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This research investigates the multifaceted determinants of academic performance in a large-scale study of 5,092 undergraduate students across diverse Moroccan universities. We delved into demographic, academic, psychological, societal, and lifestyle factors, providing a comprehensive analysis of potential influencers on academic success. These dimensions were identified as significant predictors of academic performance, as gauged by the students' Grade Point Average (GPA). The findings reveal the intricate and interconnected nature of these factors and their cumulative influence on a student's academic trajectory. Our study emphasizes the necessity for a holistic approach that integrates not only traditional academic strategies, but also psychological support, balanced lifestyle practices, and effective societal engagement. Our research underscores the rich interplay among these variables and offers a profound understanding of their collective impact on academic performance. The derived insights could be instrumental for educators, policymakers, and researchers striving to create strategies that amplify student success. While acknowledging the inherent limitations of the study, we believe the results serve as a pivotal guidepost in the ongoing quest to optimize student academic outcomes and overall well-being.

Objective: This one-year pilot study investigated the effectiveness of a multimedia campaign, Heart Healthy U (HHU), to increase awareness about the link between unhealthy behaviors and risk for heart disease among emerging adults on a college campus. This paper describes the implementation of HHU. Participants: The HHU campaign was implemented from the Fall of 2019 through Spring 2020 and during this time there were approximately 15,043 enrolled students at the south eastern U.S. college campus. Methods: The HHU campaign employed print (e.g., banners, posters, and yard signs) and electronic formats (e.g., email, Instagram). We designed the methods across three phases: (1) relationship building and formative research, (2) campaign development, and (3) the Heart Healthy U campaign launch. Results: The HHU encountered challenges when the novel coronavirus (COVID-19 or SARS-co-V2) interrupted campus life, however we relied on the electronic formats to reach students during the state-wide lockdown/quarantine mandates. In addition, there were two changes to the HHU health messages. First, we updated the health messages to illustrate that eating healthy and engaging in physical activity supports immune function. Next, we developed new health messages to address effects of physical isolation and anxiety by promoting psychological well-being during this historic public health crisis. Conclusions: We asked whether a multimedia campaign on a college campus could encourage emerging adults to consume fruits and vegetables and engage in physical activity according to the federally-recommended guidelines. It is essential that interventions intended to reach today's emerging adults be presented in formats that they use (e.g., social media platforms), supported by campus administrators, and endorsed by peer influencers. In conclusion, more intervention studies are needed to counter the unhealthy social norm behaviors common to college campus life that increase heart disease risk, particularly among marginalized populations.

Objective: The COVID-19 pandemic is expected to have serious negative consequences on mental and physical health, which may disproportionally affect young adults. The aim of this study was to understand short-term impacts on a population of students at a college that held in-person classes during the pandemic. Participants: This study was conducted at a moderately-sized private university in the southeastern United States where approximately 75% of students were enrolled in undergraduate degree programs and 25% in graduate degree programs. Methods: A survey was created to assess anxiety and depression symptoms, psychotherapeutic medication use, healthy living, and coping skills. Links to the electronic form were distributed to students via email in Spring 2020 and Fall 2020. Participation was completely voluntary and responses were collected anonymously. Results: The rate of anxiety symptoms in the study cohort was higher than the national average (31%) and increased between Spring 2020 (39%) and Fall 2020 (50%). Rates of psychotherapeutic medication use also rose, with benzodiazepine use increasing from 6% to 11% and antidepressant use increasing from 16% to 20%. Compared to the national average, fewer students in the study cohort rated their overall health as "good" or better (72-76% vs. 82%). Physical exercise, nutrition, and alcohol use worsened between Spring and Fall 2020. Problem-focused engagement was associated with significantly fewer anxiety and depression symptoms. Demographic factors such as gender, race, and sexual orientation interacted with several outcomes studied. Conclusions: Students at a private university that held in-person classes during the COVID-19 pandemic reported high rates of anxiety that increased between Spring and Fall 2020. Self-reported physical health was below average in Spring 2020 but improved in Fall 2020. Appropriate identification and management of the effects of pandemic-related stressors is critical during this uncertain time.

The purpose of this study was to explore the relationship between academic entitlement, gaming, addiction, and life balance. College students (n = 230) on academic probation (cumulative GPA < 2.0) enrolled at a large, public southern university participated in the study. We were able to successfully predict entitlement using life balance subscales; specifically, global health and quality of relationship subscale scores predicted academic entitlement. We did not find a significant relationship between gaming addiction and life balance. Additionally, we found that the probation students in this sample lead fairly balanced lives in most domains, but struggle with stress and academic entitlement to some degree. Implications and recommendations are also discussed.

This cross-sectional study explored the relationship between 24-hour movement behaviors and executive function (EF) in preschool children. A total of 426 Han Chinese preschoolers (231 males; 3.8 ± 0.6 years old) from Zhuhai, Guangdong Province, China were selected from October 2021 to December 2021. Accelerometers were used to measure physical activity (PA) and sedentary behavior (SB), while sleep duration was obtained via a parent-report questionnaire. Components of EF (cognitive flexibility, inhibitory control, and working memory) were assessed using computerized behavioral tasks. The daily composition was significantly associated with inhibitory control and working memory. Inhibitory control improvements were linked to the addition of moderate-to-vigorous physical activity (MVPA) at the expense of SB and sleep. The reallocation between MVPA, SB, sleep, and light physical activity yielded a significant association with working memory.

Despite the increasing focus on incorporating the Sustainable Development Goals (SDGs) into education through curriculum mainstreaming, related research remains lacking. This study explored the representation of SDGs in Taiwan's national curriculum in terms of selection and organization. Through a content analysis of the social studies and natural sciences curriculum guidelines, the findings revealed that SDG-related content comprises a minor part of the guidelines and is not well organized, possibly due to limitations on discipline characteristics and curriculum types. A subtle but complex implicit curriculum reflects neoliberalism, which addresses SDG-related issues through market mechanisms and shifts the focus from power, politics, and citizenship to consumers' choices and lifestyles. The results provide a reference for policymakers and educators in re-examining underrepresented SDGs and dimensions and organizing them coherently. They also bridge the gap between the international framework and national curricula, laying the foundation for international comparisons, discussions, and debates on ESD.

We developed and validated scores on the Lifestyle Practices and Health Consciousness Inventory (LPHCI)-2: Brief Version, a short form for measuring global wellness (mental and physical health). Tests of internal structure (EFA, CFA, and higher-order CFA) as well as convergent validity supported the psychometric properties of LPHCI-2: Brief Version scores.

