How Does Stress Affect Health Behaviors: Preferences, Beliefs, or Constraints?

 描述（由申请人提供）：压力如何影响健康行为-偏好，信仰或约束？这项提案的目的是确定一种行为机制，可能会导致低依从性的医疗方案和其他健康行为。低依从性通常与高水平的压力有关。压力可能会通过增加时间折扣来影响依从性，即一个人对即时相对于延迟结果的偏好;通过降低自我效能感，即一个人对他们可以实现的信念;或通过损害执行功能，即认知和行为约束，如注意力和工作记忆。在具体目标1中，我们确定了实现这些目标的适当措施。在研究1A中，我们进行了系统的文献综述，以确定措施;在研究1B中，我们仔细测试这些措施的心理测量特性。在具体目标2中，我们通过实验室实验评估压力是否会影响我们的目标，在实验中，参与者暴露于轻度压力源。我们假设，压力会增加时间折扣，降低自我效能，并损害执行控制。在具体目标3中，我们确定并制定干预措施， 与我们感兴趣的目标交战在研究3A中，我们确定了可能影响我们目标的候选干预措施或开发了新的干预措施。干预措施可能包括视频，以提高愿望， 写作练习自我肯定，电脑游戏，以增加未来的结果的显着性。然后，我们使用实验室研究来测试这些干预措施是否会吸引我们的目标，在实验室研究中，参与者首先接触到干预措施，然后对目标措施进行测试。我们假设，干预措施将减少折扣，提高自我效能，提高执行控制。最后，在具体目标4中，我们使用现场实验来测试参与我们的目标是否会提高医疗方案的依从性，在现场实验中，随机选择的家庭将暴露于我们的干预措施之一。我们感兴趣的主要坚持行为是出席产前和产后护理（ANC/PNC）访问的期待和新的母亲。我们假设暴露于干预措施将吸引我们感兴趣的目标并增加ANC/PNC依从性。前期工作：在SOBC-1期间，我们已经测试了压力对时间折扣的影响，以及简单的心理干预对心理健康的影响;因此，上述研究是我们在这一领域工作的自然延伸。总之，这些拟议的研究将有助于建立一个更机械的理解的起源和失败的健康行为，如医疗方案的遵守。

 DESCRIPTION (provided by applicant): How does stress affect health behaviors - preferences, beliefs, or constraints? The goal of this proposal is to identify a behavioral mechanism which might cause low adherence to medical regimens and other health behaviors. Low adherence is frequently associated with high levels of stress. Stress may affect adherence by increasing temporal discounting, i.e. a person's preferences for immediate relative to delayed outcomes; by decreasing self-efficacy, i.e. a person's beliefs about what they can achieve; or by impairing executive function, i.e. cognitive and behavioral constraints such as attention and working memory. In Specific Aim 1, we identify appropriate measures for these targets. In Study 1A, we conduct a systematic literature review to identify measures; in Study 1B, we carefully test the psychometric properties of these measures. In Specific Aim 2, we assess whether stress affects our targets through a laboratory experiment in which participants are exposed to mild stressors. We hypothesize that stress will increase temporal discounting, decrease self-efficacy, and impair executive control. In Specific Aim 3, we identify and develop interventions to engage our targets of interest. In Study 3A, we identify candidate interventions, or develop new ones, that may affect our targets. Interventions are likely to include videos to raise aspirations, writing exercises for self-affirmation, computer games to increase the salience of future outcomes. We then test whether these interventions engage our targets using a laboratory study in which participants are first exposed to the interventions and then tested on the target measures. We hypothesize that the interventions will reduce discounting, increase self-efficacy, and improve executive control. Finally, in Specific Aim 4, we test whether engaging our targets improves medical regimen adherence using a field experiment in which randomly selected households will be exposed to one of our interventions. Our primary adherence behavior of interest is attendance of antenatal and postnatal care (ANC/PNC) visits by expecting and new mothers. We hypothesize that exposure to the interventions will engage our targets of interest and increase ANC/PNC adherence. Preliminary work: During SOBC-1, we have already tested the effect of stress on temporal discounting, and the effect of simple psychological interventions on psychological well-being; thus, the studies described above are a natural extension of our work in this area. Together, these proposed studies will contribute to establishing a more mechanistic understanding of the origin and failure of health behaviors such as medical regimen adherence.