Stress and physical activity in children with asthma: An ecological momentary assessment study

Purpose: Children with asthma are at greater risk of physical inactivity, obesity, and other chronic health conditions. Understanding how to promote physical activity among children with asthma has been limited by retrospective self-report methods.

Methods: Low-income, Hispanic children (N = 20) (7th-12th grade) (54% male) with chronic asthma completed seven days of realtime Ecological Momentary Assessment (EMA) on Android smartphones with an average of three assessments per day. EMA surveys asked over the past few hours whether children had experienced perceived stress (e.g., from being teased, getting into an argument) (4 items, cronbach’s α = 90), asthma worry (e.g., worry about having an asthma attack) (3 items, cronbach’s α = .64), and asthma symptoms (e.g., wheezing) (4 items, cronbach’s α = .81). At the same time children wore an Actigraph GT2M accelerometer.

Results: On any given day, moderate-to-vigorous physical activity (MVPA) was negatively associated with perceived stress (r = -.495, p = < .001), and unrelated to asthma worry and asthma symptoms. The relationship between daily perceived stress and MVPA remained significant (β = -.233, p = .025) after controlling for sex, grade in school, and receipt of free school meals. For each 1-unit increase on the perceived stress scale, children engaged in 11.9 fewer minutes of MVPA that day.

Conclusions: Real-time EMA methods showed that stress unrelated to asthma was more closely associated with reduced physical activity on any given day than asthma-specific stressors—indicating potential areas to intervene in order to promote physical activity in this population.