Exploring the Impact of Social Context on Health Behaviors via mHealth: Refining Models for Cancer Prevention

Tobacco is the leading cause of preventable death and disease and is linked to approximately 20 cancers. The rate of decline of tobacco use has not been uniform across all populations. Most research on tobacco use has examined differences based on a single factor like income, yet this ignores heterogeneity within groups and how multiple demographic factors (e.g., income, sex) shape lived experiences and health behaviors. Thus it is useful to shift focus from broad sectors of the population to the interconnections among multiple demographic factors and their interaction with social, and contextual factors can contribute to tobacco outcomes. Mobile health methodology (mHealth), such as wearable sensors and ecological momentary assessment (EMA), provide real-time objective and subjective assessments of how and when emotions and behaviors change depending on time and context and can inform just-in-time adaptive interventions that are tailored to deliver the right intervention at the right time. The objective of this project is to advance methodological and content knowledge of the utility of using interactions between demographics factors and the connection with psychosocial, behavioral, and contextual factors that contribute to tobacco-related outcomes. This project will consist of a novel study using EMA and wearable sensors to investigate the real-time dynamics of interacting demographic factors with stress, negative affect, self-efficacy, and tobacco use in real-time. This work is innovative because limited studies have examined tobacco use with a focus on interactions between demographic factors using EMA; it informs targeted interventions to help all populations achieve tobacco cessation. This work directly addresses the NCI’s mission to conduct and support cancer research to advance scientific knowledge and help all people live longer, healthier lives.