Ecological Link of Psychosocial Stress to Exercise: Personalized Pathways

描述（由申请人提供）：健康行为占心血管疾病（CVD）风险的40%以上。先前关于压力和心血管疾病的研究已经提供了大量信息，但我们对将压力暴露/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受到我们的理论、测量和统计模型的限制。利用最近的方法，技术和统计学的进步，并耦合生态瞬时评估与智能手机技术和活动记录，我们的主要目的是确定瞬时压力感知对个人是否参与运动的影响，以及参与运动是否反过来影响60名间歇性锻炼的成年人随后对压力的感知。通过6个月的观察数据，我们将建立压力感知和运动的个性化模型，并额外关注感知压力的来源，并以随机方式将此信息提供给60名参与者中的30名，并继续观察所有参与者另外6个月。这项设计将测试我们的新假设，即个性化的受试者内压力和运动模型比我们传统的受试者间模型更好地预测运动，个性化的压力知识将增加运动。我们假设，1）经实验评估的个人对心理社会压力的感知与随后参与腕动计评估的运动的概率呈负相关; 2）腕动计评估的运动与随后对心理社会压力的感知呈负相关（急性运动后和一天结束时的总结）。我们还将探索：1）对于运动预测的瞬时压力感知，是否存在个人特定的压力暴露源; 2）如果那些随机接受关于他们的个性化“压力指纹”的信息的人-那些与运动减少相关的压力源-都减少了他们对那些压力源的暴露并增加了他们的运动;以及3）如果生活压力源（例如，婚姻、工作、财务），资源（例如，社会支持、财务）和个人脆弱性（例如，幼儿期逆境）是双向关系的调节者 压力感知和锻炼之间的关系重要性：这是第一项旨在记录长期实时个性化压力和运动之间双向关系的研究。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-这两个难以捉摸的公共卫生目标。开发一种针对个人的方法来理解压力和行为，可以彻底改变我们对高度流行的、迄今为止令人困惑的健康行为的概念化和治疗方式。 公共卫生相关性：健康行为占心血管疾病（CVD）风险的40%以上，但我们不知道谁会增加大多数人的风险。这可能是因为我们每天在生活中遇到的压力源类型影响了我们当天的锻炼能力;也可能是因为我们每个人都有一套独特的压力源，可以预测我们的锻炼计划。利用许多创新的进步，我们的主要目标是非侵入性地评估压力感知和压力，看看它们是否会影响人们进行锻炼，以及是否会反过来降低每个人随后对压力的感知。

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.