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 睡眠时间短、失眠症和睡眠呼吸暂停在美国人中非常普遍，并且 与显着的发病率相关，包括心理健康状况不佳、神经认知功能受损、代谢 在有害睡眠盛行的背景下，调节失调和心血管疾病。 干扰，有证据表明人口中存在睡眠差异​​，例如少数种族/族裔 - 包括墨西哥裔美国人——睡眠障碍的风险增加，这一点令人担忧，因为这个群体 与睡眠相关的许多不良心脏代谢和功能结果的风险也增加 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、饮酒和吸烟）和文化适应——个人接受的程度 （在本例中）传统的墨西哥文化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、失眠症状和睡眠呼吸暂停严重程度，并研究了 其次，本研究旨在探讨睡眠和这些社会行为因素的作用。 该人群的心脏代谢疾病风险，并探讨文化适应、社会心理压力、 为了实现这一目标，该项目将消除这些协会中的经济困难和/或不健康行为。 与马里波萨社区健康中心合作，该中心是亚利桑那州诺加利斯地区的联邦合格诊所。 诺加利斯是美国/墨西哥边境的一座小城市，是学习墨西哥非城市地区的理想地点 美国人，其中 83% 是西班牙裔/拉丁裔，33% 是移民，77% 主要讲西班牙语 这个社区参与项目将与 Mariposa 及其 Platicamos Salud 计划合作。 使用经验丰富的社区卫生工作者 (promotoras de salud) 收集数据并进行家访。 该研究将招募 N=900 名墨西哥裔美国人和 N=200 名非西班牙裔白人来完成一系列研究 临床访问的评估（问卷、访谈、人体测量和动脉僵硬度检查，以及 生物标志物收集）、1 晚家庭睡眠呼吸暂停评估、24 小时动态血压 记录，以及为期两周的家庭监测，包括睡眠日记和体动记录仪，这将产生丰富的数据集。 这有助于识别和减少人群的睡眠差异，并指出潜在的干预措施 该分析计划将利用减少心脏代谢疾病差异的方法。 机器学习分析方法，将用于评估所有之间的复杂关系 这些变量将解决睡眠医学、健康差异研究等方面的许多相关问题。 与 Mariposa 的合作将加强招募、促进研究完整性（或确保） 研究方法的适当性），并促进研究结果向社区传播 通过与 Platicamos Salud 相关的教育计划和其他社区外展工作。