Sleep and Cardiometabolic Health Disparities at the US/Mexico Border: The Nogales Cardiometabolic Health and Sleep (NoCHeS) Study

美国/墨西哥边境的睡眠和心脏代谢健康差异：诺加利斯心脏代谢健康和睡眠 (NoCHeS) 研究

• 批准号: 10188262
• 负责人: Michael A Grandner
• 金额: $ 7.07万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-04-01 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10188262
• 关键词: Acculturation; Address; Adopted; Adult; Age; Alcohol consumption; Alcohols; American; Anthropometry; Area; Behavior; Behavioral; Biological Markers; Blood Pressure; Blood Vessels; Cardiovascular Diseases; Cardiovascular system; Cities; Clinic; Clinic Visits; Cohort Studies; Collection; Communities; Community Developments; Community Health Aides; Community Outreach; Complex; Data; Data Set; Diabetes Mellitus; Diet; Disease; Economics; Education; Ensure; Environmental Risk Factor; Epidemiology; Ethnic Origin; Glycosylated hemoglobin A; Goals; Health; Health behavior; High Density Lipoproteins; High Prevalence; Hispanics; Home environment; Home visitation; Hour; Immigrant; Individual; Inflammation; Intake; Intervention; Interview; LDL Cholesterol Lipoproteins; Latino; Link; Lipids; Location; Machine Learning; Medicine; Mental Health; Metabolic; Mexican; Mexican Americans; Mexico; Modeling; Monitor; Morbidity - disease rate; Neighborhood Health Center; Neurocognitive Deficit; Not Hispanic or Latino; Obesity; Obstructive Sleep Apnea; Outcome; Participant; Phenotype; Physical activity; Play; Population; Poverty; Prevalence; Psychosocial Stress; Questionnaires; Race; Regulation; Research; Research Methodology; Risk; Risk Factors; Role; Serum; Severities; Sleep; Sleep Apnea Syndromes; Sleep Deprivation; Sleep disturbances; Sleeplessness; Smoking; Social support; Stress; Surveys; Symptoms; Testing; Weight Gain; Work; actigraphy; arterial stiffness; base; cardiometabolism; cardiovascular risk factor; caucasian American; community partnership; diaries; diet and exercise; disorder risk; disparity reduction; ethnic minority population; experience; food security; functional disability; functional outcomes; health assessment; health disparity; indexing; low density lipoprotein triglyceride; modifiable risk; mortality; perceived stress; pressure; programs; racial and ethnic; recruit; sample collection; sleep behavior; sleep health; social; social factors; socioeconomics; stressor

ABSTRACT Short sleep duration, insomnia disorder, and sleep apnea are all highly prevalent in the US population and are associated with significant morbidity, including poor mental health, impaired neurocognitive function, metabolic dysregulation, and cardiovascular disease. In the context of the high prevalence of pernicious sleep disturbances, there is evidence that sleep disparities exist in the population, such that racial/ethnic minorities – including Mexican-Americans – are at increased risk of sleep disturbances. This is alarming, since this group is also at increased risk for many of the adverse cardiometabolic and functional outcomes linked to sleep disturbances. These associations may be influenced by economic hardship, psychosocial stress, unhealthy behaviors (diet, exercise, alcohol, and smoking), and acculturation – the degree to which an individual adopts (in this case) traditional Mexican versus American culture. The first goal of this project is to examine sleep duration, insomnia symptoms, and sleep apnea severity among Mexican-Americans and examine the role of these social-behavioral factors in this relationship. Second, this study aims to examine the role of sleep and cardiometabolic disease risk in this population and explore the role of acculturation, psychosocial stress, economic hardship, and/or unhealthy behaviors in these associations. To accomplish this, this project will partner with the Mariposa Community Health Center, the federally qualified clinic in the Nogales, AZ area. Nogales is a small city on the US/Mexico border that is an ideal location for studying non-urban Mexican- Americans, as it is made up of 83% Hispanics/Latinos, 33% immigrants, and 77% who primarily speak Spanish at home. This community-engaged project will partner with Mariposa and their Platicamos Salud program that uses experienced Community Health Workers (promotoras de salud) to collect data and perform home visits. The study will recruit N=900 Mexican-Americans and N=200 Non-Hispanic Whites to complete a battery of assessments from a clinic visit (questionnaires, interviews, exam for anthropometry and arterial stiffness, and collection of biomarkers), a 1-night home sleep apnea assessment, a 24-hour ambulatory blood pressure recording, and a 2-week home monitoring period with sleep diary and actigraphy. This will result in a rich dataset that can help to identify and reduce sleep disparities in the population and point to potential intervention approaches to reducing cardiometabolic disease disparities. The analytic plan will take advantage of a machine-learning analytic approach, which will be used to evaluate the complex relationships among all of these variables. This project will address many relevant issues in sleep medicine, health disparities research, and border health. The partnership with Mariposa will enhance recruitment, promote research integrity (or ensure appropriateness of research methods), and facilitate dissemination of the study results into the community through education programs associated with Platicamos Salud and other community outreach efforts.

抽象的 睡眠持续时间短，失眠症和睡眠呼吸暂停在美国人群中都非常普遍，并且是 与明显的发病率相关，包括精神健康不良，神经认知功能受损，代谢 失调和心血管疾病。在有害睡眠的高流行率 干扰，有证据表明人口中存在睡眠分布，使种族/族裔少数民族 - 包括墨西哥裔美国人在内 - 睡眠障碍的风险增加。这很令人震惊，因为这个组是 同样有许多与睡眠有关的不良心脏代谢和功能结果的风险增加 干扰。这些关联可能受到经济困难，社会心理压力，不健康的影响 行为（饮食，运动，酒精和吸烟）和适应性 - 个人采用的程度 （在这种情况下）传统的墨西哥与美国文化。该项目的第一个目标是检查睡眠 墨西哥裔美国人的持续时间，失眠符号和睡眠呼吸暂停严重程度并检查 这些关系中的这些社会行为因素。其次，本研究旨在检查睡眠和 心脏代谢疾病在该人群中的风险，探索培养，社会心理压力的作用， 这些关联中的经济困难和/或不健康的行为。为此，这个项目将 与亚利桑那州Nogales的联邦合格诊所Mariposa社区健康中心合作。 Nogales是美国/墨西哥边境的一个小城市，是研究非城市墨西哥的理想场所 - 美国人由83％的西班牙裔/拉丁裔，33％的移民和77％的人组成 在家里。这个社区参与的项目将与Mariposa及其Platicamos Salud计划合作 使用经验丰富的社区卫生工作者（Properition de Salud）来收集数据并进行家庭访问。 该研究将招募N = 900墨西哥裔美国人和n = 200个非西班牙裔白人 诊所访问的评估（问卷，访谈，人体测量学和动脉僵硬考试，以及 收集生物标志物），一个1晚的家庭睡眠呼吸暂停评估，24小时的卧床血压 录音，以及为期2周的家庭监测期，并进行了睡眠日记和表观摄影。这将导致一个丰富的数据集 这可以帮助识别和减少人口中的睡眠分布，并指出潜在的干预 减少心脏代谢疾病分布的方法。分析计划将利用 机器学习分析方法，该方法将用于评估所有的复杂关系 这些变量。该项目将解决睡眠医学，健康差异研究的许多相关问题， 和边境健康。与Mariposa的合作关系将增强招聘，促进研究完整性（或确保 研究方法的适当性），并促进研究向社区传播 通过与Platicamos Salud和其他社区外展工作相关的教育计划。