AMERICAN INDIAN CHronic disEase RIsk and Sleep Health (AI-CHERISH)

美洲印第安人慢性病风险与睡眠健康 (AI-CHERISH)

• 批准号: 10092830
• 负责人: Lonnie A. Nelson
• 金额: $ 58.1万
• 依托单位: WASHINGTON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-13 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10092830
• 关键词: Accelerometer; Accounting; Acute; Adult; Affect; Alaska Native; American Indians; Blood Pressure; Body mass index; Cardiovascular Diseases; Cardiovascular system; Chronic; Chronic Disease; Circadian desynchrony; Clinical; Communities; Data; Data Collection; Data Set; Development; Diagnosis; Drowsiness; Economic Factors; Elderly; Enrollment; Environmental Risk Factor; Epidemiology; Event; Excessive Daytime Sleepiness; Family Study; Focus Groups; Foundations; Future; General Population; Genetic study; Geographic Locations; Glycosylated hemoglobin A; Goals; Guidelines; Health; Heart; High Prevalence; Hour; Hygiene; Hypertension; Intervention Studies; Interview; Investigation; Life Style; Link; Measures; Metabolic; Metabolic Diseases; Methods; Native-Born; Nature; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Obstructive Sleep Apnea; Outcome; Outcome Measure; Participant; Patient Outcomes Assessments; Patient Self-Report; Pittsburgh Sleep Quality Index; Population; Population Study; Positioning Attribute; Prevalence; Public Health; Qualitative Methods; Questionnaires; Race; Randomized Controlled Trials; Research; Reservations; Risk; Risk Factors; Sampling; Severities; Site; Sleep; Sleep Deprivation; Sleep Disorders; Sleep disturbances; Sleeplessness; Social Impacts; Standardization; Structure; Surveys; Time; Traffic accidents; Visit; Work; Wrist; actigraphy; adverse outcome; aged; base; blood lipid; cardiovascular disorder risk; clinical risk; cohort; comparative; diaries; dietary; disorder risk; economic impact; effective therapy; epidemiology study; ethnic minority population; experience; falls; health data; improved; indexing; informant; innovation; instrument; member; mortality; northern plains; poor sleep; prospective; racial minority; recruit; sleep health; social culture; social factors; sociodemographics

ABSTRACT: Both comparative and single-race studies suggest that sleep disorders are at least as prevalent among American Indians and Alaska Natives (AI/ANs) as they are in the all-races population. Sleep problems are known to be important contributors to chronic disease and early mortality in all populations, while effective treatment of sleep disorders improves the management of diverse health conditions. We propose to conduct an innovative mixed-methods study – American Indian CHronic disEase RIsk and Sleep Health (AI- CHERISH) – to assess the relationship between CVD and metabolic risk and sleep health in the context of Native culture. During the first 2 project years, we will conduct 5 focus groups (15 groups total; 12 participants each) and 2 rounds of semi-structured interviews with 5 key informants (30 interviews total). The resulting qualitative data will inform the development of a patient-reported outcome measure (PROM) of sleep health, to augment established measures accounting for factors specific to Native communities, and culturally-grounded, complementary guidelines for improving sleep. In the quantitative portion of this work, we will implement the largest epidemiologic study of sleep health to date with an AI/AN sample to assess the population prevalence of sleep deficiencies and their association with specific CVD risk factors. Participants in the epidemiologic study were previously enrolled in the Strong Heart Family Study (SHFS). For the epidemiologic study, we will recruit 250 AI participants aged 30–50 years from each geographic region (N=750) and collect sleep data from each participant during 2 study visits in a single 9-month period, with a visit during the months with the longest and shortest daylight exposure (May–July and November–January). For 7 days before each data collection visit, participants will wear wrist actigraphs to measure sleeping and waking activities, and will keep a diary to document waking activities as well as sleep duration, consolidation, and timing. When they return the actigraphs, they will complete 4 validated self-report instruments: the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Sleep Hygiene Index, the Insomnia Severity Index, and the STOP-Bang questionnaire. They will also provide data on sociodemographics and on CVD risk factors (blood lipids, hemoglobin A1C, blood pressure, BMI) known to be influenced by sleep. Our Specific Aims are to: 1) Develop a culturally appropriate PROM of sleep health based on the local context affecting sleep at each study site by using focus groups. 2) In key informant interviews, evaluate existing guidelines and elucidate complementary culturally-grounded guidelines for improving sleep health at each study site to augment existing guidelines for AI communities. 3) Estimate the prevalence and nature of sleep deficiencies in a sample of 750 AI adults at 3 study sites by analyzing objective data from actigraphy and subjective data from sleep/wake diaries and standardized sleep instruments collected at 2 time points during a 9-month period. 4) Assess the cross-sectional associations of poor sleep health, as defined by our objective and subjective sleep measures, with CVD and metabolic risk factors.

