Researching Equitable Sleep Time (REST) in Appalachia

研究阿巴拉契亚的公平睡眠时间 (REST)

基本信息

批准号：
10663990
负责人：
Christal L. Badour
金额：
$ 75.77万
依托单位：
UNIVERSITY OF KENTUCKY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-26 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10663990
关键词：
Address Adult Age Alcohols Anxiety Appalachian Region Attitude Automobile Driving Behavioral Belief Biological Birds C-reactive protein Cardiovascular Diseases Cardiovascular system Caring Child Sexual Abuse Cirrhosis Cognitive Communities County Data Collection Demographic Factors Diabetes Mellitus Diet Disease Disparity Distress Economics Emotional Equity Ethnic Origin Exercise Eye Face Family Financial Hardship Glycosylated Hemoglobin Glycosylated hemoglobin A Health Health Disparities Research Health Status Indicators Health behavior Heart Diseases Heart Rate Hour Immunologics Individual Individual Differences Interview Kentucky Knowledge Lead Link Malignant Neoplasms Measurement Measures Mediating Memory Mental Depression Mental disorders Metabolic Methods Modeling Morbidity - disease rate Neurocognitive Deficit Obesity Outcome Overdose Participant Perception Physical activity Predictive Factor Premature Mortality Process Productivity Public Health Race Recording of previous events Reporting Research Risk Rural Rural Appalachia Rural Community Rural Population Scientific Advances and Accomplishments Series Sex Differences Sleep Sleep Deprivation Smoking Social support Societal Factors Southeastern United States Stress Substance Use Disorder Substance abuse problem Suicide Surveys System Task Performances Testing Time Trauma United States United States National Institutes of Health Violence Well in self Work cognitive task cohort cost demographics design economic impact ethnic minority health determinants health disparity health disparity populations health inequalities holistic approach innovation insight interest longitudinal design low socioeconomic status mortality protective factors racial minority recruit rural dwellers rural health disparities rurality self reliance sex sleep health social social determinants social factors substance use

项目摘要

Insufficient sleep (habitual sleep duration of ≤6 hours), is a costly, prevalent, public health problem associated with numerous negative health outcomes. Prior research suggests that insufficient sleep is more prevalent among health disparity populations (e.g., racial minorities, adults of low socioeconomic status), but our understanding of the mechanisms and consequences of sleep disparities in rural populations is limited. The present study “Researching Equitable Sleep Time in Kentucky Communities (REST-KY),” focuses on Appalachian adults, an NIH-designated health disparity population, whose serious health inequities include multiple health morbidities and premature mortality. Six of the counties with the highest concentration of insufficient sleep in the nation are in Central Appalachian Kentucky (KY), where 25-58% of adults report insufficient sleep 15+ nights/month. These counties are severely economically distressed, yet, nearby counties with comparable economic distress, rurality, and demographic homogeneity are not “hotspots” of insufficient sleep. Use of a mixed methods, longitudinal design will allow us to evaluate mechanisms contributing to both sleep deficiencies and health in this rural community. Knowledge gaps include 1) Sparse insights into specific individual-, social-, and societal-level factors contributing to sleep deficiencies in Appalachian adults.; 2) It is not known if regional sleep and health disparities share the same underlying mechanisms; and 3) Critical points of variance between “hotspot” and non-“hotspot” counties have not been examined. We will recruit a cohort of 400 adults from 6 insufficient sleep “hotspot” counties (n=200) in Appalachian KY, and 6 similarly rural and economically distressed non-“hotspot” counties. Recruitment will be stratified across “hotspot” and non-“hotspot” counties by key demographic factors linked to sleep deficiencies (e.g., age, sex, race/ethnicity) to promote county cluster-level comparisons. Specific Aims. 1. Use mixed methods to compare how individual, social, and societal factors linked to sleep deficiencies differ between insufficient sleep “hotspot” and non-“hotspot” counties. 2. Evaluate mechanisms driving sleep deficiencies and health outcomes over time. Bi-directional models of sleep and health outcomes will be examined. 3. Quantify day-to-day sleep reactivity (i.e., the degree to which daytime distress impacts sleep) and test if individual differences in sleep reactivity predict worsened health outcomes over time. Differences by sex and county cluster (“hotspot” vs. non-“hotspot”) will also be examined in Aims 2-3. Our multiple, sophisticated objective and subjective data collection methods, made possible by our interdisciplinary team’s varied expertise, will advance scientific knowledge about biological, behavioral, emotional, and social contributions to sleep health. This holistic approach explicitly acknowledges the inseparable overlap between health function, and sleep. Our findings will offer unprecedented insight into the bi- directional relationships between sleep and health in an understudied rural health disparity population. Results will inform strategies to reduce sleep disparities, thus having strong potential for public health impact.

睡眠不足（习惯性睡眠时间≤6小时）是一个代价高昂、普遍存在的公共卫生问题先前的研究表明，睡眠不足的情况更为普遍。在健康差异人群（例如少数族裔、社会经济地位较低的成年人）中，但我们的对农村人口睡眠差异的机制和后果的了解有限。目前的研究“肯塔基州社区公平睡眠时间研究 (REST-KY)”重点关注阿巴拉契亚成年人是美国国立卫生研究院指定的健康差距人群，其严重的健康不平等包括多种健康疾病和过早死亡最集中的六个县。全国睡眠不足的地区是阿巴拉契亚中部肯塔基州 (KY)，那里 25-58% 的成年人报告睡眠不足这些县每月睡眠不足 15 晚以上，但附近县却处于严重经济困境。在类似的经济困境下，农村地区和人口同质性并不是不足的“热点” 使用混合方法、纵向设计将使我们能够评估对两者都有贡献的机制。该农村社区的睡眠不足和健康方面的知识差距包括 1) 对具体问题的了解很少。导致阿巴拉契亚成年人睡眠不足的个人、社会和社会层面的因素。2) 事实并非如此。已知区域睡眠和健康差异是否具有相同的潜在机制；以及 3) 的关键点；尚未检查“热点”县和非“热点”县之间的差异。我们将招募 400 人。来自肯塔基州阿巴拉契亚山脉 6 个睡眠不足“热点”县 (n=200) 的成年人，以及 6 个类似的农村和地区的成年人经济困难的非“热点”县将按“热点”和非“热点”分层招聘。按与睡眠不足相关的关键人口因素（例如年龄、性别、种族/民族）划分各县，以促进各县的发展集群层面的比较。具体目标 1. 使用混合方法来比较个人、社会和社会的情况。睡眠不足“热点”县和非“热点”县的睡眠不足相关因素有所不同 2。评估随着时间的推移导致睡眠不足和健康结果的机制。 3. 量化日常睡眠反应性（即白天睡眠反应性的程度）。压力影响睡眠）并测试睡眠反应的个体差异是否预示着健康状况恶化随着时间的推移，性别和县集群（“热点”与非“热点”）的差异也将在目标 2-3 中进行研究。我们的多种、复杂的客观和主观数据收集方法，通过我们的跨学科团队的不同专业知识，将推进有关生物、行为、这种整体方法明确承认了睡眠健康的情感和社会贡献。我们的研究结果将为人们提供前所未有的关于健康功能和睡眠之间的重叠的见解。未充分研究的农村健康差异人群的睡眠与健康之间的方向关系。将为减少睡眠差异的策略提供信息，从而对公共健康产生巨大的影响。