Understanding Stressors, Coping Strategies, and Physical Activity Among African American Women Using Ecological Momentary Assessment
Abstract
Psychological stress is a normal part of the human experience and can be adaptive in certain contexts. However, chronic, cumulative, or uncontrollable stressors, such as those associated with living in poverty or being a member of a marginalized group, contribute to pervasive inequities among African American women including lower rates of physical activity. Given the social and political forces that continue to shape inequities, and which have exacerbated Covid-19’s impact on African Americans, it is important to gain a better understanding of how this population is experiencing and coping with current stressors, many of which are embedded within the social climate and not easily altered. The first aim of this project is to gain a better understanding of daily stressors experienced and coping strategies utilized among African American women using ecological momentary assessment. This is an exploratory aim designed to qualitatively assess perceived stressors and to report the rates of problem-focused, emotion-approach, and emotion-avoidance coping strategies utilized by African American women in their daily lives. Assessments will occur twice daily over a 10-day period to better understand both the range of stressors as well as coping strategies utilized. The second aim of this project is to fill a gap in the literature by assessing whether the “goodness-of-fit” or “match” of coping strategies to stressors is associated with within-person daily physical activity and affect valence among African American women. This study is novel in that it focuses on within-person associations between “goodness-of-fit” coping and health behaviors—namely, daily physical activity—among an understudied, high-risk population. Based on Lazarus and Folkman’s (1984) Transactional Model of Stress, it was hypothesized that on days when participants report better “goodness-of-fit” defined as matching coping strategies with the demands of the stressor (i.e., controllable stressors with problem-focused coping; uncontrollable stressors with emotion-focused coping), they would engage in greater physical activity and report higher affect compared to days where they were not “matching” coping strategies with stressors. Regarding Aim 1, qualitative findings demonstrated a wide range of stressors, most of which occurred at the at the level of the microsystem. Participants endorsed using problem-focused and emotion-approach coping strategies most often, and emotion-avoidance strategies reported less frequently. For Aim 2, the hypothesis that match would lead to better physical activity and affect outcomes was not supported, and some findings were in the opposite direction as expected including partial match for emotion-focused coping leading to ~1 minute of less daily moderate-to-vigorous physical activity as well as partial match for problem-focused coping predicting lower affect. Main effects demonstrated that on days when participants perceived discrimination, they engaged in significantly less (-35 minutes) light physical activity relative to days when they did not report discrimination. These findings highlight the deleterious effects of discrimination on physical activity and wellbeing as well as the need for additional research to better understand stress-coping processes and their relationship with health behaviors like physical activity among African American women.