Positive Affect and Pediatric Asthma: An Innovative Positive Psychology Model to Improve Asthma Management and Health

项目概要/摘要 哮喘是儿童时期的一种主要慢性疾病，可能危及生命， 不良后果。指南推荐的医疗护理，包括使用每日有效吸入 皮质类固醇，极大地改善了哮喘的治疗。然而，哮喘仍然是一个相当大的健康问题。 令人担忧的是，特别是在青少年中，他们的预防性药物依从率往往低至50%。 考虑到青春期是一个发展时期， 增加自主权，包括自我管理自己的医疗保健，这是一项需要时间掌握的技能。此外，压力 已被证明会对青少年的哮喘健康产生负面影响，这可能部分是由于压力造成的。 与药物依从性呈负相关。因此，改进遵守《公约》的创新办法 需要预防性药物和减轻压力来促进更好的哮喘健康。 积极心理学是研究积极的经验，积极的个人特质和支持性的社会 网络.积极的影响（例如，情绪，如幸福）是积极心理学的一个主要组成部分， 在多项同行评审的研究中证明，它可以在多种情况下促进健康。证据 表明积极情绪的健康促进作用是通过其对健康的有益影响而发生的 行为（如药物依从性）和压力。考虑到药物依从性和压力在 哮喘健康，我们预计积极的影响将有利于哮喘健康，增加药物依从性， 减轻压力，并对哮喘健康有直接影响。 也就是说，积极的影响，坚持，压力和哮喘健康在本质上都是动态变化的， 但这些因素的瞬时影响和相互作用尚未得到研究 在之前的哮喘文献中。在瞬间水平上测试这些关联可能有助于揭示 这些关系为行为干预提供了信息，这些干预可以随着时间的推移而适应，不仅适合个人， 场合（即，在那一刻发生了什么），从而提高管理干预的有效性 哮喘。 因此，本研究将测试瞬间积极情绪与哮喘之间的关系 健康，以及这种关联背后的假设机制，使用纵向突发设计， 对患有中度至重度持续性哮喘的青少年进行瞬时评估。本申请中的工作 为适应性行为干预的发展奠定了基础，以更好地治疗哮喘， 青少年。

PROJECT SUMMARY/ABSTRACT Asthma, a leading chronic illness in childhood, can be life-threatening and is associated with a multitude of adverse outcomes. Guideline-recommended medical care including the use of daily, effective inhaled corticosteroids, has greatly improved the treatment of asthma. However, asthma remains a considerable health concern, particularly among adolescents, who often have preventive medication adherence rates as low as 50%. This poor adherence may not be surprising given that adolescence is a developmental period characterized by increased autonomy including self-managing one’s health care, a skill that takes time to master. Further, stress has been shown to negatively impact asthma health in adolescents, and this could in part be due to stress’ negative association with medication adherence. Thus, innovative approaches to improving adherence to preventive medication and decreasing stress are needed to promote better asthma health. Positive Psychology is the study of positive experiences, positive individual traits, and supportive social networks. Positive affect (e.g., emotions such as happiness) is a major component in Positive Psychology and has been demonstrated in multiple peer reviewed studies to boost health in several conditions. Evidence suggests that the health enhancing effects of positive affect occur through its beneficial impact on health behaviors (such as medication adherence) and stress. Given the role of medication adherence and stress in asthma health, we expect that positive affect will benefit asthma health by increasing medication adherence and decreasing stress, as well as have direct effects on asthma health. That said, positive affect, adherence, stress, and asthma health are all dynamic in nature changing from moment to moment, but the momentary effects of and interactions among these factors have not been studied together in prior asthma literature. Testing these associations at the momentary level may help uncover nuanced relationships informing behavioral interventions that can be adaptive over time to fit not only the person but the occasion (i.e., what is happening in that moment), thus increasing intervention effectiveness for the management of asthma. Thus, the present proposal will test the associations between momentary-positive-affect and asthma health, as well as the hypothesized mechanisms behind this association, using a longitudinal burst design with momentary assessment of adolescents with moderate to severe persistent asthma. The work in this application lays the foundation for the development of adaptive behavioral interventions to better treat asthma in adolescents.