Mental health again, the same hypotheses. I was expecting improvements in stress, anxiety, and depression and used a more clinically sensitive measure to evaluate this, so it was really looking for reductions in depression, reductions in anxiety, reductions in stress. Again, for the enrolled students, just seeing that flat line. So none of these were statistically significant. Just seeing a flat line from the beginning of the semester to the end of the semester. So again, somewhat disappointing. This is the measure. So remember before, I talked about how I had used a pretty basic measure of depression and anxiety and it was simply how many days were you depressed? How many days were you anxious? How many days were you stressed? This is a measure that actually evaluates each of these in a less readily apparent way. So it's asking things like features of depression. Things like I found it difficult to work up the initiative to do things. That's a feature of depression. I tended to overreact to situations, that could be stress or anxiety, potentially. It's actually stress in this case. I experienced trembling, this is an example of anxiety. So we're actually getting a much more nuanced measure for each of these domains, and so the expectation here is that if there were any variations or improvements this measure might capture it a little bit more readily, and it has been shown to be a clinically sensitive measure, meaning that following treatment and following improvement in a clinical setting with therapy, for example, or with medication this measure follows along and indicates the improvement. So that's why I was really hopeful that we'd see it but to back up, flat line for the enrolled students, no changes from the start of the semester to the end of the semester, potentially indicating that the intervention was not effective or potentially indicating that it was effective in suppressing or minimizing the observed increases in depression, anxiety, and stress that typically follow the student experience. So here we're seeing, and again the design would not allow for everyone to be analyzed simultaneously, but we could look at the groups individually and see that the control students did experience an increase in depression. They did experience an increase in stress, and it was much greater than the minimal increase in stress that was experienced for the enrolled students. So again, from this, at least from a clinical perspective looking at this, I'm actually pleased that we didn't see the typically observed spikes in depression, anxiety, and stress that follow general enrollment in school. >> I think it's really telling specifically the stress measure, because the difficulty with both depression and anxiety is that some people come in with existing conditions or come in with existing preconditions that might predispose them to having depression and anxiety but stress is I feel like while there are some cultural and structural factors and personal factors that might influence one student's stress more than another, for example, financial stress or familial stress, everyone has the same amount of academic, or close to the same amount of academic stress applied to them. So that there's the most clear difference in stress is I think really telling for how effective potentially the intervention is. >> Absolutely. So even if it reduced or focused or was effective in one of these domains, that's still potentially helpful because that's a pretty significant spike for the control students from start to finish. >> Yeah, and I think the impact of that in relationship to the dietary changes is quite powerful because of all the research linking stress and increased calorie content in foods, and then how that, kind of that spiral in the loop that that ties into to, and to the fact that both measures are existing and together. >> Absolutely. >> I think [CROSSTALK] a powerful statement. >> Wonderful, thank you. That's of course getting to the overall punchline of all of this. >> Then I will stop talking. >> Is the, no, that's wonderful, please talk, I love it. Is that it's getting to the reciprocal nature of all of these behavioral changes on our general well-being with respect to mental wellness, and stress, and it's wonderful. Okay, now I also want to talk about, I included some additional measures in this most recent version including something called self-efficacy. So one of the student feedback statements before was that they generally felt better about their ability to change this behavior. So whereas they perceived their general health feeling better, they experienced general improved feelings of wellness because they were able to do this thing that they had previously found to be insurmountable or just too hard of a behavior change to make. So in this study we also measured this notion of self-efficacy, which is one's confidence or belief in your ability to perform some task, and in this case, it was self-efficacy surrounding health behavior change and self-efficacy around physical activity as well. And what we found was that through the process of changing these small modifiable behaviors, over the course of the semester, student general self-efficacy, their the general sense of confidence and ability to navigate challenging tasks, improved, and there was no change for the control students. So again, kind of speaking to this global improvement in well-being, because self-efficacy is related to many different sorts of health outcomes, medical adherence, and so on, one's belief in their ability to do it. So that's pretty cool.
