Dunton Genevieve, Dzubur Eldin, Li Marilyn, Huh Jimi, Intille Stephen, McConnell Rob
University of Southern California, Los Angeles, USA
University of Southern California, Los Angeles, USA.
Behav Modif. 2016 Jan;40(1-2):257-80. doi: 10.1177/0145445515608145. Epub 2015 Oct 5.
The current study used a novel real-time data capture strategy, ecological momentary assessment (EMA), to examine whether within-day variability in stress and context leads to exacerbations in asthma symptomatology in the everyday lives of ethnic minority adolescents. Low-income Hispanic adolescents (N = 20; 7th-12th grade; 54% male) with chronic asthma completed 7 days of EMA on smartphones, with an average of five assessments per day during non-school time. EMA surveys queried about where (e.g., home, outdoors) and with whom (e.g., alone, with friends) participants were at the time of the prompt. EMA surveys also assessed over the past few hours whether participants had experienced specific stressors (e.g., being teased, arguing with anyone), asthma symptoms (e.g., wheezing, coughing), or used an asthma inhaler. Multilevel models tested the independent relations of specific stressors and context to subsequent asthma symptoms adjusting for age, gender, and chronological day in the study. Being outdoors, experiencing disagreements with parents, teasing, and arguing were associated with more severe self-reported asthma symptoms in the next few hours (ps < .05). Being alone and having too much to do were unrelated to the experience of subsequent self-reported asthma symptoms. Using a novel real-time data capture strategy, results provide preliminary evidence that being outdoors and experiencing social stressors may induce asthma symptoms in low-income Hispanic children and adolescents with chronic asthma. The results of this preliminary study can serve as a basis for larger epidemiological and intervention studies.
当前的研究采用了一种新颖的实时数据采集策略——生态瞬时评估（EMA），以检验压力和环境因素在一天内的变化是否会导致少数民族青少年日常生活中哮喘症状加重。患有慢性哮喘的低收入西班牙裔青少年（N = 20；7-12年级；54%为男性）在智能手机上完成了为期7天的EMA，非上学时间平均每天进行五次评估。EMA调查询问了参与者在收到提示时所处的位置（如家中、户外）以及与谁在一起（如独自一人、与朋友在一起）。EMA调查还评估了参与者在过去几个小时内是否经历了特定的压力源（如被取笑、与他人争吵）、哮喘症状（如喘息、咳嗽）或使用过哮喘吸入器。多层次模型在对研究中的年龄、性别和日期进行调整后，测试了特定压力源和环境因素与随后哮喘症状之间的独立关系。在户外、与父母发生分歧、被取笑和争吵与接下来几个小时内自我报告的更严重哮喘症状相关（p值<0.05）。独自一人和事务过多与随后自我报告的哮喘症状无关。通过使用新颖的实时数据采集策略，研究结果提供了初步证据，表明在户外和经历社会压力源可能会诱发患有慢性哮喘的低收入西班牙裔儿童和青少年的哮喘症状。这项初步研究的结果可作为更大规模流行病学和干预研究的基础。
