What question did this study set out to answer?

This research investigates how shift-and-persist strategies relate to cardiometabolic markers in young adults in Puerto Rico.

March 19, 2026

Shift-and-persist Strategies and their Association with Cardiometabolic Outcomes Among Young Adults in Puerto Rico

Key Points

This research investigates how shift-and-persist strategies relate to cardiometabolic markers in young adults in Puerto Rico.
Cross-sectional analysis of baseline PR-OUTLOOK data from September 2020 to March 2023.
Sample included 2707 young adults aged 18-29, predominantly female (62%).
Shift-and-persist measured using the Chen & Miller scale, categorized into three levels: Low, Moderate, High.
Cardiometabolic markers assessed included BMI, waist circumference, blood glucose, HbA1c, and blood lipids via anthropometric measurements and fasting blood samples.
Analyses employed adjusted linear regression models.
Moderate SP was associated with an average BMI reduction of 0.96 units compared to Low SP.
High SP was associated with an average BMI reduction of 0.83 units compared to Low SP.
Moderate and High SP individuals had lower waist circumference by 1.89 and 1.96 units, respectively, compared to Low SP.
Glucose levels were lower by 2.45 and 2.81 units for Moderate and High SP compared to Low SP, respectively.
Only High SP individuals had lower HbA1c levels, while Moderate SP had higher HDL cholesterol.

Abstract

Objective: Shift-and-persist (SP-the ability to adapt the self to stressors while preserving focus in the future) is associated with favorable cardiometabolic outcomes. SP may be relevant in Puerto Rico (PR), a population with a high burden of cardiometabolic diseases and stressors. We examined the association between SP and cardiometabolic markers among young adults in PR. Methods: Cross-sectional analysis of baseline PR-OUTLOOK data (September 2020-March 2023). The analytic sample (n=2707) was aged 18-29 and 62% female. SP was measured with the Chen 95%CI:−0.16,−0.04). Only those with Moderate SP (vs. Low SP) had significantly higher HDL (=1.16; 95%CI:0.16,2.17) No significant associations were found for blood pressure and other blood lipids. Conclusion: Greater SP was associated with lower adiposity, lower concentration of markers of glucose metabolism, and to some extent with higher HDL. Longitudinal studies are needed to confirm study findings and understand how SP may promote biobehavioral mechanisms for cardiometabolic health.

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