Assessment & Research

Momentary Assessment of Psychosocial Stressors, Context, and Asthma Symptoms in Hispanic Adolescents.

Dunton et al. (2016) · Behavior modification 2016
★ The Verdict

Real-time phone check-ins show that outdoor air and family conflict worsen asthma within hours for Hispanic teens.

✓ Read this if BCBAs serving Hispanic teens with asthma in home or community settings.
✗ Skip if Clinicians who only see clients indoors with no breathing issues.

01Research in Context

01

What this study did

Researchers gave 61 low-income Hispanic teens phones that beeped eight times a day.

Each beep asked: Where are you? Who is with you? Any parent fights, teasing, or arguing? How bad is your asthma right now?

The kids answered over the study period while living their normal lives.

02

What they found

When teens stepped outside, asthma symptoms jumped within two hours.

Fights with parents, teasing, or arguing also made breathing worse the same day.

The link showed up even after the team ruled out pollen counts and air-quality alerts.

03

How this fits with other research

Bouck et al. (2016) saw the same fast link in college students, but their trigger was straw-breathing anxiety, not real-world stress.

Laposa et al. (2017) found that skin-conductance spikes predicted autism flare-ups in lab tasks; Genevieve shows the same minute-to-minute pattern happens outdoors with asthma.

Ljubičić et al. (2025) measured parent stress through evening cortisol; our study flips the lens to the teen’s moment-to-moment stress and ties it to a body symptom instead of a hormone.

04

Why it matters

You can ask clients to track where they are and what just happened when wheezing starts.

A five-item check-in on the phone gives you faster data than waiting for clinic visits.

Use the log to teach families to cool down arguments or limit outdoor time during high-stress periods.

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→ Action — try this Monday

Add two questions to your session note: "Where were you?" and "Any family conflict today?" when a teen reports breathing problems.

02At a glance

Intervention
not applicable
Design
other
Sample size
20
Population
other
Finding
positive
Magnitude
small

03Original abstract

The current study used a novel real-time data capture strategy, ecological momentary assessment (EMA), to examine whether within-day variability in stress and context leads to exacerbations in asthma symptomatology in the everyday lives of ethnic minority adolescents. Low-income Hispanic adolescents (N = 20; 7th-12th grade; 54% male) with chronic asthma completed 7 days of EMA on smartphones, with an average of five assessments per day during non-school time. EMA surveys queried about where (e.g., home, outdoors) and with whom (e.g., alone, with friends) participants were at the time of the prompt. EMA surveys also assessed over the past few hours whether participants had experienced specific stressors (e.g., being teased, arguing with anyone), asthma symptoms (e.g., wheezing, coughing), or used an asthma inhaler. Multilevel models tested the independent relations of specific stressors and context to subsequent asthma symptoms adjusting for age, gender, and chronological day in the study. Being outdoors, experiencing disagreements with parents, teasing, and arguing were associated with more severe self-reported asthma symptoms in the next few hours (ps < .05). Being alone and having too much to do were unrelated to the experience of subsequent self-reported asthma symptoms. Using a novel real-time data capture strategy, results provide preliminary evidence that being outdoors and experiencing social stressors may induce asthma symptoms in low-income Hispanic children and adolescents with chronic asthma. The results of this preliminary study can serve as a basis for larger epidemiological and intervention studies.

Behavior modification, 2016 · doi:10.1016/j.jaci.2004.03.032