2.8.3. Composite Diet-Activity Improvement Score. In order to quantify overall change across four behaviors (FV, Fat, PA, and Sed), we developed a composite healthy diet and activity improvement score, weighting each behavior equally. All variables were transformed to better approximate normality, using square root transformation for the count outcomes (FV, PA, and Sed) and arc sine transformation for the percentage outcome, Fat [39]. To allow direct comparisons between interventions on these disparately measured variables, each individual health behavior was standardized to provide a common metric using a modified z-score (where 1 unit represents a 1-standard deviation change), with higher values representing greater healthy lifestyle improvement. Z-scores for time points after baseline were standardized relative to the overall baseline distribution to reflect improvement relative to baseline. To reflect the effect of treatment across multiple health behaviors, the mean of all four individual z-scores at each time point was calculated, as recommended [40], to derive a composite index that expressed each participant’s overall healthy behavior change. We refer to this as a “composite diet-activity improvement score.