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Positive affect measured using ecological momentary assessment and survival in older men and women.

ABSTRACT: Links between positive affect (PA) and health have predominantly been investigated by using measures of recollected emotional states. Ecological momentary assessment is regarded as a more precise measure of experienced well-being. We analyzed data from the English Longitudinal Study of Aging, a representative cohort of older men and women living in England. PA was assessed by aggregating momentary assessments over a single day in 3,853 individuals aged 52 to 79 y who were followed up for an average of 5 y. Respondents in the lowest third of PA had a death rate of 7.3%, compared with 4.6% in the medium-PA group and 3.6% in the high-PA group. Cox proportional-hazards regression showed a hazard ratio of 0.498 (95% confidence interval, 0.345-0.721) in the high-PA compared with the low-PA group, adjusted for age and sex. This was attenuated to 0.646 (95% confidence interval, 0.436-0.958) after controlling for demographic factors, negative affect, depressed mood, health indicators, and health behaviors. Negative affect and depressed mood were not related to survival after adjustment for covariates. These findings indicate that experienced PA, even over a single day, has a graded relationship with survival that is not caused by baseline health status or other covariates. Momentary PA may be causally related to survival, or may be a marker of underlying biological, behavioral, or temperamental factors, although reverse causality cannot be conclusively ruled out. The results endorse the value of assessing experienced affect, and the importance of evaluating interventions that promote happiness in older populations.

SUBMITTER: Steptoe A

PROVIDER: S-EPMC3215003 | biostudies-literature | 2011 Nov

REPOSITORIES: biostudies-literature

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Positive affect measured using ecological momentary assessment and survival in older men and women.

Steptoe Andrew A Wardle Jane J

Proceedings of the National Academy of Sciences of the United States of America 20111031 45

Links between positive affect (PA) and health have predominantly been investigated by using measures of recollected emotional states. Ecological momentary assessment is regarded as a more precise measure of experienced well-being. We analyzed data from the English Longitudinal Study of Aging, a representative cohort of older men and women living in England. PA was assessed by aggregating momentary assessments over a single day in 3,853 individuals aged 52 to 79 y who were followed up for an aver ...[more]

PMID: 22042845

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Project description:BackgroundFew adolescents achieve sufficient levels of physical activity, and many are spending most of their time in sedentary behavior. Affective response following sedentary time may influence motivation to remain sedentary. Ecological Momentary Assessment (EMA) is a real-time data capture methodology that can be used to identify factors influencing sedentary time, such as the context of the home setting, and resulting affective state within a free-living setting. The purpose of this study was to evaluate the relationship between context at home and adolescent sedentary time, and the relationship of sedentary time and subsequent affect.MethodsAdolescents (n = 284; 10-16 y) participated in an EMA study that used random, interval-based sampling methods. Adolescents each received 22 unannounced surveys over 7-days through a smartphone application. One survey was randomly sent within each 2-h time-period. These time-periods occurred between 4:00 pm-8:00 pm on weekdays and 8:00 am-8:00 pm on the weekend. This 15-question survey included a series of questions on context (indoors/outdoors, alone/not alone) and positive affect. Adolescents concurrently wore an accelerometer at the hip, and the 30-min bout of accelerometry data prior to each survey was used in analyses. Mixed-effect location scale models were used to examine the association between context at home and sedentary time (stage 1) and the adjusted sedentary time and positive affect (stage 2), with each model adjusted for covariates.ResultsAdolescents were 12.6 ± 1.9 y of age on average, about half were White (58%), and engaged in high levels of sedentary behavior during the 30 min prior to the survey (21.4 ± 6.8 min). Most surveys occurred when adolescents were with others (59%) and indoors (88%). In Stage 1, both being alone and being indoors at home were positively associated with sedentary time (p < 0.001 for both). In Stage 2, adjusted sedentary time was not related to positive affect. Age was negatively related to positive affect (p < 0.001).ConclusionsBoth contextual factors, being alone and indoors at home, were related to additional time spent sedentary compared to being with someone or outdoors. After adjustment, sedentary time was not related to subsequent positive affect, indicating other factors may be related to adolescent's positive affect in home settings.

Project description:BackgroundEcological momentary assessment (EMA) is a research design that allows for the measurement of nearly instantaneous experiences within the participant's natural environment. Using EMA can help improve recall bias, ecological validity, and patient engagement while enhancing personalization and the ubiquity of interventions. People that can benefit from the use of EMA are men who have sex with men (MSM). Previous EMA studies have been successful in capturing patterns of depression, anxiety, substance use, and risky sexual behavior. These findings are directly relevant to MSM, who have high rates of each of these psychological and behavioral outcomes. Although there is a driving force behind the growing literature surrounding EMAs among MSM, no synthesizing reviews yet exist.ObjectiveThe aims of this study were to (1) synthesize the literature across fields on how EMA methods have been used among MSM, (2) better understand the feasibility and acceptability of EMA interventions among MSM, and (3) inform designs for future research studies on best evidence-based practices for EMA interventions.MethodsBased on 4 library databases, we conducted a scoping review of EMAs used within interventions among MSM. The eligibility criteria included peer-reviewed studies conducted in the United States and the use of EMA methodology in an intervention for MSM. Modeling after the Centers for Disease Control and Prevention's Compendium of Evidence-Based Interventions as the framework, we applied a typology that used 8 distinct review criteria, for example, sample size, design of the intervention, random assignment, design of the follow-up investigation, rate of retention, and rate of engagement.ResultsOur results (k=15, N=952) indicated a range of sample sizes; the smallest sample size was 12, while the largest sample size was 120. Of the 15 studies, 7 (47%) focused on outcomes related to substance use or outcomes related to psychological experiences. Of the 15 studies, 5 (33%) implemented an EMA intervention across 30 days. Of the 15 studies, 2 studies (13%) used random assignment, and 2 studies (13%) had quasi-experimental designs. Of the 15 studies, 10 studies (67%) reported acceptable retention rates greater than 70%. The outcomes that had event-contingent prompts (ie, prompts after engaging in substance use) were not as effective in engaging participants, with overall engagement rates as low as 37%.ConclusionsOur systematic scoping review indicates strong evidence that the EMA methodology is both feasible and acceptable at high rates among MSM, especially, when examining psychological and behavioral outcomes such as negative or positive affect, risky sexual behavior, or substance use. Further research on optimal designs of EMA interventions for MSM is warranted.

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Positive affect measured using ecological momentary assessment and survival in older men and women.

Publications

Positive affect measured using ecological momentary assessment and survival in older men and women.

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