Secular Trend Analysis of NHANES Data Suggests Only Modest Increases in Health-Related Lifestyle Advice Delivered by Health Professionals
Bibliographic record
Abstract
Chronic non-communicable diseases are widespread in the US and exert a high burden on its society. Poor lifestyle habits contribute to this contemporary public health crisis. To address the prevalence of non-communicable diseases and related risk factors in Americans, we studied trends in US health professionals’ delivery of health-related lifestyle advice. The major aim was to identify trends and long-term directions in the predicted probability of lifestyle advice delivery. We conducted a secular trend analysis of 18 426 participant reports over 4 consecutive National Health and Nutrition Examination Survey cycles (2011-2018) to estimate the predict probability of their receiving specific lifestyle recommendations by a health professional. Lifestyle-related advice included: (1) sodium or salt intake monitoring; (2) physical activity or exercise encouragement; (3) fat or calorie intake monitoring; and (4) weight control within the last 12 months. In all 4 analyzed NHANES cycles combined, 24.79% (CI: 23.52-26.11) of participants received advice to reduce salt intake, 39.91% (CI: 38.67-41.16) were told to exercise and 30.01% (28.73-31.32) were advised to reduce fat/calories. Compared with 2011-2012, modest increases were observed in 2017-2018 across all lifestyle recommendations; about one-third of participants reported receiving advice to reduce sodium/salt/calories or control/lose weight. The predicted number of lifestyle recommendations received increased over the examined time frame (contrast for 2017-2018 vs 2011-2012: +0.23 (0.13-0.35), P < .001). Health professionals’ competency in delivering health-related lifestyle advice appears deficient warranting its prioritization given health promotion is an established accredited health professional competency comparable to drug prescription.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".