Examining the Role of Sleep Disturbances in Contributing to Health Risk Behaviors and Cardiometabolic Outcomes in Urban Native American Youth

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Project Summary/Abstract The coronavirus pandemic poses unprecedented challenges for people across the lifespan, including youth, and are likely more pronounced for those who live with poverty and health inequities. American Indian/ Alaskan Natives (AI/ANs) are one of the highest risk racial/ ethnic groups for health disparities, and they are a particularly vulnerable group for adverse health and socioeconomic impacts of the novel coronavirus pandemic (COVID-19). Only one prior study to date retrospectively assessed the long-term psychosocial impact of quarantine on youth and families following an infectious disease outbreak (H1N1 or SARS), and none have assessed the impact on youth in the midst of the pandemic. AI/AN adolescents experience disproportionately high rates of comorbidities known to exacerbate the negative effects of the novel coronavirus, including heart disease, diabetes, obesity, as well as behavioral health problems, including depression and alcohol and other drug (AOD) use problems, which may be exacerbated during stay-at-home orders. This application is being submitted in response to NOT MD-20-019 Notice of Special Interest: Competitive and Administrative Supplements for the Impact of COVID-19 Outbreak on Minority Health and Health Disparities. Our aims are as follows: Aim 1a. Using two waves of data (baseline and during the coronavirus pandemic), we will examine changes in individual (e.g., technology use), family (e.g., conflict and cohesion), community (e.g., sense of community), and cultural (e.g., engagement in cultural activities) risk and protective factors, and changes in sleep, risk-taking and mental health (depression, anxiety, and post-traumatic stress disorder, PTSD). Aim 1b: Using two waves of data, we will examine how changes in risk and protective factors influence changes in sleep, risk-taking behaviors, mental health. For example, we hypothesize that increases in food insecurity will be associated with greater increases in sleep problems, risk-taking behaviors and mental health problems, whereas increases in engagement in cultural activities will be associated with better outcomes. Aim 2. Using the newly added COVID-19 specific questions, we will examine the association between COVID-19 related knowledge, risk perception, and behavioral responses, and challenges related to COVID-19 public health measures (e.g., being affected by school closings) and sleep, risk-taking behaviors, and mental health. Aim 3. Randomly select a subsample (N=25) of adolescents and administer qualitative interviews to examine how the coronavirus outbreak has affected AI/AN adolescent sleep habits, routines, and behaviors. This study will facilitate better understanding of how to plan support services and prevention measures for this underserved group of adolescents. Our findings will also move the field forward as this is the only study of sleep health in the context of the coronavirus among urban AI/AN youth.