Elsevier

Behaviour Research and Therapy

Volume 101, February 2018, Pages 20-29
Behaviour Research and Therapy

Everyday stress response targets in the science of behavior change

https://doi.org/10.1016/j.brat.2017.09.009Get rights and content

Highlights

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    Stress is an established risk factor for a diverse array of negative health outcomes.

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    Responses to everyday stress can interfere with daily health behaviors such as exercise and sleep.

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    We evaluate an ecologically valid, within-person approach to measuring everyday stress.

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    This approach advances our understanding of how everyday stress influences health behaviors.

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    Everyday stress responses can be used for innovative ambulatory stress reduction intervention.

Abstract

Stress is an established risk factor for negative health outcomes, and responses to everyday stress can interfere with health behaviors such as exercise and sleep. In accordance with the Science of Behavior Change (SOBC) program, we apply an experimental medicine approach to identifying stress response targets, developing stress response assays, intervening upon these targets, and testing intervention effectiveness. We evaluate an ecologically valid, within-person approach to measuring the deleterious effects of everyday stress on physical activity and sleep patterns, examining multiple stress response components (i.e., stress reactivity, stress recovery, and stress pile-up) as indexed by two key response indicators (negative affect and perseverative cognition). Our everyday stress response assay thus measures multiple malleable stress response targets that putatively shape daily health behaviors (physical activity and sleep). We hypothesize that larger reactivity, incomplete recovery, and more frequent stress responses (pile-up) will negatively impact health behavior enactment in daily life. We will identify stress-related reactivity, recovery, and response in the indicators using coordinated analyses across multiple naturalistic studies. These results are the basis for developing a new stress assay and replicating the initial findings in a new sample. This approach will advance our understanding of how specific aspects of everyday stress responses influence health behaviors, and can be used to develop and test an innovative ambulatory intervention for stress reduction in daily life to enhance health behaviors.

Section snippets

Proposing stress response targets

Although everyone experiences stress, there is considerable variation in the nature of stress responses and their effects on health behaviors and health outcomes, both between and within individuals. A sensitive and informative stress assay should, therefore, not only identify who is broadly at risk for stress-related dysfunction (i.e., between-person effect; shows broad differences between individuals), but also identify situations and times when people are at risk (i.e., within-person effect;

Basic challenges for operationalizing stress response targets

Numerous end of day [EOD] and ecological momentary assessment [EMA] studies have examined everyday stressors and have made preliminary attempts to infer reactivity; which, at a basic level, can be characterized as a change on a response indicator (i.e., NA or PC) from pre-stressor to the time following the onset of a stressor. Yet, even this basic definition of reactivity means something different depending on the type of study. For example, EOD diary studies usually operationalize stress

Testing the impact of RRP on physical activity levels and sleep

Everyday stress responses can be construed as generally impacting health through two broad pathways. The first is that chronic stress can lead to biological dysregulation that alters immune (e.g., Segerstrom & Miller, 2004) and hormone function (Miller, Chen, & Zhou, 2007), potentially resulting in increased risk for disease and dysfunction. Although important and of great interest, this pathway falls outside of the scope of work on health behavior change. A second pathway, however, is that

Testing RRP dynamically

Although it is widely recognized that unhealthy lifestyles (e.g., persistent physical inactivity or sleep deficiency) have long-term health consequences, much less attention has been paid to the short-term influence of everyday stress on engagement in these activities. Given that the effects of stress on activity and sleep occur over short timescales (e.g., hours, days, or weeks; e.g., O'Connor et al., 2009, Payne et al., 2010, Rutledge et al., 2009, Sonnentag and Jelden, 2009, Stucky et al.,

A framework for our analytic approach

Our analytic approach involves coordinated analysis of data from multiple intensive longitudinal data sets that adopted similar within-person approaches to measuring stress responses in people's everyday lives. We will thus test a common set of hypotheses using data from independent studies that differ in their specific measures and also their sampling frequencies (EMA, EOD, or both), but that assess the same constructs (i.e., having indicators of some – and often all – of NA, PC, activity, and

Applying a stress response assay to just-in-time intervention innovations

Once we have completed our analytic goals, we will have developed an efficient and optimized assay (i.e., measurement tool) for the precise, within-person assessment of everyday stress. Such an assay would hold great potential for the development of highly tailored and effective interventions. There is a growing awareness of the need for better approaches to personalized/precision medicine (e.g., Lutz et al., 2010). In addition to the overarching focus on tailoring treatment based on biological

Summary and conclusions

The SOBC network applies the experimental medicine approach to behavior change by identifying targets for intervention to produce healthy behaviors. The overarching goal of our project addresses this aim by developing an efficient, ecologically valid, within-person approach to measuring and intervening on the deleterious effects of everyday stress on meeting medically recommended levels of two health behaviors: physical activity and sleep patterns. The conceptual and analytic approach described

Funding

This study was supported by the National Institutes of Health Science of Behavior Change Common Fund Program through an award administered by the National Institutes of Aging (UH2-AG052167). Additional information on this project, including ongoing updates on results and technical details, can be found at the project page hosted on the Open Science Framework (https://osf.io/njpbj/) as they become available.

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