Multi-profile hidden Markov model for mood, dietary intake, and physical activity in an intervention study of childhood obesity

Stat Med. 2013 Aug 30;32(19):3314-31. doi: 10.1002/sim.5719. Epub 2013 Jan 16.


Motivated by an application to childhood obesity data in a clinical trial, this paper describes a multi-profile hidden Markov model (HMM) that uses several temporal chains of measures respectively related to psychosocial attributes, dietary intake, and energy expenditure behaviors of adolescents in a school setting. Using these psychological and behavioral profiles, the model delineates health states from the longitudinal data set. Furthermore, a two-level regression model that takes into account the clustering effects of students within school is used to assess the effects of school-based and community-based interventions and other risk factors on the transition between health states over time. The results from our study suggest that female students tend to decrease their physical activities despite a high level of anxiety about weight. The finding is consistent across intervention and control arms.

Keywords: childhood obesity intervention; latent Markov model; latent variable; longitudinal analysis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Affect*
  • Eating / physiology*
  • Eating / psychology*
  • Energy Metabolism / physiology
  • Female
  • Humans
  • Louisiana
  • Markov Chains*
  • Models, Psychological*
  • Models, Statistical*
  • Motor Activity / physiology*
  • Pediatric Obesity / psychology
  • Pediatric Obesity / therapy*
  • Rural Population
  • Students