Shift‐and‐persist: A protective factor for elevated BMI among low‐socioeconomic‐status children

Abstract

Objective Low socioeconomic status (SES) is associated with many adverse health outcomes, including childhood overweight and obesity. However, little is understood about why some children defy this trend by maintaining a healthy weight despite living in obesogenic environments. The objective of this study is to test the hypothesis that the psychological strategy of “shift-and-persist” protects low-SES children from overweight and obesity. Shift-and-persist involves dealing with stressors by reframing them more positively while at the same time persisting in optimistic thoughts about the future. Design and Methods Middle school children (N = 1,523, ages 9–15) enrolled in a school-based obesity prevention trial completed health surveys and physical assessments. Multiple linear regression analysis was used to examine the role of SES, shift-and-persist strategies, and their interaction on BMI z-scores, while controlling for student race/ethnicity, gender, and reported diet and physical activity. Results Among children reporting engaging in less frequent shift-and-persist strategies, lower SES was associated with significantly higher BMI z-scores (P < 0.05). However, among children reporting engaging in more frequent shift-and-persist strategies, there was no association of SES with BMI z-score (P = 0.16), suggesting that shift-and-persist strategies may be protective against the association between SES and BMI. Conclusions Interventions aimed at improving psychological resilience among children of low SES may provide a complementary approach to prevent childhood overweight and obesity among at-risk populations.

Stress, Psychological Resources, and HPA and Inflammatory Reactivity During Late Adolescence

“…The present findings converge with past work showing that among socioeconomically disadvantaged youth, positive reappraisal tendencies and finding meaning in life were associated with reduced risk of poor health-related outcomes, such as obesity and cardiovascular risk (Chen et al, 2013; Chen et al, 2015; Kallem et al, 2013). We extend this work by demonstrating that individual psychological resources may also protect young individuals from the effects of other stressors, including major life events, daily interpersonal stress, and to some extent early adversity, on reduced HPA responses to acute stress, which is thought to be one key mechanism linking stress to health and psychopathology (Ehrlich et al, 2016; Heim & Binder, 2012).…”

Shift-and-Persist Strategies

“…In several previous studies, empirical evidence for shift-and-persist and its health-related benefits among those low in SES was demonstrated (17,18); however, all of these analyses were conducted in already completed studies in which shift-and-persist was approximated using available instruments. In the present study, we created a new measure specifically intended to probe shift-and-persist and provide information about the reliability and validity of this scale.…”

“…In previous studies, the benefits of shift-and-persist in low-SES individuals were documented for clinical outcomes (obesity, asthma) (17,18). However, more in-depth inflammatory mechanisms that might underlie shift-and-persist were not investigated.…”

Victimization and Biological Stress Responses in Urban Adolescents: Emotion Regulation as a Moderator

“…That is, researchers have not investigated the extent to which emotion regulation skill buffers adolescent victimization experiences on health outcomes or physiological stress responses such as dysregulated cortisol that predict future health. However, a related construct termed shift-and-persist (Chen 2012; Chen and Miller 2012), which has been conceptualized as a form of emotion regulation, has health benefits for children low in socio-economic status (Chen et al 2011; Kallem et al 2013). Thus, a second aim of the present study was to investigate emotion regulation—a modifiable skill taught in many school-based prevention programs—as a potential protective factor in the association between victimization experiences and biological stress responses.…”