The drop off in physical activity (PA) for children has led to an increased focus on their PA engagement, due to the poor health outcomes often linked to this decline. Subsequently, stakeholders, across a variety of fields, have problematised and intervened in activity settings to address this decline. Many of these studies acknowledge high levels of activity in the primary years and tend to prioritise their efforts on the adolescent years. An important limitation in these studies is that they greatly overlook how a decline might also be related to children's physical engagement in early childhood. To gain more insight on the role that early PA engagement may play in long-term PA participation, this paper examines early physical engagement through a focus on year one/ two students across three PA spaces - the home, the physical education (PE) class and the playground. Data was collected through a range of ethnographic and child-centred methods and examined using a Bourdieusian lens. This analysis shows that engagement in PA starts as a confluence between the physically active habitus, sport-focused PE and the sportised playground, which produces different patterns of engagement. This paper offers an in-depth examination of this process across the three spaces and identifies how these outcomes become habitualised over the course of primary school, which may play a role in affecting long-term participation. The paper concludes with a call for a more democratised approach to early primary PE, along with accompanying changes to the playground.

Physically inactive children in rural areas are overlooked in research because of the dominance of urban perspectives focusing on physical activity rather than inactivity. The aim of this article is to examine an emerging collective story of how physically inactive children (aged 9-11 years) in two rural areas experience their relationships with physical activity. Based on praxis-oriented sociocultural theorising, this study focuses on how practical physical activity is understood by rural children as part of their sociocultural environment. Five focus group interviews with 21 physically inactive rural children in western Sweden were conducted. Experiences and behaviours that the children emphasised as central to their inactivity were analysed as sociocultural expressions in a collective story about physical activity. To underline the importance of narratives for behaviour in the sociocultural environment, the collective story is presented through three composite narratives told by three fictional characters: 'Robin, the shy one', 'Kim, the farm kid', and 'Angry Alex'. Characteristic of these inactive rural children is a lack of self-confidence, a lack of meaning, and difficulties in managing social physical activities. Common to the behaviours that follow from the children's experiences is that they are perceived as deviating from what is expected of them in accordance with the cultural story about a physically active child. The analysis shows that the underlying cause is the discrepancy between the children's understanding of physical activity and the understanding conveyed via institutions informed by urban perspectives such as, for example, school. For instance, children view physical activity as part of daily labour at the same time that the school teaches physical activities intended for recreational purposes in spare time. Institutions should make room for more interpretations, including rural ones, of the meaning of physical activity and, thus, contribute to reconstructing the cultural narrative about physical activity.

In Spring 2020, the UK Government announced the cessation of in-person teaching for the vast majority of school-aged children in response to the COVID-19 pandemic. Prompting an accelerated shift towards digital learning across the curriculum, this announcement was accompanied by a rise in market-based solutions to address the problem of keeping young people active, 'healthy' and 'positive' whilst at home. The most prominent of these was offered by Joe Wicks, who broadcasted "PE with Joe" live globally via "YouTube" for five days per week for eighteen weeks. The aim of this paper is to critically explore some of the contextual factors that enabled Joe Wicks to create and legitimise a public health intervention under the title of physical education, and henceforth position himself (whether intentionally or not) as an authoritative agent for change within the discipline. After outlining who Joe Wicks is, we unpack the discursive framing of "PE with Joe" in order to locate Wicks' intervention amid the perennial politics of physical education. We then consider the meaning of "PE with Joe" and why Joe Wicks' involvement in physical education matters, reflecting upon the effects of Joe Wicks on the future of physical education practice and research. Among our conclusions is that the COVID-19 pandemic provided an opportunity for Joe Wicks -- here positioned and understood as a branded, celebrity lifestyle enterprise -- to manoeuvre himself (and his products) from the periphery to the centre of physical education's public imagery and discourse. Furthermore, we argue that exploring the ways in which Wicks' presence in the physical education space has been received, embraced, modified, challenged and resisted is vital in discerning "PE with Joe's" actual or perceived effects on the social construction of physical education, and the educational engagements of young people in physical activity in the post-COVID-19 landscape.

The concept of models-based practice has arguably provided the field of sport pedagogy with the means, lens, and tools with which to start to transform the discipline into a more desirable, equitable, and purposeful space. Despite this, there remains a need to experiment with this concept further in non-traditional ways and to continue to construct new pedagogical models meant to serve youth in ever-changing pluralist societies. The purpose of this paper, therefore, was to outline an affective-oriented composite pedagogical model, titled The Spectrum Model, by drawing from Mosston and Ashworth's theory for the spectrum of teaching and learning and neo-Aristotelian virtue ethics. To achieve this goal, I begin by highlighting the need for studying the synergy between the spectrum and models-based practice more closely. Thereafter, I attempt to clarify spectrum theory, virtue ethics, and the concept of models-based practice. Finally, I conclude by presenting two broad main ideas, three critical elements, six intended learning aspirations, and a series of suggested pedagogies acting to inform the proposed Spectrum Model. This model has the potential to influence how practitioners and scholars understand the spectrum of teaching and learning within the broader notion of models-based practice. The application and integration of moral philosophy into a well-established pedagogical framework might also help pedagogues of all kinds to envision how they could help youth to obtain a fully flourishing lifestyle through their teaching.

Lifetime participation in physical activity is a major goal of physical education. For this reason, teachers should focus on instructional units that provide students with knowledge and skills in content areas that can be used throughout their adult lives. Examples of lifetime activities include outdoor recreational activities, cycling, water sports, winter sports, racquet sports, golf, fitness pursuits, and some team sports. One lifetime activity physical educators could consider teaching is badminton. This article provides middle and high school physical education teachers with the basic but necessary information to teach an effective badminton unit.

Background: Early studies indicate children's physical activity (PA) decreased during the pandemic but may vary by school format and season. We longitudinally assessed changes in PA and screentime (ST) behaviors throughout 1 year of the COVID-19 pandemic and according to changes in school format. Methods: Parents of children (5-18 years) completed a survey about school format, home characteristics, PA, and ST. Initial data were collected in November 2020 with follow-up in February, May, and August 2021. Physical activity and ST were compared by season and school format using a 4 (format) × 4 (season) repeated measures analysis of variance. Results: Children were active for at least 60 minutes/day less often in winter (2.4 ± 0.3 days; p < 0.001; n = 176) than in other seasons. Longitudinal analysis (n = 61) showed that PA was highest among students attending school fully in-person and lowest among students attending remotely, though school format differences were not significant. Non-school ST did not differ by season or school format. Implications for School Health Policy, Practice, and Equity: These results suggest that changes in school format influence students' lifestyle behaviors. Conclusions: The impact on children's lifestyle behaviors should be considered in planning for safe, in-person operation of schools in the event of future pandemics or natural disasters.

