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BackgroundYoung adults often browse the internet for self-triage and diagnosis. More sophisticated digital platforms such as symptom checkers have recently become pervasive; however, little is known about their use. ObjectiveThe aim of this study was to understand young adults’ (18-34 years old) perspectives on the use of the Google search engine versus a symptom checker, as well as to identify the barriers and enablers for using a symptom checker for self-triage and self-diagnosis. MethodsA qualitative descriptive case study research design was used. Semistructured interviews were conducted with 24 young adults enrolled in a university in Ontario, Canada. All participants were given a clinical vignette and were asked to use a symptom checker (WebMD Symptom Checker or Babylon Health) while thinking out loud, and were asked questions regarding their experience. Interviews were audio-recorded, transcribed, and imported into the NVivo software program. Inductive thematic analysis was conducted independently by two researchers. ResultsUsing the Google search engine was perceived to be faster and more customizable (ie, ability to enter symptoms freely in the search engine) than a symptom checker; however, a symptom checker was perceived to be useful for a more personalized assessment. After having used a symptom checker, most of the participants believed that the platform needed improvement in the areas of accuracy, security and privacy, and medical jargon used. Given these limitations, most participants believed that symptom checkers could be more useful for self-triage than for self-diagnosis. Interestingly, more than half of the participants were not aware of symptom checkers prior to this study and most believed that this lack of awareness about the existence of symptom checkers hindered their use. ConclusionsAwareness related to the existence of symptom checkers and their integration into the health care system are required to maximize benefits related to these platforms. Addressing the barriers identified in this study is likely to increase the acceptance and use of symptom checkers by young adults.

Background: The school environment has the potential to influence student body mass index (BMI) through programs and policies. Our objective was to examine the effect of modifying obesity-related school policies and programs on youths' BMI trajectories. Methods: Obesity-related school policies and programs related to physical activity and healthy eating were collected from 41 schools across Ontario at baseline (2012-2013) and year 2 (2013-2014) of the COMPASS study. Self-reported height and weight were collected from the 4951 grades 9 and 10 students who attended those schools for 3 years. Linear mixed effects regression models examined the effect of modifying obesity-related school policies and programs on youths' BMI trajectories. Results: Between Y[subscript 1] and Y[subscript 2], 26 of the 41 schools implemented distinct new obesity-related programs or policies related to physical activity or healthy eating. Five of the interventions were associated with BMI trajectories of students attending those schools compared to students attending a pooled sample of control schools, predicting a higher BMI trajectory. Conclusions: Isolated programs and policies may not successfully improve youths' BMI trajectories. Further research is required to test the implementation of policies and programs that follow a comprehensive school health (CSH) approach, targeting BMI and associated behaviors.

Youth overweight and obesity (OWOB) surveillance often uses body mass index (BMI) derived from self-reported height and weight, but these measures can suffer from high proportions of missing data. Complete case analysis (CCA) is the most common approach to handle missing data, but this approach can introduce bias if missing data are not missing completely at random. Using BMI and related covariate data from 36,546 female and 37,126 male youth aged 12–19 years who participated in the COMPASS study in 2018/19, where approximately 30% of BMI data were missing, results and inference were compared between CCA and multiple imputation (MI) approaches to examine associations with youth BMI. Results of regression joint models showed contrasting findings between MI and CCA, highlighting that appropriate methodological choices in the handling of missing data are essential in youth OWOB research and that choices can impact research inference and thereby associated policy and programming recommendations. [ABSTRACT FROM AUTHOR]

Model Selection is a ubiquitous task in the model building process that seeks a parsimonious model to explain patterns in data. Bayesian Information Criteria (BIC) is one such tool that is used in applications for its property of consistency, where this term is traditionally synonymous with asymptotic consistency. This article introduces the concept of exact consistency in model selection (which places an upper bound on the probability of selecting under-fitted models) to elucidate finite-sample properties of asymptotically consistent criteria. A new class of criteria gBIC is proposed with conditions for candidate model priors that guarantee exact and asymptotic consistency. gBIC provides a theoretical means to assess the consistency of existing BIC variants by simply checking functional properties of their respective penalty components. It is shown that gBIC includes sample size adjusted BIC (SABIC) as a special case, and improves on BIC with the proposed model-modified BIC (mBIC). In comparison to BIC, mBIC guarantees higher success rates for selecting models that match or contain the data generating model at any sample size for linear regression and time series. Lastly, mBIC can easily be adopted in linear regression and time series via simple algebraic adjustments to BIC/SABIC values. [ABSTRACT FROM AUTHOR]

