pandemic) to 875 min/day during the pandemic. The odds of accumulating >13 h/day of SB was highest among females, young adults, those who completed post-secondary education, unemployed or working in the non-agriculture sector, having a chronic disease/condition, residing in an urban area, and living in a 'higher-risk' pandemic zone. The insignificant association of physical activity (PA) and the Fit from Home (FFH) intervention in reducing SB during the pandemic suggests that PA is not directly associated with SB, and that the FFH intervention was insufficient to prevent SB.

Psychological Factors Predicting Sedentary Behavior of Older Adults: A Cross-Sectional Study in Brazil

This cross-sectional study aimed to investigate the psychological factors that might predict the sedentary behavior of 654 older adults from the South Region of Brazil. The participants were evaluated by the International Physical Activity Questionnaire; Mini-Mental State Exam; Geriatric Anxiety Scale; and the scales Geriatric Depression, Purpose in Life, Perceived Stress, Rosenberg Self-Esteem, and Satisfaction with Life. Data analysis was conducted through Pearson correlation and multiple regression analysis (p < .05). No significant (p > .05) correlation was found between the sedentary behavior variables with self-esteem. Multiple regression analysis revealed that psychological variables explained 6% of the variance of sitting time during the week (R2 = .06; F = 11.546; p < .01). Depression showed a positive prediction (β = −0.10; p = .040), while life satisfaction (β = −0.16; p = .001) and purpose in life (β = −0.10; p = .026) showed negative prediction. Psychological variables predicted only 3% of the variance of sitting time during the weekend (R2 = .03; F = 5.629; p < .01), showing that life satisfaction had significant (p = .007) and negative (β = −0.13) association. Life satisfaction and purpose in life can be considered protector factors to sedentary behavior, while depression is a potentiating factor.

Systematic Review: Recommendations of Levels of Physical Activity among Colorectal Cancer Patients (2010-2019)

BACKGROUND

It is necessary to engage in an appropriate level of physical activity to improve the prognoses of colorectal cancer patients, yet no guidelines currently exist. The goals of this systematic review are to determine the impact of levels of physical activity on the prognoses of colorectal cancer patients and to suggest recommended guidelines for levels of physical activity.

METHODS

This systematic review was conducted along PRISMA guidelines. Per the inclusion criteria, papers published in academic journals in English from 2010 to 2019 were selected. A literature search was performed on PubMed (Medline), and the results of the selected studies were qualitatively synthesized.

RESULTS

Of the 13 cohort studies included in this systematic review, most studies were conducted in the United States (N = 7). Immobility or low levels of physical activity adversely affected the prognoses of colorectal cancer patients. Contrarily, high levels of physical activity increased the survival rate in people with colorectal cancer.

CONCLUSION

For colorectal cancer patients, a level of physical activity of 17.5 to 35 MET hours per week is strongly recommended, which has been shown to reduce mortality by approximately 30 to 40%. Patients with limited physical capacity should maintain a minimum level of physical activity (≥3.5 MET hours/week).

Adaptation and Psychometric Analysis of the Test of Mobile Phone Dependence-Brief Version in Italian Adolescents

Since the diffusion of recent models of mobile phones, anyone with an internet connection can communicate continuously and search for information. This raises some questions about the possible consequences of problematic mobile phone use (PMPU) in a complex life phase such as adolescence. Therefore, we performed a psychometric analysis of the brief version of the Test of Mobile Phone Dependence (TMD) in Italy. The sample comprised 575 Italian adolescents aged 11 to 18 years. Data were collected using the TMD-brief, the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance Short Form. Regarding test dimensionality, the best-fit measurement model included four factors: "Abstinence"; "Abuse and interference with other activities"; "Tolerance"; and "Lack of control" (Satorra-Bentler χ2 (48) = 185.96, p < 0.01; robust root mean square error of approximation (RMSEA) = 0.079 (90% confidence interval (CI): 0.067; 0.091); robust TLI = 0.904; robust comparative fit index (CFI) = 0.930). The Italian version of the TMD-brief was found to have good reliability and psychometric properties, and a four-factorial structure. PMPU predicted significant sleep disturbances and this relationship was moderated by clinical personality traits. Findings from this study support the use of the Italian version of the TMD-brief as a screening tool to investigate PMPU in Italian adolescents.

