User:Reed220A/Shift and Persist Strategies

Shift-and-Persist Model
Over the last decade, the Shift-and-Persist Model (13) has emerged in order to account for unintuitive, positive health outcomes in some individuals of low socioeconomic status (LINK TO SES). Although low socioeconomic status is generally associated with poorer physical and mental health outcomes (10, 11, 12), including early mortality (9), some individuals who of low socioeconomic status do not experience these negative health effects. The Shift-and-Persist model posits that these low SES individuals learned adaptive strategies for regulating their emotions (“shifting”) and focusing on their goals (“persisting”) in the face of chronic adversity (13).

Measurement
Shift-and-Persist strategies were initially measured by __ in early research. In YEAR, Chen and colleagues published the Shift-and-Persist Scale, which can be used with adults and teens. This scale is a self-report measure that asks respondent’s to rate how well 14 statements about various approaches to dealing with life stressors apply to them on a 1-4 scale (1). Out of the 14 items on the questionnaire, 4 assess a respondent’s use of shift strategies, 4 load onto persist strategies, and 6 items are non-relevant distractors that are ignored during scoring. When scoring the questionnaire, one item (#4) is reverse-scored. This scale is publically available for research and can be downloaded at LINK (1).

A simplified 5-item Shift-and-Persist scale has also been published for use with children ( http://sparqtools.org/mobility-measure/shift-and-persist-child/ ). Total scores on this version of the Shift-and-Persist Scale range from 0-20, such that higher scores are indicative of greater use of shift-and-persist strategies. This scale is also publically available online (2) and has been previously used in research with children from kindergarten-8th grade (3).

Empirical Support
In the last decade, integrative research groups concerned with clinical health psychology, social psychology, psychoneuroimmunology, and public health have published research on shift-and-persist strategies. Most empirical studies on this topic hypothesize that shift-and-persist strategies have protective effects for the health of low SES populations. However, because the majority of studies thus far have been cross-sectional, it is unknown if the use of shift-and-persist strategies directly causes the improved health outcomes that have been observed in a variety of low SES populations.

Child and Adolescent Findings
Recent research has also begun to probe whether shift-and-persist strategies have protective effects for the health and wellbeing of low SES children. For example, in a cross-sectional study of approximately 1500 children enrolled in public schools the typical association between lower SES and higher body mass index was buffered for students endorsing high use of shift-and-persist strategies (3). Similarly, greater use of shift-and-persist strategies has been linked to lower levels of asthma-related impairment and inflammation in low but not high SES children (4). Better asthma profiles have also been reported in youth that use shift-and-persist and are from families of low parent-reported social status (7).

Shift-and-persist strategy use may also temper the relationship between low SES or experiences of peer discrimination and depression in teenagers (5).

Additional research in low SES children suggests that use of shift-and-persist strategies is associated with “healthier” HPA-axis functioning, as indexed by diurnal cortisol patterns (6).