Developing, implementing, and evaluating a mixed-methods community-based participatory research sleep intervention in families with K-1st grade children living on the Blackfeet Indian Reservation

针对居住在黑脚印第安人保留地的幼儿园至一年级儿童的家庭，制定、实施和评估基于社区的混合方法参与性研究睡眠干预

• 批准号: 9892166
• 负责人: Vernon Matthew Grant
• 金额: $ 15.45万
• 依托单位: MONTANA STATE UNIVERSITY - BOZEMAN
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9892166
• 关键词: Accelerometer; Address; Adherence; Adult; Age; Alaska Native; American Indians; Area; Beds; Behavior; Biomedical Research; Body mass index; Businesses; Cellular Phone; Child; Child Development; Child Health; Childhood; Chronic Disease; Clinical Research; Communities; Coupled; Data; Development; Diet; Elderly; Ensure; Environment; Facebook; Family; Family Study; Feasibility Studies; Focus Groups; Fostering; Funding; Goals; Group Interviews; Health; Home environment; Hour; Human Resources; Indian reservation; Individual; Institutes; Intervention; Intervention Studies; Interview; Laboratories; Language; Learning; Link; Literature; Measures; Media Intervention; Mediator of activation protein; Mentored Research Scientist Development Award; Mentors; Methods; Mission; Montana; National Heart, Lung, and Blood Institute; Outcome; Outcome Study; Participant; Physical activity; Pittsburgh Sleep Quality Index; Play; Population; Positioning Attribute; Prevalence; Privatization; Public Health; Randomized Controlled Trials; Records; Reporting; Research; Research Methodology; Research Personnel; Research Training; Reservations; Resources; Risk Factors; Role; Rural Health; Schools; Scientist; Shapes; Sleep; Sleep Deprivation; Sleep Disorders; Sleep disturbances; Stress; Structure; Surveys; Testing; Text; Text Messaging; Time; Training; Trauma; Underserved Population; United States National Institutes of Health; Universities; Work; adequate sleep; base; career; career development; community based participatory research; community college; cultural values; design; diaries; evidence base; experience; faculty research; family structure; first grade; follow-up; health disparity; health equity; high risk; improved; meetings; member; novel; nutrition; obesity risk; post intervention; primary outcome; recruit; school district; secondary outcome; sleep behavior; sleep pattern; social media; teacher; translational research program; trend; tribal community; tv watching; urban Native American

Candidate: The overall goal of this K01 career development proposal is to provide me with the research and training needed to become a leader in the field of sleep intervention and health disparities research in American Indian (AI) populations. As my work has moved in to studying child sleep, it is clear that sleep intervention research is severely lacking. In addition, there are no studies that have been done in any AI community. My preliminary work on the Blackfeet reservation has shown that children do not get enough nightly sleep. These findings helped shape the direction for this K01 proposal to develop a novel sleep intervention grounded in cultural values to improve total sleep time (TST) in families that have children in the K-1st grade. The K01 research and training fulfills defined missions of the NHLBI by understanding sleep disparities and investigating factors that account for differences in a high risk, underserved AI community, and fostering the training of an AI investigator on a trajectory to becoming an independently funded researcher. My training will be targeted to two key areas (among others): 1) sleep and 2) training in mixed-methods research and randomized controlled trials with mentoring from local and national content experts. I will also enhance my understanding in two areas related to sleep: nutrition and stress/trauma. Developing and pilot-testing community-based sleep strategies grounded in AI cultural values, in combination with my training plan, will uniquely position me for a successful independent research career in sleep intervention research with underserved populations. Collectively, this K01 award will position me to develop an R01 proposal. Environment: The mentoring committee for this proposed K01 award is structured to support my research and training in sleep, nutrition, stress, mixed-methods research, accelerometry, and using social media for intervention delivery. Each mentor has extensive mentoring experience and content expertise in critical aspects of the research and training proposal. The Center for American Indian and Rural Health Equity (CAIRHE) has provided me with start-up funds, office laboratory space, IT support, statistical support, and 9 months of protected research time each year. In addition, Montana State University is committed to developing AI faculty and research with a number of institutes and centers that support health and biomedical research, including CAIRHE (NIH P20GM104417); the Montana IDeA Network of Biomedical Research Excellence, or INBRE (NIH P20GM103474); the American Indian/Alaska Native Clinical and Translational Research Program (NIH U54GM115371) among others. CAIRHE, where my office is located, provides an ideal environment for conducting community-based participatory research in tribal communities throughout Montana with resources, personnel, and expertise housed within the center. CAIRHE and other MSU research centers house several senior internal researchers with extensive NIH funding records including my primary mentor and CAIRHE director Dr. Adams. This optimal research environment will ensure that my transition into an independent health disparities scientist is successful. Research: Children sleep less now than ever before. Despite a growing body of literature in understanding child sleep patterns, sleep interventions are limited. To date, there are no sleep intervention studies that have been done in AI tribal communities. Elders and community members play a critical role in identifying culturally adaptive solutions to address problems in tribal communities. Because of the prevalence of historical trauma and mistrust of outsiders, I am uniquely positioned to do this work in my own tribal community. Preliminary data of sleep patterns showed that Blackfeet children age 2-5 and age 12-15 averaged 10.15 hours and 7.5 hours of weekday sleep. Despite this understanding, evidence-based solutions to increase TST in tribal communities are unknown. Thus, I propose to explore traditional sleep routines coupled with asking Blackfeet families about the current sleep environment in their home to develop a culturally specific sleep intervention with one child and one adult dyad. I hypothesize that the sleep intervention will increase TST (primary outcome) in the dyads. The intervention may also result in improved physical activity and diet, and decreased stress and screen time (secondary outcomes). Data will be measured at 0 and 9 weeks and then at 3 month follow-up. This hypothesis will be tested in the following specific aims: Specific Aim 1: Develop a culturally appropriate sleep intervention for Blackfeet families with K-1st grade children using surveys, focus groups, interviews, community input, and evidence-based strategies on sleep. Specific Aim 2: Feasibility test of the 9-week sleep intervention with K-1st grade Blackfeet families. The work proposed in these aims is designed to develop a comprehensive understanding of traditional sleep strategies and the child sleep environment to develop and pilot-test a novel culturally appropriate sleep intervention in the Blackfeet community. Developing culturally specific interventions to increase TST will address two significant gaps in the literature; understanding sleep problems in AI children and pilot-testing culturally adaptive sleep intervention strategies that will inform future research for investigators doing similar work in AI communities and provide direction for an R01 proposal that is one of the outcomes of this work.