Reinforcing Value of a Moderately Physiologically Challenging Active Videogame Versus a Minimally Challenging Active Videogame

Objective: This study assessed the oxygen consumption [VO₂ mL/(kg·min)], liking, and relative reinforcing (motivating) value (RRV) of a moderately physiologically challenging exergame [Nintendo Wii-Sports Boxing (Boxing)] versus a minimally challenging exergame [Nintendo Wii Lego Star Wars (Lego)]. Materials and Methods: VO₂ and liking were recorded in children(N = 28, 7.8 ± 1.3 years old) during three 10-minute conditions: recumbent resting (Resting), and playing Wii Boxing or Wii Lego. Resting was completed first, and the order of exergames was randomized. Next, children performed an operant button pressing task using a progressive fixed ratio to assess the RRV of the two videogame conditions. Children worked to earn up to 11 minutes for Boxing, Lego, or a combination of the two. The output maximum (O_max) performed to earn access to each game was the measure of RRV. Results: There was a significant (P ≤ 0.03 for all conditions) step-wise increase in VO₂ from Resting [4.3 ± 1.2 mL/(kg·min)] to Lego [5.3 ± 0.5 mL/(kg·min)] and from Lego to Boxing [11.7 ± 4.2 mL/(kg·min)]. Liking was significantly greater for Boxing (P = 0.003) and Lego (P < 0.0001, 7.1 ± 2.9 cm; 7.1 ± 2.7 cm, respectively) versus Resting (4.6 ± 3.8 cm), with no significant difference between Boxing and Lego (P = 0.358). Lastly, O_max was significantly (P = 0.021) greater for Lego (257.7 ± 390.6 presses) than for Boxing (51.7 ± 131.0 presses). Conclusion: Oxygen consumption during Wii Boxing was significantly greater than during Wii Lego. Despite this greater physiological challenge, liking was similar for both Lego and Boxing. However, children were more motivated to play Lego than Boxing.

Sedentary Lifestyle: Overview of Updated Evidence of Potential Health Risks

One-third of the global population aged 15 years and older engages in insufficient physical activities, which affects health. However, the health risks posed by sedentary behaviors are not well known. The mean daily duration of sedentary behavior is 8.3 hours among the Korean population and 7.7 hours among the American adult population. Sedentary lifestyles are spreading worldwide because of a lack of available spaces for exercise, increased occupational sedentary behaviors such as office work, and the increased penetration of television and video devices. Consequently, the associated health problems are on the rise. A sedentary lifestyle affects the human body through various mechanisms. Sedentary behaviors reduce lipoprotein lipase activity, muscle glucose, protein transporter activities, impair lipid metabolism, and diminish carbohydrate metabolism. Furthermore, it decreases cardiac output and systemic blood flow while activating the sympathetic nervous system, ultimately reducing insulin sensitivity and vascular function. It also alters the insulin-like growth factor axis and the circulation levels of sex hormones, which elevates the incidence of hormone-related cancers. Increased sedentary time impairs the gravitostat, the body's weight homeostat, and weight gain, adiposity, and elevated chronic inflammation caused by sedentary behavior are risk factors for cancer. Sedentary behaviors have wide-ranging adverse impacts on the human body including increased all-cause mortality, cardiovascular disease mortality, cancer risk, and risks of metabolic disorders such as diabetes mellitus, hypertension, and dyslipidemia; musculoskeletal disorders such as arthralgia and osteoporosis; depression; and, cognitive impairment. Therefore, reducing sedentary behaviors and increasing physical activity are both important to promote public health.

Weight Management Apps in Saudi Arabia: Evaluation of Features and Quality

Background

Weight management apps may provide support and management options for individuals with overweight and obesity. Research on the quality of weight management mHealth apps among the Saudi population is insufficient despite frequent use.

Objective

The aims of this study were to explore user perceptions of weight management apps, explore reasons for starting and stopping app use, appraise the quality of weight management apps available in the App Store, and compare the features currently available within the app market and those that are most desirable to weight management app users.

Methods

A web-based survey consisted of 31 open and closed questions about sociodemographic information, general health questions, app use, app user perceptions, and discontinuation of app use. The quality of the weight management apps available on the App Store was assessed using the Mobile App Rating Scale and evidence-based strategies. We also used six sigma evaluations to ensure that the quality measured by the tools consistently meets customer expectations.

Results

Data from the survey were analyzed. Of the respondents, 30.17% (324/1074) had used a weight management app, 18.16% (195/1074) used the apps and stopped, and 51.68% (555/1074) had never used a weight management app. Of apps mentioned, 23 met the inclusion criteria. The overall average Mobile App Rating Scale quality of apps was acceptable; 30% (7/23) received a quality mean score of 4 or higher (out of 5), and 30% (7/23) did not meet the acceptability score of 3 or higher. Evidence-based strategy results showed that feedback was not observed in any of the apps, and motivation strategy was observed in only 1 app. The sigma results of evidence-based strategies reflect that most of the apps fail to pass the mean.

