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：这个K01职业发展建议的总体目标是为我提供 成为睡眠干预和健康领域的领导者所需的研究和培训 美洲印第安人 (AI) 人群的差异研究。随着我的工作转向研究儿童睡眠， 显然，睡眠干预研究严重缺乏。此外，目前还没有研究表明 在任何人工智能社区中完成。我对黑脚保留地的初步研究表明，孩子们不 每晚睡眠充足。这些发现帮助确定了 K01 提案开发小说的方向 基于文化价值观的睡眠干预，旨在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 的既定使命 差异和调查导致高风险、服务不足的人工智能社区差异的因素，以及 促进人工智能研究人员的培训，使其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（其中包括）：1）睡眠；2）混合方法研究培训 以及在当地和国家内容专家指导下的随机对照试验。我也会加强我的 了解与睡眠相关的两个领域：营养和压力/创伤。开发和试点测试 基于人工智能文化价值观的基于社区的睡眠策略，结合我的培训计划，将 使我能够在睡眠干预研究方面取得成功的独立研究生涯 服务不足的人群。总的来说，这个 K01 奖项将使我能够制定 R01 提案。 环境：拟议的 K01 奖项的指导委员会旨在支持我的研究和 睡眠、营养、压力、混合方法研究、加速度测量以及使用社交媒体进行培训 干预实施。每位导师在关键领域都拥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。美国印第安人和农村健康公平中心 （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 每年有数月受保护的研究时间。此外，蒙大拿州立大学致力于发展 人工智能教师和研究与许多支持健康和生物医学研究的研究所和中心合作， 包括 CAIRHE (NIH P20GM104417)；蒙大拿州 IDeA 生物医学研究卓越网络，或 INBRE（NIH P20GM103474）；美洲印第安人/阿拉斯加原住民临床和转化研究计划 （NIH U54GM115371）等。我的办公室所在的 CAIRHE 为我提供了理想的环境 利用资源在蒙大拿州各地的部落社区开展基于社区的参与性研究， 中心内拥有人员和专业知识。 CAIRHE 和其他密歇根州立大学研究中心拥有多个 拥有大量 NIH 资助记录的高级内部研究人员，包括我的主要导师和 CAIRHE 导演亚当斯博士。这种最佳的研究环境将确保我过渡到独立 健康差异科学家是成功的。 研究：现在孩子们的睡眠时间比以往任何时候都少。尽管越来越多的文献在理解 儿童睡眠模式、睡眠干预措施有限。迄今为止，尚无睡眠干预研究表明 是在人工智能部落社区中完成的。长辈和社区成员在文化认同方面发挥着关键作用 解决部落社区问题的适应性解决方案。由于历史创伤的普遍存在 以及对外来者的不信任，我处于独特的地位，可以在我自己的部落社区中开展这项工作。初步数据 睡眠模式研究显示，2-5 岁和 12-15 岁的黑脚儿童平均睡眠时间为 10.15 小时和 7.5 小时 工作日睡眠。尽管有这样的理解，但提高部落社区 TST 的基于证据的解决方案 未知。因此，我建议探索传统的睡眠习惯，同时向黑脚族家庭询问有关 他们家中当前的睡眠环境，针对一个孩子制定一种针对特定文化的睡眠干预措施 和一个成人二人组。我假设睡眠干预会增加二人组的 TST（主要结果）。 该干预措施还可能改善身体活动和饮食，减少压力和屏幕时间 （次要结果）。数据将在第 0 周和第 9 周以及后续 3 个月时测量。这 假设将在以下具体目标中进行检验： 具体目标 1：为 K-1st 黑脚族家庭制定文化上合适的睡眠干预措施 使用调查、焦点小组、访谈、社区意见和基于证据的方法对儿童进行评分 睡眠策略。 具体目标 2：对 K-1 年级黑脚家庭进行 9 周睡眠干预的可行性测试。 这些目标中提出的工作旨在全面了解传统睡眠 策略和儿童睡眠环境，以开发和试点测试一种新颖的适合文化的睡眠 对黑脚社区的干预。制定针对特定文化的干预措施以增加 TST 将 解决文献中的两个重大空白；了解人工智能儿童的睡眠问题并进行试点测试 文化适应性睡眠干预策略将为研究人员进行类似的未来研究提供信息 在人工智能社区中工作，并为 R01 提案提供指导，这是这项工作的成果之一。