An online survey on experiences of 47 caregivers of persons with intellectual disability during COVID-19 pandemic was carried out to find out their experiences, with the aim to understand the focus areas of challenges, so as to organise need-based support systems. A validated questionnaire was used to collect data. The participants belonged to different states of India with varied socio-economic backgrounds. The results revealed that most of them experienced challenges in supporting persons with intellectual disability. Many found online classes beneficial, while some caregivers had difficulty in keeping the person occupied or managing challenging behaviour. Some caregivers were happy to get more time to spend with the person with intellectual disability at home. The outcome of this study suggests that irrespective of the background, the families faced challenges, the needs were varied and therefore specific efforts are to be taken to support the families so that they are prepared.

Background: People with intellectual disabilities (IDs) and their caregivers face difficulties during the COVID-19 pandemic. However, limited studies have comprehensively investigated their challenges, especially in Japan. We aimed to clarify the concerns and needs of people with IDs and their caregivers during the COVID-19 pandemic in Japan. Method: From March to August 2021, 27 in-depth interviews were conducted with principal caregivers of people with moderate to profound IDs in Japan. We then transcribed the interviews and conducted deductive coding using predetermined codes focused on their daily life difficulties. Inductive coding was used to ensure that no important themes were overlooked. Results: We found four concerns and four needs among people with IDs and their caregivers as significant themes. Conclusions: Our results provide useful information for supporting people with IDs and their caregivers, especially among those who need medical or social care in accordance with the infection control and social-distancing policies.

Healthy lifestyle technologies (HLT) have gained popularity in young people's daily lives, but the long-term effect of these technologies on their physical activity (PA) participation and health learning is unclear. This systematic review (a) explores the effect of HLT use on the PA participation and health learning of young people (aged 13-18), and (b) determines whether the effects were long-term and/or sustainable. Literature searches were conducted in five databases to identify studies published in academic journals in English between 2011 to 2022 which explored young people's use of HLT to support their PA participation and health learning. Twenty-six studies were identified. The reported impact of these technologies focused on three dimensions: behavior change, psychological responses, and facilitators and barriers to HLT use. This review concluded that HLT can have positive short-term effects on young people's PA participation and health learning, but the long term or sustainable influence remains inconclusive.

Lifestyle risk behaviours--physical inactivity, poor diet, poor sleep, recreational screen time, and alcohol and tobacco use--collectively known as the "Big 6" emerge during adolescence and significantly contribute to chronic disease development into adulthood. To address this issue, the Health4Life program targeted the Big 6 risk behaviours simultaneously via a co-designed eHealth school-based multiple health behaviour change (MHBC) intervention. This study used multiple causal mediation analysis to investigate some potential mediators of Health4Life's effects on the Big 6 primary outcomes from a cluster randomised controlled trial of Health4Life among Australian school children. Mediators of knowledge, behavioural intentions, self-efficacy, and self-control were assessed. The results revealed a complex pattern of mediation effects across different outcomes. Whilst there was a direct effect of the intervention on reducing moderate-to-vigorous physical activity risk, the impact on sleep duration appeared to occur indirectly through the hypothesised mediators. Conversely, for alcohol and tobacco use, both direct and indirect effects were observed in opposite directions cancelling out the total effect (competitive partial mediation). The intervention's effects on alcohol and tobacco use highlighted complexities, suggesting the involvement of additional undetected mediators. However, little evidence supported mediation for screen time and sugar-sweetened beverage intake risk. These findings emphasise the need for tailored approaches when addressing different risk behaviours and designing effective interventions to target multiple health risk behaviours. The trial was pre-registered with the Australian and New Zealand Clinical Trials Registry: ACTRN12619000431123.

Background: Saudi Arabia has the second-highest prevalence of diabetes in the Middle East. Therefore, providing patients with high-quality materials is essential to help them understand their illness. The Patient Education Materials Assessment Tool (PEMAT) contrasts and evaluates materials regarding understandability and actionability. Purpose: This study aimed to evaluate materials for type 2 diabetes using a printed version of the PEMAT. Methods: This observational study was conducted in Riyadh from December 2022 to May 2023. Sixty-nine samples were collected from hospitals affiliated with the Ministry of Health and the government sector. Results: Materials evaluated in this study had an excellent understandability score of 78.9% and a low actionability score of 66.6%, with significant differences between the sources. Some of the materials (42%) achieved high quality regarding understandability and actionability. Discussion: Less than half of the materials were considered high quality. Approximately 99% of the materials made their purposes completely evident and logically presented the information, and approximately 97% identified at least one action. However, only 17.4% of the materials provided summaries and tangible tools. Translation to Health Education Practice: Health Educators should consider including summaries and tangible tools when developing patient education materials to make them more understandable and actionable.

Purpose: To (a) present a theoretical framework that describes how learners' movement habits become relevant in the development of movement capability and (b) present data that illustrate how this process occurs in practice. Method: An investigation with preservice physical education teachers was conducted in two phases. The first phase involved examining participants' movement habits, and the second phase involved examining the participants' development of novel capabilities in the context of unicycling. Results: Empirical materials from two participants are presented as case studies. The cases demonstrate how different sets of movement habits interact with novel tasks, making the demand for creative action more or less likely. The cases also demonstrate how subjective and physical elements are interwoven. Finally, the cases provide insights into potentially productive habits for movement learning. Discussion/Conclusion: The paper is concluded with pedagogical implications, including a consideration of how crises might be managed in educational contexts.

Background: Cognitive reserve (CR) has not been studied in people with Intellectual Developmental Disability, a population with a high incidence of dementia. Commonly adopted CR proxies should be adapted to reflect more specifically the experiences of people with Intellectual Developmental Disability. Method: This scoping review intended to identify CR proxies relevant to people with this condition. Results: Some of these were the same already detected in a population without intellectual disabilities (education, occupation, physical activity, leisure, community and social activities); others were found to be specifically relevant for this population: type of schooling, parental educational level, environmental stimulation and living place. Conclusions: These proxies need to be considered in studies on CR and Intellectual Developmental Disability and in clinical practice. Research on the protective effect of CR aims to encourage policies promoting lifestyle-based educational and preventive interventions and overcome participation barriers for people with Intellectual Developmental Disability.

