Socio-ecological factors linked to co-occurring early childhood sleep health disparities and developmental outcomes

与同时发生的儿童早期睡眠健康差异和发育结果相关的社会生态因素

• 批准号: 10685997
• 负责人: Ariel A Williamson
• 金额: $ 79.61万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-20 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10685997
• 关键词: 5 year old; Address; Affect; African American; Age; Asthma; Attention; Belief; Black Populations; Black race; Brain; Buffers; Caregivers; Categories; Characteristics; Child; Child Care; Child Rearing; Childhood; Data; Development; Disparity; Distal; Education; Electronics; Emotional; Employment Status; Environment; Exposure to; Family; Goals; Green space; Guidelines; Health behavior; Hour; Household; Impairment; Incidence; Income; Intervention; Link; Mediating; Methods; Neighborhoods; Obesity; Obstructive Sleep Apnea; Outcome; Policies; Poverty; Prevalence; Qualitative Methods; Quality of Care; Quality of life; Race; Reporter; Reporting; Research; Risk; Schedule; Sleep; Sleep Apnea Syndromes; Sleep Deprivation; Snoring; Stress; Structural Racism; Symptoms; Toxin; Work; Youth; actigraphy; adverse outcome; caregiver stress; disparity reduction; early childhood; effective intervention; emotion regulation; emotional functioning; environmental tobacco smoke; ethnic minority; executive function; experience; health disparity; health equity promotion; health literacy; informant; innovation; lead exposure; minority children; neighborhood safety; neurobehavioral; peer; physical conditioning; primary caregiver; racial bias; racial disparity; racial minority; racism; recruit; resilience; sleep health; social; social skills; socioeconomic disparity; teacher; vigilance; walkability

PROJECT SUMMARY/ABSTRACT There is an urgent need to address pediatric sleep health disparities in early childhood, as sleep deficiencies disproportionately affect racially/ethnically minoritized children and negatively impact crucial neurobehavioral and social-emotional development. Two common early childhood sleep deficiencies linked to adverse outcomes are (1) sleep disordered breathing (SDB), which ranges from snoring to severe obstructive sleep apnea (OSA), and (2) insufficient sleep, or sleeping less than age-based 24-hour sleep guidelines. Compared to non-Latinx White (hereafter ‘White’) youth, non-Latinx Black/African American (‘Black’) youth are 4-6 times more likely to experience SDB and are also more likely to experience short sleep duration. SDB and insufficient sleep also often co-occur in young children. The mechanisms of racial disparities in co-occurring SDB and insufficient sleep and their developmental impacts are poorly understood, which impedes effective intervention. The long-term goal of this research is to develop multi-level interventions that leverage modifiable socio-ecological factors to reduce the incidence and developmental consequences of common, co-occurring racial sleep health disparities in preschoolers. To achieve this goal, there is a critical need to identify the factors that contribute to or buffer against these disparities and their developmental impacts. Although socioeconomic disparities in SDB and insufficient sleep are well documented, family factors including caregiver stress, health literacy, and work schedules are rarely considered. Few studies have examined other modifiable family factors, such as bedtime routines, bedtime electronics, and parenting practices, which may contribute to or buffer against disparities in these sleep deficiencies and related outcomes. Furthermore, ongoing personally mediated and structural racism faced by Black families, teachers’ racial bias, childcare quality, and neighborhood characteristics are likely, but understudied, contributors to these disparities. To address these gaps and inform effective interventions, the objectives of this work are to (1) examine racial disparities in the neurobehavioral and social-emotional impacts of early childhood SDB and/or insufficient sleep and (2) identify proximal and distal socio-ecological factors linked to these racial disparities in sleep-related outcomes. Black and White 3-5-year-olds will be recruited with (A) SDB only, (B) insufficient sleep only, (C) SDB and insufficient sleep, and (D) matched healthy controls to examine the following aims, using a multi-method, multi-informant approach with caregiver and teacher reporters, observational tasks, and qualitative methods. Aim 1 will compare neurobehavioral (executive functioning, attention, vigilance) and social-emotional functioning (social skills, emotion regulation) in groups A, B, C, and D. Aim 2 will identify modifiable family factors that contribute to sleep-related racial disparities in the developmental outcomes of Black and White children in groups A, B, C, and D. Aim 3 will identify proximal and distal childcare and neighborhood factors that contribute to sleep- related racial disparities in the developmental outcomes of Black and White children in groups A, B, C, and D.

项目摘要/摘要 由于睡眠不足 不成比例地影响大致/种族少数的儿童，并对关键的神经行为产生负面影响 和社会情感发展。与逆境有关的两个常见的幼儿睡眠不足 结局是（1）睡眠失调的呼吸（SDB），范围从打扰到严重的阻塞性睡眠 呼吸暂停（OSA）和（2）睡眠不足或小于基于年龄的24小时睡眠指南。比较的 对于非Latinx White（以下称为“白色”）青年，非LATINX Black/African American（'Black'）青年是4-6次 更有可能体验SDB，并且更有可能经历短时间的睡眠时间。 SDB和 幼儿的睡眠不足也经常同时发生。共同存在的种族差异的机制 SDB和睡眠不足及其发育影响的理解不足，这阻碍了有效的 干涉。这项研究的长期目标是制定多层干预措施以利用可修改 社会生态因素减少共同，共同存在的事件和发展后果 学龄前儿童的种族睡眠健康差异。为了实现这一目标，迫切需要确定 有助于或缓冲这些分布及其发育影响的因素。虽然 SDB和睡眠不足的社会经济差异已得到充分记录，包括护理人员在内的家庭因素 很少考虑压力，健康素养和工作时间表。很少有研究检查其他可修改 家庭因素，例如就寝时间，就寝时间电子和育儿习惯，这可能有助于 或缓冲这些睡眠不足和相关结果中的差异。此外，个人持续 黑人家庭，教师的种族偏见，育儿质量和 邻里特征可能是这些差异的贡献者，但可以理解。解决这些 差距并告知有效的干预措施，这项工作的目标是（1）研究种族差异 儿童早期SDB和/或睡眠不足的神经行为和社会情感影响，（2）识别 与睡眠有关的结果中的这些种族差异相关的近端和远端社会生态因素。黑色的 只有（a）SDB，（b）睡眠不足，（c）SDB和不足 睡眠和（d）使用多方法，多种形式的匹配的健康对照以检查以下目标 与看护人和教师记者，观察任务和定性方法相关的方法。目标1意志 比较神经行为（执行功能，注意力，警惕）和社会情感功能（社会 技能，情绪调节）A，B，B，C和D。AIM2将确定可改变的家庭因素 在A，B，C，C， 和D. AIM 3将确定有助于睡眠的近端和远端育儿和邻里因素 - A，B，C和D组中黑人和白人儿童发展成果的相关种族差异。