Project 1: Addressing Sleep Duration, Regularity, and Efficiency: A Multidimensional Sleep Health Intervention for Reducing Ethnic Disparities in Cardiometabolic Health (The DREAM Study)

项目 1：解决睡眠持续时间、规律性和效率问题：减少心脏代谢健康种族差异的多维睡眠健康干预措施（DREAM 研究）

• 批准号: 10494221
• 负责人: Nour Makarem
• 金额: $ 67.98万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10494221
• 关键词: Address; Adult; Affect; Behavior Therapy; Behavioral; Biological; Biological Markers; Black Populations; Blood Pressure; Cancer Hospital; Cardiovascular Diseases; Caribbean region; Cause of Death; Characteristics; Chronic Disease; Communities; Community Health Aides; Consolidated Framework for Implementation Research; Development; Diet; Dimensions; Disease Outcome; Education; Educational Materials; Effectiveness; Enrollment; Ensure; Evaluation; Feedback; Future; Generations; Goals; Health; High Prevalence; High Risk Woman; Hypertension; Individual; Intervention; Language; Latinx; Life; Malignant Neoplasms; Measures; Methods; Modeling; Monitor; Morbidity - disease rate; Motivation; National Institute on Minority Health and Health Disparities; New York; New York City; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Obesity; Outcome; Pathway interactions; Physical activity; Presbyterian Church; Process; Public Health; Randomized; Randomized Controlled Trials; Reduce health disparities; Research; Risk; Risk Factors; Role; Screening for cancer; Sleep; Techniques; Testing; Time; Washington; Woman; Work; actigraphy; aged; alertness; arm; base; behavior change; cancer prevention; cancer risk; cardiometabolic risk; cardiometabolism; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; community center; community engagement; ethnic disparity; ethnic minority; evidence base; experience; glycemic control; health disparity; health equity; health training; healthspan; implementation determinants; implementation intervention; implementation science; improved; inflammatory marker; intervention effect; lifestyle factors; lifestyle intervention; men; middle age; minority health; mortality; multiple chronic conditions; novel; poor sleep; population health; primary outcome; racial and ethnic; racial and ethnic disparities; racial minority; satisfaction; scale up; secondary outcome; sleep health; sleep quality; systematic review; systemic inflammatory response; treatment arm; trial design

ABSTRACT: Cardiovascular disease (CVD) and cancer, the leading causes of mortality in Latinx, share many risk factors, including cardiometabolic risk factors. Latinx have some of the highest prevalence rates for obesity and type 2 diabetes (T2D), and in New York City, one of the highest hypertension (HTN) burdens. Improving multiple domains of cardiometabolic health (CMH) through contextual behavioral interventions can have far-reaching effects for reducing the burden of multiple morbidities. Despite a strong evidence base supporting the role of sleep as a major contributor to CMH, including work by our team, most lifestyle interventions have targeted diet or physical activity and not sleep. Sleep is amenable to intervention, and can improve CMH through complementary or synergistic biologic pathways with other lifestyle factors. Insufficient, irregular, and poor quality sleep is widely prevalent, affecting >50% of US adults with a disproportionately higher burden in racial and ethnic minorities, and sleep health disparities have been shown to account for a large portion of racial and ethnic disparities in CMH. We will conduct community engagement and stakeholder participatory research to refine and culturally adapt a multidimensional sleep health (MDSH) intervention for Latinx adults (Aim 1). Using a parallel two-arm randomized controlled trial (RCT) design, we will evaluate the effect of the MDSH intervention on improving blood pressure (BP), glycemic control indicators, and anthropometric markers of adiposity (Aim 2). We will enroll 300 midlife to older Latinx men and women at high risk for multiple chronic diseases, identified through the New York-Presbyterian Hospital cancer screening centers, and randomize to either a control arm that receives standard Life's Simple 7 cardiovascular health educational materials or an intervention arm that, in addition to Life's Simple 7 materials, receives a MDSH intervention based on evidence-based sleep hygiene education and established behavior change techniques (personalized sleep health feedback, goal setting, self-monitoring, motivational enhancement). We will further leverage this RCT to explore the effect of sleep on markers of systemic inflammation that are related to both CVD and cancer risk. Finally, using the Consolidated Framework for Implementation Research and working closely with the COMMUNITY Center Implementation Science Core, we will use mixed methods to understand implementation determinants, processes, and outcomes, ensuring the successful completion and future expansion of this work (Aim 3). Community health workers, with experience working with the NYC Latinx communities, will deliver the intervention, and we will assemble a community and stakeholder collaborative panel, with support from the COMMUNITY CONNECTOME, that will actively participate in all aspects of the aims. Findings will inform the development and implementation of scalable and sustainable personalized population health approaches for addressing sleep health disparities to improve the effectiveness, implementation, and reach of interventions aimed at reducing multiple chronic diseases and extending healthspan.

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