Pilot study of daily activities,
the urban landscape, cortisol
and stress
University of Pennsylvania School of Medicine
Center for Clinical Epidemiology and Biostatistics
Mentor: Douglas J. Wiebe, PhD
Presenters: Kent Amoo-Achampong
Kathy Lugo
Outline
•
•
•
•
•
•
•
•
Background
Objectives
Process
Technology
Study Protocol
Data Management
Results
Conclusions
Background
• Socioeconomic
status & health
• Levels of exposure
to environmental
stress
• Diurnal pattern of
cortisol
Background
• Socioeconomic
status & health
• Levels of exposure
to environmental
stress
• Diurnal pattern of
cortisol
Objectives
• Devise and implement a protocol that would
enable us to prospectively monitor where
young urban adults spend time over the course
of their daily activities
• Assess the accuracy and reliability of study
devices
• Evaluate the willingness of subjects to
complete the study
• Determine the feasibility for conducting a
similar study at a larger level in the future
Process
• How do we learn about where people go,
what they experience, and whether it is
stressful?
•
•
•
•
•
GPS- for prospective follow-up
GIS- for retrospective follow-up
Stress via cortisol
Stress via heart rate
Subjects underlying characteristics
Methods of data collection
• Technology
•
•
•
Global Positioning System
Saliva samples
Heart rate monitor
• Self report interview
Technology
Practice Runs
• Test GPS
accuracy by
comparing GPS
data & self
report data
from the Bar
Crawl test run
Self report interview
• Developing the questionnaire
o Personal Control and Mastery
o Social Network Diversity
o Emotional Support
o Chronic Burden
o Physical Activity
o Alcohol/Tobacco use
o Sleep quality
o Symptoms of depression
Study Protocol
• Recruitment
o Convenience sample
o STARS study sample
• 4 day period
o Baseline Interview
 Study procedures/
administer
questionnaire
o 2 day data collection
period
o Exit interview
 self-reported path
using STARS
mapping software
Equipment
Data Management
• GPS data and corresponding heart rate are
matched by their time-date stamps and
imported into ArcGIS software.
• Data is over-layed on a satellite image of
Philadelphia, along with the self-reported
daily paths, with corresponding stress
indicator
• The paths with corresponding heart rate are
animated in ArcGIS to assess concordance
between the two methods
Clip of animation
Results
• Sample characteristics
o Age: 20
o Gender: 3 males, 4 females
o Race: 3 African Americans, 4 Caucasians
• Performance of technology
• Cohesive layering of data
• Subject compliance with study protocol
Presenting our work
• Submission of abstract to the American
Public Health Association
• Submit manuscript for publication
Conclusions
• Enrollment continues, but thus far the
protocol we developed appears to be
feasible, and could be applied to a larger
study for analysis on how urban
environments can impact stress and,
consequently, health in young adults
• Douglas Wiebe, PhD
• Joanne Levy
• The SUMR program sponsors:
• Wharton Health Care
Management Department
• Leonard Davis Institute of
Health Economics
• Center for Health Equity
Research and Promotion
(CHERP)