Everyday Stress Response Targets in the Science of Behavior Change

 描述（由申请人提供）：压力是心脏、代谢和神经系统疾病的一个有记录的风险因素。个人如何应对日常压力会影响他们是否符合国家健康行为指南，如锻炼和睡眠。该项目的总体目标是利用实验医学方法开发一种有效的，生态有效的，人内的方法来测量和干预日常压力对满足两种健康行为的建议水平的有害影响：身体活动和睡眠模式。在第一阶段，我们将开发，验证和提供一个压力测试，评估压力过程中的可塑性成分，这些成分在个人自然环境中实时地推动健康行为决策和制定。在第二阶段，我们将使用这种检测方法来评估“及时”干预方法，这些方法在特定的压力反应成分最具可塑性并能对健康行为产生积极影响的时候和背景下针对这些成分。与以前的日常压力研究相比，我们将在10个密集的纵向数据集中进行协调分析，分离压力源反应性，恢复和堆积对健康行为的影响。通过复制 通过10项研究的结果，我们将确保确定最可靠和最有效的靶点 进行干预。从压力理论得出的中心假设是， 反应性、不完全或缓慢的恢复以及更频繁的压力反应将对健康行为参与产生负面影响。拟议研究的基本原理是，通过确定这些健康行为的最强预测因子，压力干预将更有效地增加体力活动和睡眠，以满足当前的指导方针（例如，疾病控制中心推广的临床建议）。从这一假设延伸出的具体目标包括：1）测试跨10个密集纵向数据集的预测，这些数据集可以识别压力源反应性、恢复和堆积，并且比传统压力指数更有用，2）测试这三个分量预测日常身体活动和睡眠的预测，3）识别风险更高的人的特征对这些干扰健康行为的压力的耐受性（或弹性），4）将这些组分掺入新的样品中，5）测试与个人易受压力影响的时间相关的“及时”干预措施。该研究团队拥有10多年的合作历史，代表了日常压力和健康行为干预的理论，设计和分析专家。该方法是创新的，因为它测试了基于理论的健康行为预测，将在10个数据集上复制效果，并将根据这些结果开发和测试新的和基于实践的“及时”干预措施。这项拟议的研究通过推进我们对压力如何影响疾病发展的理解，以及通过使用基于精准医学的干预措施来改善日常健康行为以达到其推荐水平，具有重要意义。

 DESCRIPTION (provided by applicant): Stress is a documented risk factor for cardiac, metabolic, and neurological disease. How individuals respond to everyday stressors can interfere with whether they meet national guidelines for health behaviors such as exercise and sleep. The overarching goal of this project is to utilize an experimental medicine approach to develop an efficient, ecologically valid, within-person approach to measuring and intervening on the deleterious effects of everyday stress on meeting recommended levels of two health behaviors: physical activity and sleep patterns. In Phase 1, we will develop, validate and deliver a stress assay that assesses malleable components of the stress process that drive health behavior decisions and enactment as they unfold, in real-time and in individuals' natural environments. In Phase 2, we will use this assay to evaluate "just-in-time" intervention approaches that target specific stress response components at times and in contexts when they are most malleable and can positively impact health behaviors. In contrast to previous daily stress studies, we will conduct coordinated analyses in 10 intensive longitudinal datasets separating effects of stressor reactivity, recovery and pile-up on health behaviors. By replicating the results across 10 studies we will ensure identification of the most reliable and potent targets for intervention. The central hypothesis, drawn from stress theory, is that larger initial stressor reactivity, incomplete or slow recovery, and more frequent stress responses will negatively impact health behavior engagement. The rationale for the proposed research is that by identifying the strongest predictors of these health behaviors, stress interventions will be more effective in increasing physical activity and sleep to meet current guidelines (e.g. Center for Disease Control- promoted clinical recommendations). Specific aims extended from this hypothesis include: 1) Test the prediction across 10 intensive longitudinal datasets that stressor reactivity, recovery and pile-up can be identified and are more useful than traditional stress indices, 2) Test the prediction that these three components predict daily physical activity and sleep, 3) Identify characteristics of people who are either more at-risk (or resilient) to these stress interfering with health behaviors, 4) Validate these components in a novel sample, and 5) Test "just-in-time" interventions tied to times when individuals are vulnerable to the effects of stress. The research team has a history 10+ years collaboration and represents experts in theory, design, and analysis of daily stress and health behavior intervention. The approach is innovative because it tests theory- based predictions for health behaviors, will replicate effects across 10 datasets, and will develop and test novel and empirically-based "just-in-time" interventions from these results. The proposed research is significant by advancing our understanding of how stress influences the development of disease and by using interventions grounded in precision medicine to improve daily health behaviors to achieve their recommended levels.