候选人：K 01职业发展计划的总体目标是为我提供 研究和培训需要成为睡眠干预和健康领域的领导者 美国印第安人（American Indian，AI）。随着我的工作转向研究儿童睡眠， 很明显，睡眠干预研究严重缺乏。此外，没有任何研究表明， 在任何一个AI社区都是如此。我对黑脚保留地的初步研究表明， 保证充足的夜间睡眠。这些发现帮助K 01提出了开发一部小说的方向。 基于文化价值观的睡眠干预，以改善有孩子的家庭的总睡眠时间（TST）， K-1级。K 01研究和培训通过了解睡眠来实现NHLBI的定义任务 差异和调查因素，解释高风险，服务不足的AI社区的差异，以及 促进人工智能调查员的培训，使其成为一名独立资助的研究人员。我 培训将针对两个关键领域：1）睡眠和2）混合方法研究的培训 以及在当地和国家内容专家的指导下进行的随机对照试验。我也会提高我的 了解与睡眠有关的两个领域：营养和压力/创伤。开发和中试 基于人工智能文化价值观的社区睡眠策略，结合我的培训计划， 独特的定位我在睡眠干预研究成功的独立研究生涯， 服务不足的人群。总的来说，这个K 01奖项将使我能够制定R 01提案。 环境：这个拟议的K 01奖项的指导委员会的结构是为了支持我的研究， 睡眠，营养，压力，混合方法研究，加速度计和使用社交媒体的培训 干预交付。每位导师都具有丰富的指导经验和关键领域的内容专业知识， 研究和培训建议的各个方面。美国印第安人和农村健康公平中心 （CAIRHE）为我提供了启动资金，办公室实验室空间，IT支持，统计支持，以及9 每年有几个月的研究时间受到保护。此外，蒙大拿州立大学致力于发展 人工智能教师和研究与一些机构和中心，支持健康和生物医学研究， 包括CAIRHE（NIH P20 GM 104417）;蒙大拿州IDEA生物医学研究卓越网络，或 INBRE（NIH P20 GM 103474）;美洲印第安人/阿拉斯加原住民临床和转化研究计划 (NIH U 54 GM 115371）等。CAIRHE，我的办公室所在地，提供了一个理想的环境， 在蒙大拿州的部落社区进行基于社区的参与性研究， 中心内的人员和专业知识。CAIRHE和其他MSU研究中心拥有几个 拥有大量NIH资助记录的高级内部研究人员，包括我的主要导师和CAIRHE 主任亚当斯医生。这种最佳的研究环境将确保我过渡到一个独立的 健康差异科学家是成功的。 研究：儿童睡眠比以往任何时候都少。尽管越来越多的文献认为 儿童睡眠模式，睡眠干预有限。到目前为止，还没有睡眠干预研究 在人工智能部落社区中进行。长者和社区成员在确定文化上的重要作用 适应性解决方案，以解决部落社区的问题。由于历史创伤的普遍存在 和对外人的不信任，我在自己的部落社区里做这项工作是独一无二的。初步数据 黑脚儿童2-5岁和12-15岁的平均睡眠时间分别为10.15小时和7.5小时 平日的睡眠。尽管有这样的理解，基于证据的解决方案，以增加TST在部落社区 是未知的。因此，我建议探索传统的睡眠习惯，并询问黑脚家庭， 目前的睡眠环境在他们的家，以制定一个特定的文化睡眠干预与一个孩子 和一个成年二分体我假设睡眠干预会增加TST（主要结局）。 这种干预也可能导致身体活动和饮食的改善，并减少压力和屏幕时间 （次要结果）。将在第0周和第9周以及随后的3个月随访时测量数据。这 将在以下具体目标中检验这一假设： 具体目标1：为患有K-1 st的黑脚家庭制定文化上适当的睡眠干预措施 通过调查、焦点小组、访谈、社区投入和基于证据的方法对儿童进行分级 睡眠策略 具体目标2：对K-1年级黑脚家庭进行9周睡眠干预的可行性测试。 在这些目标中提出的工作旨在发展对传统睡眠的全面理解 策略和儿童睡眠环境，以开发和试点测试一种新的文化适当的睡眠 黑脚社区的干预。制定针对特定文化的干预措施，以增加TST， 解决文献中的两个重大空白;理解AI儿童的睡眠问题和试点测试 文化适应性睡眠干预策略，将为未来的研究人员做类似的研究提供信息。 在AI社区工作，并为R 01提案提供方向，这是这项工作的成果之一。