Health behavior accounts for upwards of 40% of incident cardiovascular disease (CVD) risk. Prior research on stress and CVD has been informative, yet significant gaps remain in our understanding of the basic mechanistic pathways and processes linking stress exposure/perceptions to health behaviors. We also don't understand how individual differences in personal resources and vulnerabilities buffer or aggravate the impact of stress on these behaviors. Our ability to assess complex, potentially bi-directional associations of stress exposure/perception to behavior has been limited by our theoretical, measurement, and statistical models. Using recent methodological, technological, and statistical advances, and coupling ecological momentary assessment with smartphone technology and actigraphy, our Primary Aim is to ascertain both the effect of momentary stress perception on whether an individual engages in exercise, and whether engaging in exercise in turn influences the subsequent perception of stress among 60 intermittently exercising adults. With 6 months of observational data we will build personalized models of stress perception and exercise, with an additional focus on the sources of perceived stress, and provide this information to 30 of the 60 participants in a randomized manner, and continue to observe all participants for six additional months. This design will test our novel hypothesis that personalized within-subject models of stress and exercise better predicts exercise than our traditional between-subject models, and that personalized stress knowledge will increase exercise. We hypothesize that, 1) Ecologically assessed individual perceptions of psychosocial stress are inversely associated with the probability of subsequently engaging in actigraphy-assessed exercise;2) Actigraphy- assessed exercise is inversely associated with subsequent perceptions of psychosocial stress (acutely post- exercise and end-of-day summary for the day). We will also explore: 1) if there are person-specific sources of stress exposure for the exercise-predictive momentary stress perceptions;2) if those randomized to receiving information on their personalized """"""""stress fingerprint"""""""" - those stress sources associated with decreased exercise - both decrease their exposure to those stressors and increase their exercise;and 3) if life stressors (e.g., marital, work, financial), resources (e.g., social support, financial), and personl vulnerabilities (e.g., early childhood adversity) are moderators of the bi-directional relationship between stress perception and exercise. Significance: This is the first study designed to document the bi-directional relationship between personalized stress and exercise in real-time over an extended period. By using innovative within-person models, we may find that personalized treatment targets better aid us in decreasing stress, and improving regular exercise behavior - two elusive public health goals. The development of a person-specific methodology to understanding stress and behavior could revolutionize the way we conceptualize and treat highly prevalent, hitherto baffling health behaviors.

Public Health Relevance

Health behavior accounts for upwards of 40% of incident cardiovascular disease (CVD) risk, yet we don't know who to increase these in most persons. It may be that the type of stressor we encounter in our lives each day influences our ability to exercise that day;it is also possible that each one of us has a unique set of stressors that predict our exercise routine. Using many innovative advances, our Primary Aim is to noninvasively assess stress perception and stress, and see if they influence when someone engages in exercise, and whether engaging in exercise in turn decreases each person's subsequent perception of stress.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
3R01HL115941-01S1
Application #
8606598
Study Section
Special Emphasis Panel (ZRG1-BBBP-J (50))
Program Officer
Stoney, Catherine
Project Start
2012-10-01
Project End
2015-08-31
Budget Start
2013-02-01
Budget End
2013-08-31
Support Year
1
Fiscal Year
2013
Total Cost
$83,731
Indirect Cost
$31,399
Name
Columbia University (N.Y.)
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
621889815
City
New York
State
NY
Country
United States
Zip Code
10032
Diaz, Keith M; Krupka, David J; Chang, Melinda J et al. (2016) Validation of the Fitbit One® for physical activity measurement at an upper torso attachment site. BMC Res Notes 9:213
Alcántara, Carmela; Biggs, Mary L; Davidson, Karina W et al. (2016) Sleep Disturbances and Depression in the Multi-Ethnic Study of Atherosclerosis. Sleep 39:915-25
Suls, Jerry; Green, Paige A; Davidson, Karina W (2016) A Behavioral Framework to Address the Emerging Challenge of Multimorbidity. Psychosom Med 78:281-9
Sumner, Jennifer A; Khodneva, Yulia; Muntner, Paul et al. (2016) Effects of Concurrent Depressive Symptoms and Perceived Stress on Cardiovascular Risk in Low- and High-Income Participants: Findings From the Reasons for Geographical and Racial Differences in Stroke (REGARDS) Study. J Am Heart Assoc 5:
Chen, Xiaoli; Wang, Rui; Lutsey, Pamela L et al. (2016) Racial/ethnic differences in the associations between obesity measures and severity of sleep-disordered breathing: the Multi-Ethnic Study of Atherosclerosis. Sleep Med 26:46-53
Alcántara, Carmela; Muntner, Paul; Edmondson, Donald et al. (2015) Perfect storm: concurrent stress and depressive symptoms increase risk of myocardial infarction or death. Circ Cardiovasc Qual Outcomes 8:146-54
Denton, Ellen-Ge D; Shaffer, Jonathan A; Alcantara, Carmela et al. (2015) Hispanic residential ethnic density and depression in post-acute coronary syndrome patients: Re-thinking the role of social support. Int J Soc Psychiatry 61:225-35
Alcántara, Carmela; Molina, Kristine M; Kawachi, Ichiro (2015) Transnational, social, and neighborhood ties and smoking among Latino immigrants: does gender matter? Am J Public Health 105:741-9
Alcántara, Carmela; Klesges, Lisa M; Resnicow, Ken et al. (2015) Enhancing the Evidence for Behavioral Counseling: A Perspective From the Society of Behavioral Medicine. Am J Prev Med 49:S184-93
Diaz, Keith M; Krupka, David J; Chang, Melinda J et al. (2015) Fitbit®: An accurate and reliable device for wireless physical activity tracking. Int J Cardiol 185:138-40

Showing the most recent 10 out of 26 publications