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

应聘者：这份K01职业发展提案的总体目标是为我提供 需要研究和培训才能成为睡眠干预和健康领域的领先者 美国印第安人(AI)人群的差异研究。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，还没有研究表明， 在任何人工智能社区都可以完成。我对黑脚保留地的初步研究表明，孩子们不会 保证每晚充足的睡眠。这些发现帮助形成了K01提案的方向，即开发一部小说 以文化价值观为基础的睡眠干预，以改善有孩子的家庭的总睡眠时间(TST) K-1年级。K01研究和培训通过了解睡眠来完成NHLBI的明确任务 差异和调查因素，说明高风险、服务不足的人工智能社区中的差异，以及 促进对人工智能调查员的培训，使其走上成为一名独立资助研究人员的轨道。我的 培训将针对两个关键领域(除其他外)：1)睡眠和2)混合方法研究培训 并在当地和国家内容专家的指导下进行随机对照试验。我也会加强我的 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，与我的培训计划相结合，将 为我在睡眠干预研究领域取得成功的独立研究生涯做好准备 服务不足的人群。总而言之，这一K01奖项将使我能够制定R01提案。 环境：这个建议的K01奖项的指导委员会是为了支持我的研究和 在睡眠、营养、压力、混合方法研究、加速测量方面的培训，以及使用社交媒体 干预性交付。每位导师都有丰富的指导经验和关键领域的内容专业知识 研究和培训提案的各个方面。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、办公实验室空间、IT支持、统计支持和9 每年几个月的受保护研究时间。此外，蒙大拿州立大学致力于发展 人工智能教师和研究人员与许多支持健康和生物医学研究的机构和中心合作， 包括CAIRHE(NIH P20GM104417)；蒙大拿州卓越生物医学研究想法网络，或 美国印第安人/阿拉斯加原住民临床和转化研究计划 (NIH U54GM115371)等。我的办公室所在的CAIRHE提供了一个理想的环境 利用资源在蒙大拿州各地的部落社区开展基于社区的参与性研究， 中心内的人员和专业知识。CAIRHE和密歇根州立大学的其他研究中心有几个 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 亚当斯医生主任。这种最佳的研究环境将确保我过渡到独立的 健康差距科学家是成功的。 研究表明，现在的儿童睡眠比以往任何时候都要少。尽管有越来越多的文学作品在理解 儿童睡眠模式、睡眠干预是有限的。到目前为止，还没有睡眠干预研究 已经在人工智能部落社区完成了。长辈和社区成员在文化认同方面发挥着关键作用 解决部落社区问题的适应性解决方案。因为历史创伤的盛行 以及对外人的不信任，我在我自己的部落社区中处于独特的地位来做这项工作。初步数据 的睡眠模式显示，2-5岁和12-15岁的黑脚儿童平均睡眠时间分别为10.15小时和7.5小时 平日里的睡眠。尽管如此，提高部落社区TST的循证解决方案 都是未知的。因此，我建议探索传统的睡眠习惯，并向黑脚家庭询问 他们目前在家中的睡眠环境，以发展一个孩子的特定文化睡眠干预 和一个成年二分体。我假设睡眠干预将增加二元体的TST(主要结果)。 这种干预还可能改善体力活动和饮食，减少压力和屏幕时间 (次要结果)。在0周和9周测量数据，然后在3个月的随访中测量数据。这 假设将在以下具体目标中得到检验： 具体目标1：为患有K-1的黑脚家庭开发一种文化上合适的睡眠干预 使用调查、焦点小组、访谈、社区意见和基于证据的方法对儿童进行评分 关于睡眠的策略。 具体目标2：对K-1年级黑脚家庭进行为期9周的睡眠干预的可行性检验。 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宜的睡眠 对黑脚族社区的干预。开发针对文化的干预措施以提高TST将 解决文献中的两个重大空白；了解人工智能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提供信息，供进行类似研究的研究人员参考 在人工智能社区工作，并为这项工作的成果之一的R01提案提供方向。

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.