We investigated the association between religious participation and executive function in a national sample of Canadian adults aged 45 to 85 years. Executive function scores were aggregated from six neurocognitive tests. We regressed the aggregate scores onto religious participation and controlled for numerous covariates. The analyses were stratified by age: 45 to 64 years and ≥ 65 years. In comparison to persons who reported never participating in religious activities, persons who reported daily-weekly participation had statistically significantly lower executive function scores; we observed this finding for both age groups. Associations for monthly-yearly religious participation versus never participating were also inverse yet not necessarily statistically significant at the 5% level. The strongest inverse associations were observed in models adjusted for social networks, social support, and social participation. Our findings mesh with recent research and suggest the need to carefully assess the role of religious participation when promoting executive function. Future research warrants employing longitudinal designs to further investigate the association. [ABSTRACT FROM AUTHOR]

To investigate the association between religious participation and memory in persons aged 45–85 years. Using the Canadian Longitudinal Study on Aging, frequency of religious participation was measured from "daily" to "never"; immediate and delayed recall memory were assessed with the Rey Auditory Verbal Learning Test. We regressed memory onto religious participation for persons aged < 65 years and persons aged ≥ 65 years. We found some evidence of effect modification: among persons < 65 years, monthly to yearly participation versus never attending was positively associated with immediate and delayed recall memory; among persons aged ≥ 65 years, weekly or more participation versus never attending was negatively associated with immediate and delayed recall memory. However, regression coefficients were small (−0.09 ≤ B ≤ 0.06) and most were not statistically significant (p < 0.05). Insufficient evidence existed to conclude that religious participation was associated with memory in our sample. [ABSTRACT FROM AUTHOR]

Introduction: To assess the association between perceived susceptibility of developing cancer and being screened via sigmoidoscopy/colonoscopy and prostate-specific antigen, respectively. Methods: Participants aged 35-69, who resided in Alberta, Canada, were enrolled into the study between 2000 and 2008. We used general linear mixed models, adjusted for age, marital status, work status, education, family history and place of residence, to explore the association. Results: Perceived susceptibility of developing cancer was associated with both screening tests at baseline and a maximum of 14-year follow-up: (i) colorectal cancer screening - adjusted odds ratios were 1.97 (95% CI = 1.52-2.55) per one-unit increase in participants' personal belief in susceptibility to cancer, and 1.03 (95% CI = 1.00-1.04) per one-percent increase in participants' estimate of their own chance of developing cancer; (ii) prostate cancer screening - adjusted odds ratios were 1.36 times greater (95% CI = 1.07-1.72), and 1.02 times higher (95% CI = 1.01-1.03), for each respective perceived susceptibility measure. Conclusion: Health promotion can focus on targeting and heightening personal perceived susceptibility of developing cancer in jurisdictions with low screening rates for colorectal or prostate cancer. [ABSTRACT FROM AUTHOR]

Introduction: Few studies have assessed the relationship between chronic disease risk behaviours and body mass index (BMI) in a longitudinal, sex/gender-specific context. This study used gender-specific analyses to assess the extent to which chronic disease risk behaviour latent classes are associated with BMI and weight status at follow-up. Methods: Longitudinal data from 4510 students in Grades 9 to 12, tracked from 2013-2015, who participated in the COMPASS study were used to assess gender differences in the lagged association between previously determined latent classes (of physical activity and substance use) with BMI using multilevel mixed-effects models. Our multilevel regression models assessed the association between two latent classes, active experimenters and inactive non-using youth, with BMI when stratified by gender. Results: Male inactive non-substance-using youth were associated with a 0.29 higher continuous BMI (95% CI: 0.057, 0.53) and odds of overweight/obesity increased by 72% (OR = 1.72, 95% CI: 1.2, 2.4) for binary BMI at follow-up relative to active youth who experiment with substance use. No significant associations were detected in females. Conclusion: Over time, physical activity has a protective role on BMI in male youth. Both substance use and physical inactivity should be addressed in obesity prevention efforts. Gender stratification in analyses is also important since females and males have different contributing factors to increases in BMI. [ABSTRACT FROM AUTHOR]