Conclusions

App users desired a feature that allows them to communicate with a specialist, which is a missing in the available free apps. Despite the large number and accessibility of weight management apps, the quality and features of most are variable. It can be concluded from six sigma results that passing the mean does not ensure that the quality is consistently distributed through all app quality properties and Mobile App Rating Scale and evidence-based strategies do not give developers an indication of the acceptance of their apps by mobile users. This finding stresses the importance of reevaluating the passing criterion, which is ≥50% for designing an effective app.

Access to an Electronic Health Record: A Polish National Survey

In Poland, as in many countries around the world, e-health services are becoming more and more popular. Obligatory e-sick leave was implemented, followed by e-prescriptions and e-referrals. Therefore, it is worth considering the introduction of a complete electronic health record (EHR) that can be accessed by doctors and patients. The main aim of the study is to find out whether patients want to have access to their EHRs and if they would agree to pay for such a service. The research was based on three surveys conducted among 1000 Polish adults in 2007, 2012, and 2018. The sample collection was carried out by the national opinion poll agency, with the use of computer-assisted telephone interviews. Over 60% of respondents were interested in the possibility of accessing EHRs in general, and almost 50% of them were ready to pay for it. Nevertheless, when analyzing all the year-on-year trends, they were subject to a gradual decrease. The youngest age group was the one most interested in EHRs, while the group comprising respondents in middle age was the one most willing to pay for it. There is still great potential in implementing EHRs on a bigger scale.

Associations of Objectively-Assessed Smartphone Use with Physical Activity, Sedentary Behavior, Mood, and Sleep Quality in Young Adults: A Cross-Sectional Study

This study assesses the associations of objectively-measured smartphone time with physical activity, sedentary behavior, mood, and sleep patterns among young adults by collecting real-time data of the smartphone screen-state. The sample consisted of 306 college-aged students (mean age ± SD: 20.7 ± 1.4 years; 60% males). Over seven days of time, the following variables were measured in the participants: objectively-measured smartphone use (Your Hour and Screen Time applications), objective and subjective physical activity (GoogleFit and Apple Health applications, and the International Physical Activity Questionnaire (IPAQ), respectively), the number of hours sitting (IPAQ), mood (The Profile of Mood State (POMS)), and sleep (The Pittsburgh Sleep Quality Index (PSQI)). Multiple regressions analyses showed that the number of hours sitting per day, physical activity, and the POMS Global Score significantly predicted smartphone use (adj.R2 = 0.15). Further, participants with low levels of physical activity were more likely to increase the use of smartphones (OR = 2.981). Moreover, mood state (β = 0.185; 95% CI = 0.05, 0.32) and sleep quality (β = 0.076; 95% CI = -0.06, 0.21) predicted smartphone use, with those reporting poor quality of sleep (PSQI index >5) being more likely to use the smartphone (OR = 2.679). In conclusion, there is an association between objectively-measured smartphone use and physical activity, sedentary behavior, mood, and sleep patterns. Those participants with low levels of physical activity, high levels of sedentary behavior, poor mood state, and poor sleep quality were more likely to spend more time using their smartphones.

Sedentary Behavior and Problematic Smartphone Use in Chinese Adolescents: The Moderating Role of Self-Control

This study investigated smartphone use characteristics including the purpose of smartphone use (i.e., leisure, learning, or work) and situational smartphone use (i.e., sitting, standing, or moving about) in Chinese adolescents. Moreover, it tested the moderating role of self-control in the link between sedentary behavior and problematic smartphone use. A total of 947 adolescents completed measures of the purpose of their smartphone use, situational smartphone use, sedentary behavior, self-control, time on smartphone, and smartphone addiction. Results showed that the majority of smartphone use was for leisure and learning, and 90.9% of adolescents reported typically sitting as they used the smartphone. Problematic smartphone use was positively correlated with sedentary behavior and negatively correlated with self-control. Moreover, the relationship between sedentary behavior and problematic smartphone use was moderated by self-control, in that the negative correlation was stronger for adolescents with low self-control and weaker for those with high self-control. These results contribute to the understanding of when sedentary behavior is associated with problematic smartphone use. Several limitations and implications are discussed in this study.

