Developing, implementing, and evaluating a mixed-methods community-based participatory research sleep intervention in families with K-1st grade children living on the Blackfeet Indian Reservation

针对居住在黑脚印第安人保留地的幼儿园至一年级儿童的家庭，制定、实施和评估基于社区的混合方法参与性研究睡眠干预

• 批准号: 10401838
• 负责人: Vernon Matthew Grant
• 金额: $ 15.34万
• 依托单位: MONTANA STATE UNIVERSITY - BOZEMAN
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10401838
• 关键词: Accelerometer; Address; Adherence; Adult; Age; Alaska Native; American Indians; Area; Beds; Behavior; Biomedical Research; Blackfeet; Body mass index; Businesses; Cellular Phone; Child; Child Development; Child Health; Childhood; Chronic Disease; Clinical Research; Communities; Coupled; Data; Development; Diet; Elderly; Ensure; Environment; Facebook; Family; Family Study; Feasibility Studies; Focus Groups; Fostering; Funding; Goals; Group Interviews; Health; Health Disparities Research; Home; Hour; Human Resources; Indian reservation; Individual; Institutes; Intervention; Intervention Studies; Interview; Laboratories; Language; Learning; Link; Literature; Measures; Mediator of activation protein; Mentored Research Scientist Development Award; Mentors; Methods; Mission; Montana; National Heart, Lung, and Blood Institute; Outcome; Outcome Study; Participant; Physical activity; Pittsburgh Sleep Quality Index; Play; Population; Positioning Attribute; Prevalence; Privatization; Public Health; Randomized Controlled Trials; Records; Reporting; Research; Research Methodology; Research Personnel; Research Training; Reservations; Resources; Risk Factors; Role; Rural Health; Schools; Scientist; Shapes; Sleep; Sleep Deprivation; Sleep Disorders; Stress; Structure; Surveys; Testing; Text; Text Messaging; Time; Training; Trauma; Underserved Population; United States National Institutes of Health; Universities; Work; adequate sleep; base; career; career development; community based participatory research; community college; cultural values; design; diaries; evidence base; experience; faculty research; family structure; feasibility testing; first grade; follow-up; health disparity; health equity; high risk; improved; intervention delivery; meetings; member; novel; nutrition; obesity risk; pilot test; poor sleep; post intervention; primary outcome; recruit; school district; secondary outcome; sleep behavior; sleep pattern; social media; teacher; translational research program; trend; tribal community; tv watching; urban Native American

Candidate: The overall goal of this K01 career development proposal is to provide me with the research and training needed to become a leader in the field of sleep intervention and health disparities research in American Indian (AI) populations. As my work has moved in to studying child sleep, it is clear that sleep intervention research is severely lacking. In addition, there are no studies that have been done in any AI community. My preliminary work on the Blackfeet reservation has shown that children do not get enough nightly sleep. These findings helped shape the direction for this K01 proposal to develop a novel sleep intervention grounded in cultural values to improve total sleep time (TST) in families that have children in the K-1st grade. The K01 research and training fulfills defined missions of the NHLBI by understanding sleep disparities and investigating factors that account for differences in a high risk, underserved AI community, and fostering the training of an AI investigator on a trajectory to becoming an independently funded researcher. My training will be targeted to two key areas (among others): 1) sleep and 2) training in mixed-methods research and randomized controlled trials with mentoring from local and national content experts. I will also enhance my understanding in two areas related to sleep: nutrition and stress/trauma. Developing and pilot-testing community-based sleep strategies grounded in AI cultural values, in combination with my training plan, will uniquely position me for a successful independent research career in sleep intervention research with underserved populations. Collectively, this K01 award will position me to develop an R01 proposal. Environment: The mentoring committee for this proposed K01 award is structured to support my research and training in sleep, nutrition, stress, mixed-methods research, accelerometry, and using social media for intervention delivery. Each mentor has extensive mentoring experience and content expertise in critical aspects of the research and training proposal. The Center for American Indian and Rural Health Equity (CAIRHE) has provided me with start-up funds, office laboratory space, IT support, statistical support, and 9 months of protected research time each year. In addition, Montana State University is committed to developing AI faculty and research with a number of institutes and centers that support health and biomedical research, including CAIRHE (NIH P20GM104417); the Montana IDeA Network of Biomedical Research Excellence, or INBRE (NIH P20GM103474); the American Indian/Alaska Native Clinical and Translational Research Program (NIH U54GM115371) among others. CAIRHE, where my office is located, provides an ideal environment for conducting community-based participatory research in tribal communities throughout Montana with resources, personnel, and expertise housed within the center. CAIRHE and other MSU research centers house several senior internal researchers with extensive NIH funding records including my primary mentor and CAIRHE director Dr. Adams. This optimal research environment will ensure that my transition into an independent health disparities scientist is successful. Research: Children sleep less now than ever before. Despite a growing body of literature in understanding child sleep patterns, sleep interventions are limited. To date, there are no sleep intervention studies that have been done in AI tribal communities. Elders and community members play a critical role in identifying culturally adaptive solutions to address problems in tribal communities. Because of the prevalence of historical trauma and mistrust of outsiders, I am uniquely positioned to do this work in my own tribal community. Preliminary data of sleep patterns showed that Blackfeet children age 2-5 and age 12-15 averaged 10.15 hours and 7.5 hours of weekday sleep. Despite this understanding, evidence-based solutions to increase TST in tribal communities are unknown. Thus, I propose to explore traditional sleep routines coupled with asking Blackfeet families about the current sleep environment in their home to develop a culturally specific sleep intervention with one child and one adult dyad. I hypothesize that the sleep intervention will increase TST (primary outcome) in the dyads. The intervention may also result in improved physical activity and diet, and decreased stress and screen time (secondary outcomes). Data will be measured at 0 and 9 weeks and then at 3 month follow-up. This hypothesis will be tested in the following specific aims: Specific Aim 1: Develop a culturally appropriate sleep intervention for Blackfeet families with K-1st grade children using surveys, focus groups, interviews, community input, and evidence-based strategies on sleep. Specific Aim 2: Feasibility test of the 9-week sleep intervention with K-1st grade Blackfeet families. The work proposed in these aims is designed to develop a comprehensive understanding of traditional sleep strategies and the child sleep environment to develop and pilot-test a novel culturally appropriate sleep intervention in the Blackfeet community. Developing culturally specific interventions to increase TST will address two significant gaps in the literature; understanding sleep problems in AI children and pilot-testing culturally adaptive sleep intervention strategies that will inform future research for investigators doing similar work in AI communities and provide direction for an R01 proposal that is one of the outcomes of this work.

