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

项目摘要/摘要 哮喘是儿童时期的一种主要慢性病，可能危及生命，并与多种疾病有关 会带来不利的后果。指南-建议的医疗护理，包括使用每日有效的吸入剂 皮质类固醇，极大地改善了哮喘的治疗。然而，哮喘仍然是一种相当健康的疾病。 尤其是在青少年中，他们的预防性服药依从率往往低至50%。 考虑到青春期是一个发育时期，其特点是 增强自主性，包括自我管理自己的医疗保健，这是一项需要时间才能掌握的技能。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。 与服药依从性呈负相关。因此，提高遵守情况的创新方法 为了促进更好的哮喘健康，需要预防性药物和减轻压力。 积极心理学研究积极的经历、积极的个人特质和支持性的社会。 网络。积极情绪(如快乐等情绪)是积极心理学的一个重要组成部分 已经在多项同行评议的研究中证明在几种情况下可以促进健康。证据 提示积极情感的健康促进作用是通过它对健康的有益影响来实现的。 行为(如服药依从性)和压力。考虑到服药依从性和压力在 对于哮喘健康，我们预计积极的影响将通过增加服药依从性和 减轻压力，以及对哮喘健康有直接影响。 也就是说，积极的情感、坚持、压力和哮喘健康在本质上都是动态的，从 但这些因素的瞬时影响和相互作用尚未被研究 一起出现在先前的哮喘文献中。在瞬间水平上测试这些关联可能有助于发现细微差别 为行为干预提供信息的关系，随着时间的推移可以适应，不仅适合个人，而且适合 (即，当时发生了什么)，从而增加了管理层的干预效力 哮喘的症状。 因此，目前的建议将测试瞬间积极情感和哮喘之间的联系。 健康，以及这种关联背后的假设机制，使用纵向突发设计 对患有中度到重度持续性哮喘的青少年的瞬时评估。此应用程序中的工作 为开发适应性行为干预措施以更好地治疗哮喘奠定了基础 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.