JMIR Publications

ABSTRACT

Background:

Digital tools can help cultivate states of wellbeing through psychological interventions. Interventions and policies with the most promise of influencing individual and population health and wellbeing in real-world contexts require understanding the dynamic relationships between different domains of wellbeing in daily life.

Objective:

To consider multiple components of the health behavior-wellbeing system to identify potential targets for designing ecologically-relevant interventions in everyday life.

Methods:

We used self-reported affective states, purpose in life, and physical activity collected via smartphone-based experience-sampling twice per day over 28 days as participants (n = 226 young adults; Mage = 20.2 years, SDage = 1.7; 76% women, 25% men) went about their daily lives. We used a multilevel vector autoregressive model to isolate within- and between-person relationships among day’s physical activity, night’s sleep duration, night’s sleep quality, happiness, sadness, anger, anxiousness, and purpose in life. This approach generates three networks describing the relationships among variables of interest: 1) a directed temporal network revealing within-person time-lagged previous day relationships among variables, 2) a contemporaneous undirected network revealing within-person same-day relationships among variables, and 3) an undirected between-person network identifying between-person differences in how variables are associated with one another.

Results:

Our complex system approach to the health behavior-wellbeing system revealed significant interplay among physical activity, sleep, affect, and purpose in life. We found that when an individual had higher than their own typical level of physical activity on a day, they had an increase of happy affect the next day. Higher sleep quality on a day also predicted a decrease in negative affective states the next day. We found that purpose in life predicted decreased sad, anxious, and angry affect up to two days later. For contemporaneous relationships, higher than usual happiness predicted increased purpose in life and lower anger, anxiety, and sadness on the same day. We found that people who on average were happier tended to endorse a higher sense of purpose in life and experience increased sleep quality whereas people who on average were sadder tended to have increased anxiety and anger.

Conclusions:

Collectively, these findings suggest that behavioral interventions targeting sleep and physical activity may observe shorter term (up to one day) effects on wellbeing whereas interventions cultivating a sense of purpose in life can have slightly longer effects on wellbeing, bleeding into the next few days. Our findings suggest that approaches simultaneously considering whole-person wellbeing rather than just one domain of wellbeing hold promise for informing the design of behavior interventions with the most promise of influencing health in real-world contexts. Moving forward, digital health tools should incorporate tracking multiple domains of wellbeing in daily life to increase opportunities for whole-person health approaches in virtual care settings.