This study aimed to identify the prevalence of current smoking and examine the association between meeting combinations of the 24-h movement guidelines and current smoking in autistic adults. This cross-sectional study administered an electronic survey to a national sample of autistic adults in the United States. The study outcome was current smoking. Independent variables included the 24-h movement behaviors. Multivariable statistical modeling was used to assess the study aims. The study sample (n = 259) had a mean age of 31.05 years (standard deviation = 7.70), 58.7% were male, 11.2% were fully independent, and 35.5% were current smokers. Current smokers met significantly fewer 24-h movement guidelines than non-smokers (mean = 1.52 (standard deviation = 0.73) vs mean= 1.93 (standard deviation = 0.88), respectively, t = 3.77, p < 0.01). Autistic adults with high levels of sedentary behavior were almost three times more likely (odds ratio = 2.784, 95% confidence interval = 1.490, 5.237) to be a current smoker than those who did not meet these guidelines. Autistic adults not meeting sleep and sedentary behavior recommendations had a 1.581 increased odds (odds ratio = 1.581 95% confidence interval = 1.25, 2.001) of being a smoker as compared to those meeting these recommendations. Current smoking was highly prevalent in this sample. Improving sleep health and reducing sedentary time may be viable intervention targets to help promote smoking cessation in autistic adults.

This study was conducted as a descriptive and cross-sectional study to examine the effects of game addiction and social media addiction on the lifestyle of Turkish adolescents. The study was conducted between May to June 2022, involved 1116 adolescents in the 13-18 age group receiving education in three high schools situated in the Western region of Turkey. Data were collected online with the Descriptive Information Form, Game Addiction Scale Short Form for Adolescents (GAS), Social Media Addiction Scale for Adolescents (SMAS), and Adolescent Lifestyle Profile Scale (ALP). Mean, percentage, t test, analysis of variance and linear regression analysis were used for analyzing data. There was a statistically significant difference between the presence of social media accounts and smartphones, duration of having social media account, average time spent daily on social media accounts and virtual games, social media use characteristics for the last 6 months, interests of influencers followed on social media, affection by influencers, and effect of social media on daily life and the mean scores on GAS, SMAS, and ALP. It was determined that game addiction and social media addiction explained 61.8% of the lifestyles of adolescents and significantly affected them. In addition, social media use characteristics, game addiction, and social media addiction explain and significantly predict the lifestyle of adolescents at a rate of 62.8%. The results of the study reveal that game addiction and social media addiction is a significant predictor of Turkish adolescents' lifestyle. It can be recommended to provide trainings that shed light on the importance of efficient use of technology to adolescents and their parents and to evaluate the effectiveness of these trainings.

In this study, primary school pupils have been surveyed using the methodology of drama pedagogy, focusing on two research questions: what the risks of online activities are and how children cope with these, and what the experiences of children with distance learning were. This study investigated both areas jointly from the pupils' perspective. Three anonymous online focus groups were conducted with 16 Hungarian pupils (4 boys and 12 girls; age range: 11-15 years) in July 2020, who joined to the research on a voluntary basis and have been recruited from three rural counties with different socioeconomic backgrounds. Respondents unequivocally recounted that during the lockdown, they had spent a significant part of their time in front of a screen, mostly without adult supervision. Whilst most only experienced different forms of teasing, some cyberbullying instances bordered on criminal cases and required the involvement of parents. High exposure to such risks was experienced during the months when online learning mainly consisted of receiving assignments to work on, and most teachers were almost unavailable. Future research could compare the experiences of pupils and teachers, creating an online safe space for them where they could respond to each other's perceptions, interpretations and opinions anonymously.

This study examines a three-year teacher wellness initiative in five Colorado, USA, school districts. It focuses on teacher professional development (PD) about self-care and burnout, the value participants attached to the training, and change in teachers' lifestyles, self-care practices, and burnout. Results reveal the value teachers attached to the PD and lifestyles do not show significant differences over time. Self-care practices and burnout show statistically significant improvement during the intervention years, although magnitudes of the differences are small, indicating negligible practical significance.

Kazakhstan's efforts to expand its physical culture have brought tremendous benefits. However, there are still unresolved issues in the teaching of physical education in our country's schools. Despite many ethnic and cultural traditions, combining learning opportunities in the classroom is ineffective. Domestic experience in sports is underutilized due to a lack of educational literature and scientific evidence that supports the use of traditional outdoor sports. The purpose of this study is to improve the motor abilities of young children by using carefully selected traditional outdoor sports. A study on the use of folk games in working with children in primary schools found that teachers' knowledge of the possibilities of folk games is inadequate. Finally, the findings suggest that incorporating traditional games into the physical education curriculum for students in lower grades can serve as a model for healthy lifestyles. Various types of games and exercises help to improve physiological systems, physical development and physical fitness in children and foster positive moral and volitional qualities.

Type 2 diabetes is a complex disease with several modifiable lifestyle factors. The Extension 'Live well, Eat well, be Active with Diabetes' curriculum provides four 90-minute sessions teaching individuals to live well, eat well, and be active with diabetes. Fourteen Extension educators implemented and evaluated the curriculum with 107 participants. Participants reported the program helped them feel better able to take care of their health. We observed significant differences in participants' retrospective pre and post 'Live well,' 'Eat well' and 'be Active' total scores. Extension has a unique opportunity to educate individuals so they may better manage their diabetes.

Very little has been published reporting on long-term outcomes experienced by young adults (aged 19 to 34 years old) who participated in 4-H youth development programs. We adopted Gambone et al.'s (2002) framework advancing three long-term outcomes for early adulthood: economic stability, health and well-being, and community involvement. With cross-sectional survey methods, we compared long-term impacts between 693 California 4-H young adult alumni and 373 young adults in a U.S. general population sample who had not participated in 4-H. The results demonstrated that 4-H alumni report more positive long-term outcomes than the U.S. general population sample. The study contributes to the dearth of research around long-term outcomes, may be useful for marketing and funding, and will help better understanding the public value of Extension.

Social networking sites are a new ecosystem of social relations in which adolescents follow public figures or influencers: instagrammers, tweeters and youtubers. Their behaviour in the posts they publish become a trend and a model for the new generations. In order to explore these behaviours and their consequences, it is useful to study the behaviour of the 10 instagramers, 10 tweeters and 10 youtubers with the largest number of followers in the world. A mixed method was employed, combining: social media analysis (SNA) methodology executed by monitoring Twitter, Instagram and YouTube accounts and their publications (300 posts with the highest number of likes). The FanapageKarma tool was used to capture data by applying data mining techniques. Subsequently, sentiment analysis was performed using Meaning Cloud software, determining sentiment polarity analysis quantitatively. Finally, a semantic analysis of the content was performed using Nvivo. The results of multi-regression and sentiment's analysis show clear differences between social networking sites. Twitter is a space for critical analysis of information and social movements, especially climate change. In this space adolescents defend their values and ideology. Instagram is a showcase for fashion and beauty, where brands support an idealised and desirable lifestyle. YouTube is a space for entertainment and comedy. It concludes that despite their differences there is one univocal feature, the effort of influencers to capture audiences and establish parasocial relationships.