摘要：比较研究和单一种族研究都表明，睡眠障碍至少与 在美洲印第安人和阿拉斯加原住民 (AI/AN) 中普遍存在，因为他们在所有种族人口中都存在。 众所周知，这些问题是导致所有人群慢性病和早期死亡的重要原因，而 我们建议有效治疗睡眠障碍可以改善多种健康状况的管理。 进行一项创新的混合方法研究——美洲印第安人慢性病风险和睡眠健康（AI- CHERISH）——在 Native 背景下评估 CVD 和代谢风险与睡眠健康之间的关系 在项目的前 2 年中，我们将举办 5 个焦点小组（总共 15 个小组；每个小组 12 名参与者）。 对 5 位关键知情人进行 2 轮半结构化访谈（总共 30 次访谈）。 数据将为睡眠健康的患者报告结果测量 (PROM) 的开发提供信息，以增强 制定了考虑到原住民社区特定因素并具有文化基础的措施， 在这项工作的定量部分，我们将实施改善睡眠的补充指南。 迄今为止最大规模的睡眠健康流行病学研究，采用 AI/AN 样本来评估睡眠健康的人群患病率 睡眠不足及其与特定 CVD 危险因素的关联。 我们将招募之前参加过强心脏家族研究 (SHFS) 的流行病学研究。 来自每个地理区域的 250 名年龄在 30-50 岁的人工智能参与者 (N=750) 并收集每个人的睡眠数据 参与者在 9 个月内进行了 2 次研究访问，访问时间最长的月份是 每次数据收集访问前 7 天，最短日照时间（5 月至 7 月和 11 月至 1 月）。 参与者将佩戴手腕活动记录仪来测量睡眠和清醒时的活动，并记日记 当他们返回活动记录仪时，记录清醒活动以及睡眠持续时间、巩固情况和时间安排。 他们将完成 4 个经过验证的自我报告工具：匹兹堡睡眠质量指数、Epworth 嗜睡度 他们还将测量量表、睡眠卫生指数、失眠严重程度指数和 STOP-Bang 问卷。 提供有关社会人口统计学和 CVD 危险因素（血脂、血红蛋白 A1C、血压、 BMI）已知受睡眠影响，我们的具体目标是： 1) 制定适合文化的 PROM。 通过使用焦点小组，根据影响每个研究地点睡眠的当地情况来确定睡眠健康状况 2) 重点。 知情者访谈，评估现有指南并阐明基于文化的补充指南 改善每个研究地点的睡眠健康，以增强人工智能社区的现有指南 3) 估计 通过分析目标，了解 3 个研究中心 750 名人工智能成年人样本中睡眠不足的患病率和性质 来自体动记录仪的数据以及来自睡眠/觉醒日记和收集的标准化睡眠仪器的主观数据 9 个月期间的 2 个时间点 4) 评估睡眠健康状况不佳的横截面关联，如下所示。 由我们的客观和主观睡眠测量以及心血管疾病和代谢危险因素定义。