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（CVD）发生风险的40%以上。先前关于压力和心血管疾病的研究已经提供了信息，但我们对压力暴露/感知与健康行为之间的基本机制途径和过程的理解仍然存在重大差距。我们也不了解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活动记录仪相结合，我们的主要目的是确定瞬时压力感知对个人是否从事运动的影响，以及从事运动是否反过来影响60名间歇性运动的成年人随后对压力的感知。通过6个月的观察数据，我们将建立个性化的压力感知和运动模型，并额外关注感知压力的来源，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。这一设计将验证我们的新假设，即个性化的压力和锻炼的主题内模型比传统的主题间模型更能预测锻炼，个性化的压力知识将增加锻炼。我们假设：1)经生态评估的个体对社会心理压力的感知与随后参与活动描记法评估的运动的概率呈负相关；2)活动记录仪评估的运动与随后的心理社会压力感知呈负相关（剧烈运动后和一天结束时的总结）。我们还将探讨：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)如果那些随机接受个性化“压力指纹”信息的人——那些与减少锻炼有关的压力源——既减少了对这些压力源的暴露，又增加了锻炼；3)生活压力源（如婚姻、工作、财务）、资源（如社会支持、财务）和个人脆弱性（如童年早期逆境）是否为双向关系的调节因子

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.