This application is being submitted in response to Notice Number NOT-OD-09-058, entitled """"""""NIH Announces the Availability of Recovery Act Funds for Competitive Revision Applications. For the supplement, we propose to add three hormonal measurements (cortisol, progesterone, and DHEA) to our R21 study entitled """"""""Outcome Measurement in Older Adults with Chronic illness. The current longitudinal study of older adults with chronic pain involves an extensive array of quality of life measurement techniques. We propose to examine diurnal patterns in these hormones that are indicative of more or less adaptive ways of regulating stress (e.g., a """"""""challenge"""""""" vs. """"""""threat"""""""" pattern). We will collect the hormone data """"""""in vivo,"""""""" meaning that they would do them at home, at the same time we are getting Ecological Momentary Assessment (EMA) data from them (in fact, we will use our existing EMA device to prompt them to save hormone samples). This means we would be able to relate diurnal hormone patterns to both EMA and Day Reconstruction Method measures of physical symptoms, daily activities, and well being. The original study design called for two waves of data collection on a sample of 100 osteoarthritis patients and 50 healthy controls. We have recruited most of the sample, and wave 2 data collection is due to begin in October, 2009. We propose to add the hormone measurement to the wave 2 data collection;we would have all of the data-including the new hormone measures--collected by the end of January, allowing us to spend the final months of the grant period on data analyses.
Our goal is to apply methodological advances in emotion measurement to improve health-related quality of life measures. Specifically, we propose to examine two newer approaches to measurement that have been designed by psychologists for the purpose of overcoming recall biases: Ecological Momentary Assessment (EMA), which are """"""""real time"""""""" measures and therefore not subject to recall biases, and a new diary-based approach to measuring quality of life, the Day Reconstruction Method (DRM). We intend to begin to test the usefulness and validity of these measures among lower extremity osteoarthritis patients (LE-OA) and in a comparison group of healthy older adults.