Technology, Physical Activity, Loneliness, and Cognitive Functioning in Old Age

Abstract. Information and communication technology (ICT) has the potential to benefit aging processes. This study examined portable ICT usage and associated changes in physical activity, loneliness, and cognitive functioning. Ninety-two mostly-novice tablet-users aged 51–85 years participated in technology workshops and then reported on their portable ICT use biweekly for 6+ months. Physical activity, loneliness, and executive functioning were assessed before and after this period. More frequent use of exercise functions was associated with more moderate-intensity physical activity and less sitting, controlling for pretracking levels. More frequent use of social functions was associated with more social loneliness and a tendency toward less emotional loneliness, controlling for pretracking levels of loneliness. The use of exercise and social functions showed no associations with executive functioning. Portable ICT thus may bring both risks and benefits for physical and social functioning in older adulthood.

Smartphone Nonusers: Associated Sociodemographic and Health Variables

Smartphone abuse and the associated consequences have been intensely studied. However, little attention has been given to the group of people who have a smartphone and yet barely use it. One might think that they are at the opposite end of abuse, both behaviorally and in relation to the consequences. This study aims to establish sociodemographic variables and health indicators for smartphone nonusers. A population survey through random stratified sampling in a large city (Madrid, Spain) obtained 6,820 people between 15 and 65 years who own a smartphone. About 7.5 percent (n = 511) stated they do not use their smartphone regularly. This group comprised more of men than of women with a higher mean age, underprivileged social class, residence in less-developed districts, and a lower education level. They showed worse mental health indicators, lower perceived quality of life relating to their health, more sedentarism, and greater tendency toward being overweight/obese and a higher feeling of loneliness. When looking at all these variables together, the regression model showed that in addition to sex, age, social class, and education level, the only significantly associated health indicator was a feeling of loneliness. Mobile phone abuse is associated with health problems, but nonregular use does not reflect the opposite. It is important to study the group of nonusers and explore the reasons and related consequences, particularly the role of perceived loneliness, which is paradoxical as a smartphone is a tool that can foster interpersonal contact.

Smartphone Use Predicts Being an "Active Couch Potato" in Sufficiently Active Adults

Purpose: To investigate the relationship between smartphone use, television viewing, and the "active couch potato" in sufficiently active adults. Methods: A sample of 328 sufficiently active adults aged 18 to 80 years (mean ± SD = 38 ± 15 years) completed surveys assessing smartphone use, television viewing, physical activity, and sedentary behavior. Active couch potatoes were defined as individuals who met physical activity guidelines and engaged in 8 or more hours per day of sedentary behavior. Results: Mean smartphone use was 4.04 ± 3.74 hours per day. There were 128/328 (39%) participants coded as active couch potatoes. Active couch potato was significantly positively (Wald = 7.326, P = .007) associated with smartphone use. Being an active couch potato was not (Wald = 0.658, P = .417) associated with television viewing. Sedentary behavior and smartphone use were significantly greater (t ≥ 3.55, P < .001) among active couch potatoes (11.35 ± 3.25 hours sitting per day, 4.95 ± 4.5 hours smartphone use per day) than sufficiently active, nonsedentary individuals (5.06 ± 1.64 hours sitting per day, 3.45 ± 3.04 hours smartphone use per day). Conclusion: In sufficiently active adults, smartphone use predicted being an active couch potato and television viewing did not.

Problematic Use of Mobile Phones in Australia…Is It Getting Worse?

Rapid technological innovations over the past few years have led to dramatic changes in today's mobile phone technology. While such changes can improve the quality of life of its users, problematic mobile phone use can result in its users experiencing a range of negative outcomes such as anxiety or, in some cases, engagement in unsafe behaviors with serious health and safety implications such as mobile phone distracted driving. The aims of the present study are two-fold. First, this study investigated the current problem mobile phone use in Australia and its potential implications for road safety. Second, based on the changing nature and pervasiveness of mobile phones in Australian society, this study compared data from 2005 with data collected in 2018 to identify trends in problem mobile phone use in Australia. As predicted, the results demonstrated that problem mobile phone use in Australia increased from the first data collected in 2005. In addition, meaningful differences were found between gender and age groups in this study, with females and users in the 18-25 year-old age group showing higher mean Mobile Phone Problem Use Scale (MPPUS) scores. Additionally, problematic mobile phone use was linked with mobile phone use while driving. Specifically, participants who reported high levels of problem mobile phone use, also reported handheld and hands-free mobile phone use while driving.