Measurement of Nature Contact: The Influence of Cultural Practices on Sleep Health and Chronic Disease among Rural and Urban American Indians

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PROJECT SUMMARY Researchers have called for a deeper understanding of how social, cultural and environmental factors influence chronic disease and sleep health outcomes. The parent grant –American Indian CHronic disEase RIsk and Sleep Health (AI- CHERISH; R01MD014035)—aims to estimate the prevalence of sleep problems and their associations with specific cardiovascular and metabolic risk factors, as well as the qualitative characterization of cultural factors related to sleep health among participants recruited from American Indian (AI) participants previously enrolled in the Strong Heart Family Study (SHFS). This Diversity Supplement uses secondary analysis of quantitative data to develop a geographical variable (RUCA), and to test associations and interactions between this variable, sleep health, and chronic disease risk factors. It also uses secondary qualitative data to develop a measure of cultural practices involving nature contact. This new measure will be tested for interaction effects on associations between the RUCA variable and sleep problems. This Supplement will enhance the parent study’s ability to meet each of its specific aims through deepening understanding of geographic variations in sleep health as well as through enhancing understanding of specific cultural features key to sleep health by urbanicity and rurality, characterized by the creation of a rural-urban commuting area (RUCA) variable. Findings will enhance our understanding of geographic variation in sleep health and chronic disease outcomes, as well of culturally appropriate psychometric instruments that may help identify pathways for prevention and treatment. Findings will also contribute to a limited body of literature on the health benefits of nature contact among AIs. Dr. Fernandez’ long-term goal is to obtain the training and skills needed to become an independent mixed- methods investigator to address health disparities among American Indian and Alaska Native (AI/AN) populations, with a specific emphasis on measurement development. In collaboration with her mentoring team, she proposes 2 years of research and career development activities designed to achieve this goal. Dr. Fernandez’ research and career development activities include a comprehensive literature review; formal coursework in statistical methods and participation in the NIMHD Health Disparities Research Institute; grant writing training and manuscript preparation; data analysis; and the submission of a competitive Mentored Research Scientist Development Award (K01) application.