Ecological Link of Psychosocial Stress to Exercise: Personalized Pathways

描述(申请人提供)：健康行为占心血管疾病风险的40%以上。以前关于压力和心血管疾病的研究已经提供了丰富的信息，但在我们对将压力暴露/感知与健康行为联系起来的基本机制途径和过程的理解方面仍然存在重大差距。我们也不明白个人资源和脆弱性的个体差异如何缓冲或加剧压力对这些行为的影响。我们评估压力暴露/感知与行为之间复杂的、潜在的双向关联的能力一直受到我们的理论、测量和统计模型的限制。利用最新的方法、技术和统计进展，并将生态瞬时评估与智能手机技术和动作记录仪相结合，我们的主要目标是确定瞬时压力感知对个人是否参与锻炼的影响，以及参与锻炼是否反过来影响60名间歇性锻炼成年人随后的压力感知。利用6个月的观察数据，我们将建立个性化的压力感知和锻炼模型，额外关注感知到的压力来源，并以随机方式将这些信息提供给60名参与者中的30名，并继续观察所有参与者6个月。这一设计将检验我们的新假设，即个性化的受试者内部压力和锻炼模型比我们传统的受试者之间模型更能预测锻炼，并且个性化的压力知识将增加锻炼。我们假设，1)生态评估的个体对心理社会压力的感知与随后从事活动评估的锻炼的可能性呈负相关；2)活动评估的锻炼与随后的心理社会压力的感知呈负相关(强烈地在运动后和一天结束时总结)。我们还将探索：1)是否存在特定人的压力暴露来源，以预测运动的瞬时压力感知；2)如果那些随机接受关于其个性化“压力指纹”的信息的人--那些与运动减少相关的压力源--都减少了他们对这些压力源的暴露，并增加了他们的锻炼；以及3)生活压力因素(例如，婚姻、工作、经济)、资源(例如，社会支持、经济)和个人脆弱性(例如，儿童早期逆境)是否是双向关系的调节因素 在压力感知和锻炼之间。意义：这是第一项旨在记录个性化压力和运动之间的双向关系的研究，在较长一段时间内实时进行。通过使用创新的人内模型，我们可能会发现个性化的治疗目标更好地帮助我们减轻压力，改善定期锻炼行为-这两个公共卫生目标难以实现。开发一种针对特定人的方法来理解压力和行为，可能会彻底改变我们对高度普遍的、迄今令人困惑的健康行为的概念化和处理方式。 公共卫生相关性：健康行为占心血管疾病(CVD)发病风险的40%以上，但我们不知道在大多数人中，谁会增加这些风险。这可能是我们每天生活中遇到的压力源的类型影响了我们当天锻炼的能力；也可能是我们每个人都有一套独特的压力源来预测我们的锻炼计划。利用许多创新的进展，我们的主要目标是非侵入性地评估压力感知和压力，并看看它们是否会影响一个人何时参加锻炼，以及参加锻炼是否反过来降低了每个人随后对压力的感受。

DESCRIPTION (provided by applicant): Health behavior accounts for upwards of 40% of incident cardiovascular disease (CVD) risk. Prior research on stress and CVD has been informative, yet significant gaps remain in our understanding of the basic mechanistic pathways and processes linking stress exposure/perceptions to health behaviors. We also don't understand how individual differences in personal resources and vulnerabilities buffer or aggravate the impact of stress on these behaviors. Our ability to assess complex, potentially bi-directional associations of stress exposure/perception to behavior has been limited by our theoretical, measurement, and statistical models. Using recent methodological, technological, and statistical advances, and coupling ecological momentary assessment with smartphone technology and actigraphy, our Primary Aim is to ascertain both the effect of momentary stress perception on whether an individual engages in exercise, and whether engaging in exercise in turn influences the subsequent perception of stress among 60 intermittently exercising adults. With 6 months of observational data we will build personalized models of stress perception and exercise, with an additional focus on the sources of perceived stress, and provide this information to 30 of the 60 participants in a randomized manner, and continue to observe all participants for six additional months. This design will test our novel hypothesis that personalized within-subject models of stress and exercise better predicts exercise than our traditional between-subject models, and that personalized stress knowledge will increase exercise. We hypothesize that, 1) Ecologically assessed individual perceptions of psychosocial stress are inversely associated with the probability of subsequently engaging in actigraphy-assessed exercise; 2) Actigraphy- assessed exercise is inversely associated with subsequent perceptions of psychosocial stress (acutely post- exercise and end-of-day summary for the day). We will also explore: 1) if there are person-specific sources of stress exposure for the exercise-predictive momentary stress perceptions; 2) if those randomized to receiving information on their personalized "stress fingerprint" - those stress sources associated with decreased exercise - both decrease their exposure to those stressors and increase their exercise; and 3) if life stressors (e.g., marital, work, financial), resources (e.g., social support, financial), and personl vulnerabilities (e.g., early childhood adversity) are moderators of the bi-directional relationship between stress perception and exercise. Significance: This is the first study designed to document the bi-directional relationship between personalized stress and exercise in real-time over an extended period. By using innovative within-person models, we may find that personalized treatment targets better aid us in decreasing stress, and improving regular exercise behavior - two elusive public health goals. The development of a person-specific methodology to understanding stress and behavior could revolutionize the way we conceptualize and treat highly prevalent, hitherto baffling health behaviors. PUBLIC HEALTH RELEVANCE: Health behavior accounts for upwards of 40% of incident cardiovascular disease (CVD) risk, yet we don't know who to increase these in most persons. It may be that the type of stressor we encounter in our lives each day influences our ability to exercise that day; it is also possible that each one of us has a unique set of stressors that predict our exercise routine. Using many innovative advances, our Primary Aim is to noninvasively assess stress perception and stress, and see if they influence when someone engages in exercise, and whether engaging in exercise in turn decreases each person's subsequent perception of stress.