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

摘要/摘要 美国印第安人/阿拉斯加原住民(AI/ANS)是美国最危险的种族/民族之一 对于不利的心脏代谢(CM)和行为健康(BH)结果，包括心血管疾病(CVD)， 糖尿病、肥胖行为以及酒精和其他药物(AOD)的使用问题。城市人工智能/人工智能构成结束 占人工智能/AN总人口的三分之二，代表着高度被剥夺公民权和边缘化的人口 他们可能面临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出现的关键发育期 易受伤害人群的问题，因为行为健康风险因素往往在青春期和早期就开始了 CM失调和BH问题的出现可能会为持续扩大的健康差距奠定基础 长大成人。睡眠是一个重要但尚未被研究的危险因素，可能导致CM和BH 青少年的问题，但之前没有研究调查睡眠对健康的作用 城市人工智能/青年之间的差距。目前的建议建立在我们团队进行 与城市AI/AN青年一起进行的研究，并提供了一种全面、混合的方法来调查 睡眠障碍在促进健康行为和临床相关健康结局中的作用 文化敏感、社区知情和综合框架。具体地说，这个项目结合了一个 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、酒精和其他药物使用、身体不活动和使用电子媒体， 测量的CM风险因素，以及更好地理解睡眠的社会和文化背景的定性方法 城市AI/AN青年及其对下游BH和CM问题的影响。这项工作的成果将是 解决几个关键的知识差距，这些差距对于更好地了解普遍存在的健康差距至关重要 在城市人工智能/AN青年中，确定哪些青年最有风险，并为未来提供新的和文化上的- 在这个服务不足的社区内进行敏感的干预。

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.