# Associations Between Coping Self-Efficacy and Physiologic Stress Indices in Adults with Multiple Chronic Conditions

> **NIH NIH P30** · JOHNS HOPKINS UNIVERSITY · 2020 · $70,572

## Abstract

Project Summary/ Abstract
Although only 25% of US adults have multiple chronic conditions, people with multiple conditions account for 71% of
US healthcare spending. However, not all people experience the same symptoms or progression of their multiple chronic
conditions. This variability is partially due to environmental and psychosocial factors including self-efficacy which is the
confidence to successfully perform specific behaviors and influence specific life domains. Cellular and systemic changes
also accompany chronic disease progression including Interleukin 6 (IL-6) and tumor necrosis factor alpha receptor 1
(TNFαR1), brain derived neurotropic factor (BDNF) and heart rate variability (HRV). The effect of self-efficacy on health
behavior has been widely studied, but there is a gap in what is known about the direct effect of self-efficacy on
physiologic mechanisms, especially in people with multiple chronic conditions. This applicant's previous research
showed an association between IL-6 and coping self-efficacy in two cross-sectional studies (N=48 & N=160) of older
adults with at least one chronic disease. Further mechanistic research is needed to explore the associations between
coping self-efficacy and the stress response networks. Therefore, the purpose of this 2-year diversity supplement is to
evaluate the associations and pre-post intervention changes between coping self-efficacy and physiologic stress indices
(IL-6, TNFαR1, BDNF, HRV) in community-dwelling adults with multiple chronic conditions. Recruitment will be
embedded within the current PROMOTE center-affiliated pilot studies (N=115). Utilizing 3 PROMOTE P30 pilots
presents an opportunity to concurrently evaluate coping self-efficacy and physiologic stress indices within each study,
between studies and in pooled data across the 3 studies. The proposed study builds upon the strengths of the individual
pilot studies by adding a coping self-efficacy measurement and a more diverse array of physiologic measures of the stress
response network, including heart-rate variability, certain pro-inflammatory cytokines (IL-6 and TNFαR1) and BDNF.
Understanding the physiologic mechanisms of self-efficacy may reveal new ways to measure it as an outcome of self-
efficacy based interventions. Adding biologic data to the study of self-efficacy may influence policy change toward re-
imbursement, accessibility and streamlining self-efficacy based interventions into mainstream healthcare settings. With
large numbers of adults with multiple chronic conditions and the resulting economic costs, this research contributes to the
goal of reducing the chronic disease burden in this country.

## Key facts

- **NIH application ID:** 9997240
- **Project number:** 3P30NR018093-02S2
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Sarah L Szanton
- **Activity code:** P30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $70,572
- **Award type:** 3
- **Project period:** 2018-08-22 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9997240

## Citation

> US National Institutes of Health, RePORTER application 9997240, Associations Between Coping Self-Efficacy and Physiologic Stress Indices in Adults with Multiple Chronic Conditions (3P30NR018093-02S2). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9997240. Licensed CC0.

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