In this study, we apply theories about self-efficacy, empowerment and motivation to account for the phenomena that people with diabetes Mellitus type 1 express as being influential for people with diabetes' behaviour regarding self-regulation. They must make significant changes to their lifestyle, to keep the disease stabilized. The changes can be cumbersome and hard to implement why people with diabetes receive training in self-regulation. For many people it can be challenging to comply with the recommendations. We conducted field observations and surveys to understand how people with diabetes experience their perceived self-efficacy, and what motivates them to perform blood sugar measurements and physical activities. We found differences in people with diabetes' ability to follow the recommendation based on gender, motivation, and their level of self-efficacy. We also found indications on how a motivational dialog may affect both professionals and people with diabetes. Thus, we suggest that guidance of people with diabetes should be based on an emancipating motivational approach such enabling the possibility of strengthening the people with diabetes' motivation and thereby their self-efficacy. Through these processes, the people with diabetes may become able to achieve a higher level of health literacy such experiencing a better outcome of their self-regulation. With this paper we contribute to the contemporary overall knowledge about the diabetes field, such our investigation focus on people with diabetes ability to act upon information provided by healthcare professionals and how to best approach the issues people with diabetes experience as being essential for their general well-being and everyday lives.

In today's world, the importance of physical activity for daily life continues to increase. However, it cannot be said that the level of interest of our society in physical activity is sufficient. In the reports of organisations such as the Ministry of Health, Public Health Institution of Turkiye and Active Living Association, it has been reported that 3/4 of the population of Turkiye does not have sufficient physical activity level and the most sedentary group is the 15-19 age group. These serious rates were seen as an important justification for research on this subject. This aims to examine the differentiation status of the participants in terms of some demographic variables to determine the factors that prevented high school students from participating in physical activities. The research is a quantitative study and was carried out in a descriptive survey model. The sample of the research consisted of 376 participants from high school students who continue their education in schools under the Directorate of National Education in Kahramanmaras city centre in Turkiye. The data of the research were analysed by using the statistical software JAMOVI 2.3.16.0 package program. As a result of the research, it was found that the scores of the participants for the factors that prevented their participation in physical activities were at a moderate level. In the scale of factors that prevented high school students from participating in physical activities, statistically, significant differences were found in terms of gender, family monthly income, how many days a week they do sports, mother's interest in sports, father's interest in sports, PE teacher's attitude and friends' attitudes. As a result, in this study, high school students' concerns about the factors that prevent their participation in physical activities were determined in terms of different variables.

Although there have been many studies investigating international students, many of them focused on the students who travel in pursuit of higher education in English countries and/or universities. This current qualitative study is intended to explore the experiences of international students, particularly the challenges, and strategies to deal with the challenges and the culture shock while studying in Jambi, Indonesia. In order to collect the data, a semi-structured interview was employed and guided by an interview protocol to stimulate the participants in answering the questions during the interview. The participants of this study were nine international students who studied at one public university in Jambi. Through thematic analysis, we found that international students faced some challenges living and studying in Jambi, such as language issues, academic issues, individual issues, and living style and related issues. To overcome the challenges, international students employed two main strategies, including self-management strategies and seeking help. Moreover, although the culture of international students is quite similar to the culture of the hosting country, we identified a lack of foreigner sense and physical contact as the culture shocks experienced by one international student. Looking at the challenges and culture shocks experienced by international students, this study suggests that preparation is crucial for prospective international students before pursuing their studies overseas.

The study analyzed the possible effects of retro walking exercise techniques on the skill of balance in hearing impaired individuals. The study is a quasi-experimental study and the single group pretest-post-test design among the experiment models was used. The study groups was applied a retro walking exercise for eight weeks. 25 hearing impaired students participated in the study, who had not engaged in any sports branches previously, in the 13-17 age group and did not have any neurological and orthopedical diseases in the last 6 months as the study group. In order to measure dynamic balance, the 'Techno Body ProKin Balance Measurement Device' was used. At the end of the eight week exercise program, the same measurements were taken again and the development level within the group was assessed. The descriptive statistics, arithmetic averages and standard deviation values of the participants' age, height, weight and hearing impairment percentages were determined. It was analyzed whether the data displayed normal distribution. Since it was seen that the data displayed normal distribution, the Paired Sample t-test was done. As a result of the study, it was seen that there was a significant difference between the pretest, post-test mean ranks of the participants' both feet, right and left feet perimeter length (PL) (p<0.05). It was seen that this difference was in favor of the post-test when the mean ranks and totals of the scores were taken into consideration. It was seen that there was a significant difference between left foot MECAP pretest and post-test mean ranks as well (p<0.05). In addition a significant difference was also found between both feet and right foot MECML values' pretest, post-test mean ranks (p<0.05). The results of the study showed that the retro walking exercise program is effective in hearing impaired individuals in terms of improving their dynamic balance skill. Through the findings, it can be said that the use of different, efficient and safe exercise methods such as retro walking should be given importance to for hearing impaired individuals to be more active and do efficient and safe exercises.

The study aims to determine the socio-demographic and debt profile of the public-school teachers in the Schools Division of Aklan, Philippines, their reasons on acquiring debt and perceived ways to avoid debts. This study utilized descriptive correlational research design utilizing a researcher-made instrument on socio-demographic profile, pattern of expenditures, debt profile covering the type of debts, total cost of debts, reasons for having debts and perceived ways to manage debts. The data gathered were tabulated and analyzed using the IBM Statistical Package for Social Sciences (SPSS) version 26. The take-home pay of the teachers was only more than half of their gross income. Most of the spouses of the married teachers were employed but many of them have relatively lower income. Their monthly family income was higher than the reported average family income for 2022 and their expenditures are also relatively higher than the average family expenditures in provinces for 2022. Almost one-half of the income of the teachers was used to pay their debts -- both thru automatic payroll deduction and thru personal transactions. The bigger the household size, the higher the expenditure because there were more needs and there were many people consuming commodities. The higher the family income, the bigger the expenditure since lifestyle often adjusts with income. Young; married teachers; those occupying higher position and longer tenure have higher cumulative debts. Increase in family expenditure could cause increase in the number of debts as linked to the Theory of Reasoned Action and Theory of Planned Behavior. High regard for education, health, and safety triggered teachers to have debts, which can only be avoided thru better money and lifestyle management and having additional source of income.

