Examining the Role of Sleep Disturbances in Contributing to Health Risk Behaviors and Cardiometabolic Outcomes in Urban Native American Youth

总结/摘要 美国印第安人/阿拉斯加原住民（AI/AN）是美国风险最高的种族/族裔群体之一。 不良心脏代谢（CM）和行为健康（BH）结局，包括心血管疾病（CVD）， 糖尿病、肥胖行为和酒精及其他药物使用问题。城市人工智能/人工智能占 占总AI/AN人口的三分之二，代表着高度被剥夺权利和边缘化的人口 他们可能有CM和BH问题的特别风险，但他们在 健康研究。青春期是理解CM和BH出现的关键发展时期 易受伤害人群的问题，因为行为健康风险因素通常开始于青春期和早期 CM失调和BH问题的出现可能为持续扩大的健康差距奠定基础 一直到成年睡眠是一个重要但未充分研究的风险因素，可能导致CM和BH 青少年的问题，但没有先前的研究调查了睡眠在促进健康方面的作用 城市AI/AN青年的差异。目前的建议是建立在我们团队进行 研究与城市AI/AN青年，并提供了一个全面的，混合的方法来调查 睡眠障碍对健康行为和临床相关健康结果的作用 文化敏感、社区知情和综合框架。具体而言，该项目包括一个 客观和主观测量的睡眠的纵向评估，BH问题的多个维度， 包括烟草、咖啡因、酒精和其他药物的使用，缺乏身体活动和电子媒体的使用， 测量CM风险因素，以及更好地了解睡眠的社会和文化背景的定性方法 在城市AI/AN青年和下游BH和CM问题的影响。这项工作的成果将 解决几个关键的知识差距，这对于更好地了解普遍存在的健康差距至关重要 在城市AI/AN青年中，确定哪些青年风险最大，并为未来的小说和文化提供信息- 在这个服务不足的社区进行敏感的干预。

Summary/Abstract American Indian/Alaska Natives (AI/ANs) are one of the most at-risk racial/ethnic groups in the United States for adverse cardiometabolic (CM) and behavior health (BH) outcomes, including cardiovascular disease (CVD), diabetes, obesogenic behaviors and alcohol and other drug (AOD) use problems. Urban AI/ANs constitute over two-thirds of the total AI/AN population and represent a highly disenfranchised and marginalized population who may be at particular risk for CM and BH problems, but they have been significantly under-represented in health studies. Adolescence is a critical developmental period for understanding the emergence of CM and BH problems in vulnerable populations, as behavioral health risk factors often begin in adolescence and early onset of CM dysregulation and BH problems can set the stage for widening health disparities that continue long into adulthood. Sleep is an important but understudied risk factor that may contribute to CM and BH problems in adolescents, but no prior studies have investigated the role of sleep in contributing to health disparities in urban AI/AN youth. The current proposal builds on our team’s extensive experience conducting research with urban AI/AN youth and provides a comprehensive, mixed method approach to investigate the role of sleep disturbances in contributing to health behaviors and clinically relevant health outcomes in a culturally sensitive, community-informed, and integrated framework. Specifically, this project incorporates a longitudinal assessment of objectively and subjectively measured sleep, multiple dimensions of BH problems, including tobacco, caffeine, and alcohol and other drug use, physical inactivity and electronic media use, measured CM risk factors, and qualitative methods to better understand the social and cultural context of sleep in urban AI/AN youth and the influence on downstream BH and CM problems. Outcomes from this work will address several key knowledge gaps, which are crucial to better understand pervasive health disparities among urban AI/AN youth, to identify which youth are most at risk, and to inform a future novel and culturally- sensitive intervention within this underserved community.