候选人：该K01职业发展建议的总体目标是为我提供 研究和培训需要成为睡眠干预和健康领域的领导者 美洲印第安人（AI）人口的差异研究。随着我的工作已经开始学习儿童睡眠， 显然，睡眠干预研究严重缺乏。另外，没有研究 在任何AI社区中完成。我在Blackfeet预订方面的初步工作表明，孩子没有 每晚都有足够的睡眠。这些发现有助于塑造了这一K01提议开发小说的方向 以文化价值为基础的睡眠干预措施，以改善有孩子的家庭的总睡眠时间（TST） K-1年级。 K01研究和培训通过了解睡眠来履行NHLBI的明确任务 差异和调查因素，这些因素解释了高风险差异，服务不足的AI社区以及 促进对AI研究者的培训，以成为一名独立资助的研究人员。我的 培训将针对两个关键领域（等）：1）睡眠和2）混合方法研究的培训 以及由本地和国家内容专家的指导进行的随机对照试验。我还将增强我的 与睡眠有关的两个领域的理解：营养和压力/创伤。开发和试点测试 基于社区的睡眠策略以AI文化价值为基础，结合我的培训计划，将 独特地将我定位为成功的独立研究职业在睡眠干预研究中 服务不足的人群。总的来说，这项K01奖将使我提出R01提案。 环境：该拟议的K01奖的指导委员会旨在支持我的研究和 培训睡眠，营养，压力，混合方法研究，加速度计和使用社交媒体的培训 干预交付。每个导师在关键方面都有丰富的指导经验和内容专业知识 研究和培训建议的各个方面。美洲印第安人和农村卫生公平中心 （Cairhe）为我提供了启动资金，办公实验室空间，IT支持，统计支持和9 每年受保护的研究时间数月。此外，蒙大拿州立大学致力于发展 AI的教师和研究的许多机构和中心支持健康和生物医学研究， 包括Cairhe（NIH P20GM104417）；蒙大拿州的生物医学研究卓越思想网络或 inbre（NIH P20GM103474）;美洲印第安人/阿拉斯加本地临床和翻译研究计划 （NIH U54GM115371）等。我办公室所在的凯尔（Cairhe）提供了理想的环境 用资源在整个蒙大拿州的部落社区进行基于社区的参与研究， 中心内的人员和专业知识。凯尔（Cairhe）和其他密歇根州立大学研究中心（MSU Research Center 内部研究人员拥有广泛的NIH资金记录，包括我的主要导师和凯尔 主任亚当斯博士。这个最佳研究环境将确保我向独立的过渡 健康差异科学家成功。 研究：儿童现在比以往任何时候都更少睡眠。尽管越来越多的文献理解 儿童睡眠方式，睡眠干预措施有限。迄今为止，没有睡眠干预研究 在AI部落社区完成。长者和社区成员在识别文化方面发挥着关键作用 适应性解决方案，以解决部落社区的问题。由于历史创伤的流行 以及对局外人的不信任，我有一个独特的位置，可以在自己的部落社区中做这项工作。初步数据 睡眠方式表明，2-5岁的Blackfeet儿童平均为10.15小时零7.5小时 工作日睡眠。尽管有这种理解，但基于证据的解决方案可以增加部落社区的TST 是未知的。因此，我建议探索传统的睡眠习惯，并向Blackfeet家庭询问有关 当前家中的睡眠环境与一个孩子开发具有文化特定的睡眠干预措施 和一个成人二元。我假设睡眠干预将增加二元组中的TST（主要结果）。 干预措施也可能改善体育锻炼和饮食，减少压力和筛查时间 （次要结果）。数据将在0和9周内测量，然后在3个月的随访中进行测量。这 假设将在以下具体目的中进行检验： 特定目的1：为K-1ST的Blackfeet家庭开发适合文化的睡眠干预措施 使用调查，焦点小组，访谈，社区意见和基于证据的孩子的年级儿童 睡眠策略。 特定目标2：与K-1级Blackfeet家庭进行9周睡眠干预的可行性测试。 这些目标中提出的工作旨在对传统睡眠有全面的理解 策略和儿童睡眠环境发展和试验一种新颖的文化睡眠 干预Blackfeet社区。制定具有文化特定的干预措施以增加TST 解决文献中的两个重大差距；了解AI儿童的睡眠问题和试点测试 具有文化自适应的睡眠干预策略，这些策略将为未来的研究提供为类似的研究人员提供的研究 在AI社区工作，并为R01提案提供指导，这是这项工作的结果之一。