The pandemic of 2020 frequently necessitated that offshore school teachers continue their instruction of Chinese children in the online format rather than face-to-face back in China; a so-called emergency remote teaching response. A required change in pedagogy accompanied a range of challenges in an effort to offer quality education to English as a Second Language (ESL) students. During the fall 2020-2021 academic year, a sample of 25 teachers and 3 principals provided feedback on those inherent challenges in a mixed method study consisting of surveys, interviews, and focus groups. Factors that impacted the delivery were identified in broad categories of teacher lifestyle, hindrances with technology, teaching practice, and pedagogical support. The findings were unique in that 1) they were nested in a response to a difficult context as opposed to a carefully planned online instruction and 2) second language students constituted a different learning cohort. This work further adds to the literature by suggesting that cognitive load, self-regulation, and attentional literacy deserve careful consideration when contexts of ESL learning with technology are implicated. This work further adds to the literature by suggesting that cognitive load, self-regulation and attentional literacy deserve careful consideration when contexts of ESL learning with technology are implicated.

Language politeness is considered one of the defining characteristics of Indonesian society. In the age of global communication and computing, moderate politeness, centered on politeness of opinion, politeness in deliberation, and politeness in respecting the opinions of others, is an important factor. However, progressive politeness in Urban Muhammadiyah Primary School is becoming a growing concern that requires special attention. The purpose of this study was to examine this violation in the interactions between learners, teachers, and principals in Yogyakarta, Indonesia. This study adopts a qualitative approach with a case study design. The data were collected from interviews, observations, and documentation. Interviews were conducted with classroom teachers, principals, and learners, while observations were recorded through field notes and reflections. Moreover, audio-visual documentation in the form of photographs, videos, and recordings during the learning processes and interactions between learners or teachers were utilized. Data collection was based on four strategies: observation, interview, documents, and audio-visual, as outlined in Creswell's theory. Validity was examined using data triangulation, member checking, prolonged duration of data collection, repeated observations in the study location, and peer examination. The findings of the study include a) There was a violation of the politeness through bullying, body shaming, and verbal abuse, which violated the principles of appreciation and sympathy. b) Urban Muhammadiyah Primary School helped promote language politeness through several methods, including performing Duha prayers, morning recitation with assistance from the teacher and principal, and teacher role modelling by arriving at school at 06.15 and reciting Asmaul Husna together. Importantly, these efforts positively affected the politeness of the learners. This study provides an update on the assistance given to learners to address impoliteness, including Duha prayers, morning recitation, and memorization of Al-Qur'an and Asmaul Husna assisted by teachers. Moreover, the school has a well equipped School Health Unit (SHU) to promote a healthy, clean, disciplined, and polite lifestyle. Appeals are made through persuasive and affectionate books and direct assistance from teachers as role models. The study of the Quran and Asmaul Husna demonstrates children's moderate politeness in expressing their opinions. The agreement to develop a joint discipline demonstrates the children's moderate politeness in deliberation.

Purpose: To examine the relationship between acculturation indicators and metabolic syndrome among Hispanic adults living in the Dallas-Fort Worth-Arlington, Texas metropolitan area. Methods: This study utilized secondary data collected from a larger 2014 study among 128 Hispanic adults living in Dallas-Fort Worth-Arlington. The current study examined two research questions: (1) Is there a relationship between acculturation indicators (nativity, duration in the United States, and the Short Acculturation Scale for Hispanics score) and metabolic syndrome among Hispanic adults living in Dallas-Fort Worth-Arlington? (2) Is there a relationship between acculturation indicators and the individual markers associated with metabolic syndrome (high waist circumference, high blood pressure, elevated fasting blood glucose, elevated blood triglycerides, and reduced high density lipoprotein cholesterol among Hispanic adults living in Dallas-Fort Worth-Arlington? Results: Most participants were female (aged 40 and older) born outside of the United States. More than half of the participants had been in the United States fewer than 20 years and revealed loweracculturation scores. More than one-third of the participants also had metabolic syndrome. Prevalence of metabolic syndrome was higher among females compared to males. Most participants had abnormal high-density lipoprotein and waist circumference. Acculturation scores and nativity were not associated with abnormal metabolic syndrome markers. Duration in the United States was not associated with metabolic syndrome markers of high waist circumference, reduced high-density lipoprotein, and elevated blood triglycerides. However, duration in the United States was associated with metabolic syndrome markers of high blood pressure and elevated fasting blood glucose. Conclusions and Recommendations: Acculturation is a multifaceted, dynamic phenomenon that influences health at multiple levels. Future studies can explore a range of social-ecological factors that interact with acculturation and health. Because metabolic syndrome is considered a "lifestyle syndrome," there is an additional need to examine behavioral health and relationships among diet, physical activity, and acculturation. Through a social-ecological and culturally relevant lens, health education specialists can lead interprofessional efforts to promote health literacy and healthy lifestyle behaviors among Hispanic individuals and communities. These action steps can be integral components of professional preparation programs that offer students opportunities to engage in service learning and develop core competencies in their disciplines.

As an integral part of the concept of lifelong learning, non formal learning enables adults to acquire the necessary skills to adapt more easily to the ever-changing social life. Concerned with these values, through the lens of the ODD, with reference to Health and well-being, which indicates "ensuring a healthy life and promoting well-being for all ages", we wanted to investigate a group of teachers who followed a training program aimed at the healthy lifestyle of the educable. Healthy lifestyle education can play a significant role in changing health behaviors and attitudes towards our own health, as well as those we educate. Teachers become not only mentors for children, but also role models. Starting from this concept, we want to find out if the learners are able to include health-promoting behaviors in their daily routine and if they implement strategies that promote health, well-being, for themselves, including the learners. A number of N=63 teaching staff from Ia?i county, located in the north-eastern part of Romania, participated in this study. Of these, a number of N=35 respondents teach at the preschool education level and a number of N=28 at the primary education level. All respondents are female, of whom N=49 teach in urban areas, and N=14 in rural areas. The research tools were applied in electronic version, using Google forms. The obtained data were statistically analyzed using IBM SPSS software. Findings indicate significant effects of the training program on all target variables. The results of this research will be used to add to our knowledge of behavioral change and learning in adulthood.

