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: 10450469
• 负责人: Ariel A Williamson
• 金额: $ 78.09万
• 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/10450469
• 关键词: 5 year old; Address; Affect; African American; Age; Asthma; Attention; Belief; Black Populations; Black race; Brain; Buffers; Caregivers; Characteristics; Child; Child Rearing; Childhood; Data; Development; 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; Obstructive Sleep Apnea; Outcome; Policies; Poverty; Prevalence; Qualitative Methods; Quality of life; Reporter; Reporting; Research; Risk; Schedule; Sleep; Sleep Apnea Syndromes; Sleep Deprivation; Snoring; Stress; Structural Racism; Symptoms; Time; Toxin; Work; Youth; actigraphy; adverse outcome; base; caregiver stress; disparity reduction; early childhood; effective intervention; emotion regulation; emotional functioning; environmental tobacco smoke; executive function; experience; health disparity; health equity promotion; health literacy; informant; innovation; lead exposure; neighborhood safety; neurobehavioral; peer; physical conditioning; primary caregiver; racial and ethnic; racial bias; racial disparity; 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.

项目概要/摘要 由于睡眠不足，迫切需要解决儿童早期睡眠健康差异问题 对种族/民族少数儿童产生不成比例的影响，并对关键的神经行为产生负面影响 和社会情感发展。两种常见的儿童早期睡眠不足与不良反应有关 结果是 (1) 睡眠呼吸障碍 (SDB)，范围从打鼾到严重阻塞性睡眠 呼吸暂停 (OSA)，以及 (2) 睡眠不足，或睡眠时间低于基于年龄的 24 小时睡眠指南。比较的 非拉丁裔白人（以下简称“白人”）青少年是非拉丁裔黑人/非裔美国人（“黑人”）青少年的 4-6 倍 更有可能经历 SDB，也更有可能经历短睡眠时间。深圳发展银行和 睡眠不足也常常同时发生在幼儿身上。种族差异共现的机制 SDB 和睡眠不足及其对发育的影响知之甚少，这阻碍了有效的 干涉。这项研究的长期目标是开发利用可修改的多层次干预措施 社会生态因素，以减少常见、同时发生的事件的发生率和发育后果 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 造成或缓冲这些差异及其发展影响的因素。虽然 SDB 的社会经济差异和睡眠不足都有据可查，家庭因素包括照顾者 压力、健康素养和工作日程很少被考虑。很少有研究考察其他可修改的 家庭因素，例如就寝时间、就寝电子产品和养育方式，可能会导致 或缓冲这些睡眠不足和相关结果的差异。此外，个人持续 黑人家庭面临的介导性和结构性种族主义、教师的种族偏见、儿童保育质量以及 邻里特征很可能是造成这些差异的因素，但尚未得到充分研究。为了解决这些 差距并为有效的干预措施提供信息，这项工作的目标是（1）审查 儿童早期 SDB 和/或睡眠不足对神经行为和社会情感的影响，以及 (2) 确定 与睡眠相关结果的种族差异相关的近端和远端社会生态因素。黑色的 3-5岁的白人将被招募为（A）仅SDB，（B）仅睡眠不足，（C）SDB和睡眠不足 睡眠，(D) 匹配健康对照，使用多方法、多信息者来检查以下目标 与看护者和老师记者的接触、观察任务和定性方法。目标1将 比较神经行为功能（执行功能、注意力、警惕性）和社会情感功能（社交功能） A、B、C 和 D 组中的技能、情绪调节）。目标 2 将识别有助于改变的家庭因素 A、B、C 组黑人和白人儿童发育结果中与睡眠相关的种族差异， D. 目标 3 将确定影响睡眠的近端和远端儿童保育和邻里因素 A、B、C 和 D 组黑人和白人儿童的发展结果存在相关的种族差异。