Integrating GPS, GIS, and Ecological Momentary Assessment to Determine the Effect of Home and Neighborhood Context on Adolescent Sleep

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Project Summary/Abstract Insufficient sleep doubles the risk of obesity among youth and increases the risk of cardiovascular disease (CVD) in adulthood. Over 75% of US high school students do not meet national sleep recommendations. Given these alarming trends, a better understanding of the environmental determinants of sleep in adolescents is needed in order to identify targets for interventions and public health strategies to promote healthy sleep. While research increasingly suggests that home and neighborhood context impact sleep, key methodological issues limit understanding of the environmental determinants of adolescent sleep. Research on the influence of neighborhood-level factors (e.g. crime, disorder) on sleep typically focuses on the area surrounding adolescents' homes. This approach does not account for mobility and the accumulation of exposures across multiple contexts (e.g. home, school, in transit) during daily activities, leading to exposure misclassification. The home sleep environment (e.g. light, noise) may also vary by night, but is typically assessed at a single timepoint. Mobile health methods including smartphone GPS tracking and ecological momentary assessment (EMA) offer an innovative opportunity to overcome the limitations of past studies by developing person- centered measures of environmental exposures that account for variation over space and time. With this career development award, I will develop critical skills in environmental exposure assessment and health behavior science necessary to pursue a novel independent research program that identifies modifiable environmental determinants of sleep and other CVD-related outcomes and their mechanisms of effect using advanced, cutting-edge methods. In the proposed research study, I will enroll a diverse cohort of 160 adolescents aged 15-18 through a large urban pediatric primary care research network. I will use smartphone GPS tracking, EMA, geographic information systems (GIS), and actigraphy to collect high-resolution longitudinal data on adolescents' exposures to the home and neighborhood context and sleep outcomes over a 14-day period. The research aims include 1) quantifying adolescents' exposure during daily activities to neighborhood factors hypothesized to influence sleep, 2) determining the extent to which adolescents' exposure to adverse sleep environments varies across nights and by housing conditions, and 3) determining the extent to which daily measures of home and neighborhood exposures are associated with adolescent sleep outcomes. With guidance from an expert, interdisciplinary mentorship team at the Children's Hospital of Philadelphia and the University of Pennsylvania, I will obtain training in 1) space-time data collection and analysis, 2) ecological momentary assessment, and 3) sleep research. Completion of the K01 research and training plan will prepare me to compete successfully for R01-level research funding and will uniquely position me as an independent investigator who conducts large-scale epidemiologic investigations on spatiotemporal, environmental determinants of child and adolescent health behaviors related to cardiovascular health.