In this research, it is aimed to investigate the relationship between nutritional literacy and healthy lifestyle behaviors of prospective teachers according to various variables. Correlational survey model of the quantitative research methods is used in this survey. A moderate positive relationship was found between prospective teachers' nutritional literacy and healthy lifestyle behaviors. Based on the positive relationship between nutritional literacy and healthy lifestyle behaviors, it is recommended that nutritional literacy level be associated with healthy lifestyle by giving nutrition education at all school levels and undergraduate education in order to increase the level of healthy lifestyle behaviors in individuals.

This research aimed to determine the opinions of teacher parents about distance education process during COVID-19. The study was designed as a case study which is one of the methods in qualitative research. The sample of the study composed of 83 teacher parents from different branches in Turkey. Maximum variation and criterion sampling methods were used to select the participants. The data of the study were gathered though open ended questions developed by the researchers and were analyzed through descriptive and content analyses. According to the participants, distance education is perceived and accepted as a means of support rather than an alternative to face-to-face education. Participants mentioned the distance education carried out during the pandemic process as a beneficial practice in order to prevent students from breaking off from education but also they stated administrative issues, lack of computer science knowledge and internet-related problems. The inability to disseminate distance education to all students, especially disadvantaged students due to the lack of infrastructure, indifferent parents and the fact that distance education is insufficient in the education of young children/special education students show that distance education has not yet met the expectations to provide equal opportunities for everyone involved.

Flipped learning is a pedagogical approach that directs instruction from a group to an individual learning space. This approach can stimulate students' motivation, promote adequate physical activity levels, and reduce sedentary (SED) behaviour. Addressing the literature gap regarding the correlations among these factors in school physical education (PE), this study aimed to examine the association of students' motivation, physical activity levels, and SED behaviour with flipped learning in a four-lesson learning unit. Framed by self-determination theory, a quasi-experimental design was adopted to measure and compare the moderate-to-vigorous physical activity (MVPA), SED, and motivation levels of 111 primary school students aged between 10 and 11 years (mean = 10.07, standard deviation = 0.26) in Hong Kong. Fifty-two of the participants were female, and 59 were male. They were randomly assigned to experimental (n = 57) and control (n = 54) groups, in which a flipped learning approach was adopted in the experimental group for two weeks. A questionnaire survey and accelerometers were used to measure participants' motivation (autonomous motivation, controlled motivation, and amotivation) and their physical activity levels. The findings revealed significantly higher MVPA levels and lower SED levels in the experimental group. Autonomous motivation was found to have a positive correlation with MVPA levels and a negative correlation with SED levels, indicating a positive predictor of the two. The findings of this study reveal the potential of flipped learning to enhance students' MVPA and reduce their SED behaviour during primary school PE lessons.

Hypertension (HTN) management continues to be a concern due to challenges with behavioral risk factors. Patient education to modify unhealthy behaviors appears to be effective in managing HTN. Therefore, this meta-analysis aimed to determine whether individualized face-to-face education and counseling have a beneficial effect on systolic and diastolic blood pressure (SBP and DBP) in hypertensive patients. Studies were extracted from PubMed, Scopus, Cochrane Library, and Web of Science databases. Nine studies, comprising 2627 participants, were included. Random effects models were used to pool estimates of mean differences (MDs) with 95% confidence intervals (CIs) in SBP and DBP between the intervention and usual care groups. SBP and DBP were significantly reduced at the 6-month (MD = -4.38 mmHg, 95% CI: -6.95 to -1.81; MD = -2.09 mmHg, 95% CI: -3.69 to -0.50, respectively) and 12-month time points (MD = -2.48 mmHg, 95% CI: -3.96 to -1.01; MD = -1.71 mmHg, 95% CI: -2.88 to -0.55, respectively) with intervention. At the 24-month time point, there was a significant change in SBP (MD = -2.13 mmHg, 95% CI: -3.94 to -0.32) with intervention compared with the usual care group. This study showed that individualized face-to-face education and counseling add significant benefits to usual care for lowering blood pressure in hypertensive patients.

Parents are key to promoting children's healthy growth and development. However, school nurses need knowledge about how to best support parents' health-promoting activities. This study aimed to explore parents' thoughts regarding their normal-weight 6-year-old children's food and physical activity behaviors as expressed during health conversations with the school nurse. Qualitative content analysis of audio-recorded conversations (n = 30) showed that parents think of their children's behaviors in terms of: (a) children's personality in relation to food and physical activity; (b) recognizing children's food and physical activity behaviors; (c) parenting in relation to food and physical activity; (d) interaction with children in situations around food and physical activity; and (e) contextual circumstances to promote children's healthy food and physical activity behaviors. The study contributes with novel knowledge regarding clinical work in health promotion, with suggestions for how school nurses can engage parents in promoting and sustaining healthy food and physical activity behaviors.

Background. Monitoring food intake and physical activity (PA) using tracking applications may support behavior change. However, few longitudinal studies identify the characteristics of young adults who track their behavior, findings that could be useful in designing tracking-related interventions. Our objective was to identify predictors of past-year food and PA tracking among young adults. Methods. Data were available for 676 young adults participating in the ongoing longitudinal Nicotine Dependence in Teens Study. Potential predictors were measured in 2017-2020 at age 31, and past-year food and PA tracking were measured in 2021-2022 at age 34. Each potential predictor was studied in a separate multivariable logistic regression model controlling for age, sex, and educational attainment. Results. One third (37%) of participants reported past-year PA tracking; 14% reported past-year food, and 10% reported both. Nine and 11 of 41 potential predictors were associated with food and PA tracking, respectively. Compensatory behaviors after overeating, trying to lose weight, self-report overweight, reporting a wide variety of exercise behaviors, and pressure to lose weight predicted both food and PA tracking. Conclusion. Food and PA tracking are relatively common among young adults. If the associations observed herein between compensatory behavior after overeating and tracking (among other observed associations) are replicated and found to be causal, caution may need to be exercised in making "blanket" recommendations to track food intake and/or PA to all young adults seeking behavior change.

To understand divergent and remarkable lives lived, we examined the accomplishments, family dynamics, life orientation, psychological well-being, and definition of a meaningful life among two exceptional groups at age 50: Top Science, Technology, Engineering, & Mathematics (STEM) doctoral students (270 males, 255 females, originally surveyed in their mid-20s) and profoundly gifted adolescents (263 males, 71 females, top 0.01% in ability, first studied at age 12). The creativity and occupational stature of both cohorts were extraordinary and commensurate. Life priorities, time allocation, and breadth of interests created paths that differed for women and men, resulting in contrasting, but equally exceptional, life outcomes across career, life, and relationship satisfaction. Distinct constellations of personal attributes of intellectually and scientifically brilliant women, relative to such men, operated to form satisfying and productive lives that differed for the women and men as a whole. Findings cast light on the participation of women and men in STEM and conceptually demanding leadership positions.

