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

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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.