Background: People with intellectual disabilities are more likely to experience sleep problems, which can affect quality of life, physical health, mental health and well-being. Methods: An integrative literature review was conducted to investigate what is known about behavioural sleep disturbances in people with an intellectual disability. The search used the following databases: Scopus, PsycInfo and Cinahl, to find papers published since 2015. Results: Within intellectual disability research, sleep appears as a common issue due to its high prevalence, negative relationships with an individual's physical and mental health, their quality of life, and impact of sleep problems on family or carers. The growing evidence base appears to support the use of behavioural, lifestyle and pharmacological interventions to improve sleep in people with an intellectual disability. Conclusion: A wide array of literature provides evidence that people with intellectual disabilities are affected by and need support with their sleep.

Changes in antenatal gut microbiota (GM) have been associated with gestational diabetes and obesity which are influenced by diet and lifestyle. Gamification can be used as an interactive health education tool to convey this concept to the public. Thus, we designed an interactive story titled 'MoM: Microbiome of Maternity' highlighting the importance of diet and lifestyle during pregnancy. Using the 'RPG Maker MV' software, a branching narrative emphasizing flavour texts with a local flair was developed. The choice-based game narrative revolves around daily diet and lifestyle preferences in an engaging story throughout pregnancy. A graphical report is provided at predetermined intervals, highlighting the relevant details on their health and GM. A pilot evaluation was conducted using feedback surveys: Part A evaluated the knowledge on GDM, healthy diet and GM (13 items, score [more than or equal to]8 ([more than or equal to]60%) depicts adequate knowledge) and Part B evaluated the satisfaction on the game design and structure (24 items, score [more than or equal to]38 depicts satisfaction and pleasant experience). We found that the initial knowledge on the introduced health concept were inadequate (Part A score 7.67 ± 2.97). After playing 'MoM', their understanding was improved and were satisfied with the design (Part B score 42.3 ± 6.49). In conclusion, 'MoM' is an effective educational game in promoting health awareness among women.

The American Dream is thoroughly woven into the American life and has broad individual and cultural implications. At its heart, the American Dream represents opportunity and prosperity but has recently developed into a hyper-consumption ideology. Because of the current state of economic and environmental conditions, new ideas of what the American Dream should be are emerging. The current study investigates how the American Dream is perceived among college students and whether the traditional values of the Dream are still relevant among this generation. Results showed that, overall, college students are split as to whether the American Dream is outdated (47% vs. 47%). The results also suggest differing levels of buy-in to the American Dream among college students. Specifically, there are three different groups which vary in their amount of buy-in to the Dream: Disillusioned who make up 47% of the total respondents, Reformers who are 16% of the total respondents, and Status Quo who make up 31% of the total respondents. Those who are Disillusioned believe the traditional Dream is outdated and new values need to be added. In direct comparison, those who advocate a Status Quo American Dream, support the traditional Dream and do not think new values need to be added. In the middle, are Reformers, who advocate new values be added to the American Dream but do not think that the traditional Dream is outdated. These different clusters vary on the factors used in life decisions, their individual values, environmental concern, and frugality. The American Dream will probably continue to evolve as new generations change their beliefs as to what constitutes important life goals. If it remains a flexible construct, the American Dream may never be outdated but may need continual updates as to what exactly the American Dream represents.

The role of regular physical activity and healthy eating in preventing obesity is well documented. Research has suggested that lifestyle interventions, i.e., programs comprising exercise, nutrition education, and behavior modification, are the preferred, non-invasive strategies to prevent childhood obesity. However, minority groups, e.g., underserved Latinx adolescents, experience high attrition rates and other barriers that limit their participation in obesity prevention programs. The purpose of this study was to examine indicators of the feasibility of the remotely delivered BRAVO! lifestyle intervention in preventing obesity among Latinx youth. This pilot study was a quasi-experimental trial with a sample of 11 pediatrician-referred participants (M[subscript age]=13.73±1.10) assigned to two parallel arms: 1) BRAVO! and 2) as-usual control arms. Researchers designed the BRAVO! lifestyle intervention program comprising 16 hours of remotely instructed (via zoom) exercise training and six hours of family nutrition education. Behavior modification strategies were based on the self-determination theory. The results showed high demand with program adherence being 93.3% and 86.7%, for exercise and nutrition, respectively. There was a statistically significant intervention effect on PA (F[1,8]=7.88, p=0.006, [eta]p2=0.42), integrated (F[1,8]=20.00, p=0.002, [eta]p[superscript 2]=0.71), introjected regulation (F[1,8]=7.94, p=0.008, [eta]p[superscript 2]=0.60), and amotivation (F[1,8]=18.24, p=0.002, [eta]p[superscript 2]=0.69), and psychological well-being (F[1,8]=12.31, p=0.008, [eta]p[superscript 2]=0.61). Finally, interview analyses showed that participants were highly satisfied with the BRAVO! program and they perceived BRAVO! suitable for them. In conclusion, our pilot study findings supported feasibility of the remotely delivered BRAVO! lifestyle intervention.

Objective: The objectives of this study were to (1) measure the acceptability of Students As LifeStyle Activists (SALSA) Youth Voices (SYV) programme, (2) determine the skills gained by peer leaders from their participation in SYV and (3) determine whether peer leaders were able to design and implement an action to promote healthy eating and physical activity in their school. Design: Process evaluation. Setting: Peer leaders (aged 15-16 years) from high schools in Western Sydney, Australia. Method: We conducted a process evaluation to determine the reasons why students participated in SYV, which workshop activities they enjoyed, the skills they gained from participating in SYV and whether the actions were designed and implemented. Peer leaders completed an online survey at the end of the Leadership Day. The peer leaders then presented their actions at an SYV Action Day event and completed a further online survey. Results: Eighty-four peer leaders from seven high schools in Western Sydney participated in SYV. Peer leaders reported their involvement with the SYV programme as positive, with 68% rating it as 'very valuable'. Skills gained by the peer leaders included teamwork (90%), communication (85%), leadership (77%) and confidence (65%). Peer leaders planned and devised actions, which included installing water refill stations, fitting the school gymnasium with new equipment, redesigning girls' sports shorts, and other strategies to engage girls in physical activity. Students from all seven schools presented their actions to receive feedback and expressed confidence that their actions were sustainable. Conclusion: The SYV programme showed that providing peer leaders with ownership of their actions was successful in creating healthy school environments, while building leadership, teamwork, communication skills and confidence in adolescents.