Sociocultural Shifting, Sleep and Cardiometabolic Risk in African-American Women

项目总结 非裔美国女性的冠心病(CHD)相关死亡率和 残疾与所有其他种族/族裔群体的妇女相比。这种过重的负担已经持续了几十年， 而且在年轻到中年女性中的比例也在上升。新出现的证据表明，睡眠障碍 (例如，睡眠时间短、睡眠连续性差)可能是非裔美国人患冠心病风险的重要驱动因素 然而，因为大多数关于非裔美国女性睡眠障碍的研究都集中在 与其他种族/民族的妇女相比，在有关因素的认识上存在很大差距 这可能会促进和防止非裔美国女性的睡眠障碍。这样的信息 对于制定针对性的干预措施以改善睡眠并最终减少CHD至关重要 在这一人群中的风险。这项拟议的项目旨在考察是否以及如何“转移”--一部小说， 被认为在非裔美国女性中突出的社会文化现象可能会影响睡眠 这群人之间的骚乱。转换被定义为一种看似适应性的做法，在这种做法中，非裔美国人 女性从事自我改变的行为，既要适应主导社会，又要适应非洲人-- 美国男人。尽管记录在对非裔美国人的定性研究和轶事描述中 过去30年的女性经历，关于转变的实证研究只是最近才出现，而且 没有一个人关注健康。我们有令人信服的中年早期非裔美国人的初步数据 女性，表明报告的转变(例如，改变言语模式，淡化成就，自我 沉默)与主观睡眠障碍和身体质量指数(BMI)相关，但不能用 情绪低落，或歧视或其他慢性应激源。根据这些初步数据，我们将 检查换班、日常心理过程和睡眠之间的预期相互关系 来自不同SES背景的400名年龄在35-54岁的非裔美国女性中的骚乱。移位和 主观睡眠质量将通过有效的问卷调查来衡量，睡眠持续时间和连续性将 在14天的基线过程中通过活动描记进行评估，以便阐明 暂时性，随访12个月。为了让我们更深入地了解如何转变 可能会导致夜间睡眠障碍，日间压力的报告，负面情绪和 警觉性将通过每日日记进行评估，同时在14天内进行活动评估。 最后，我们将检验我们假设的关系是否会因社会经济地位而恶化 (SES)，这可能会增加转移的可能性，或者通过促进积极的弹性因素来改善 社会互动和自我照顾(情感支持、参加宗教服务、自我同情)。一个 探索性目标还将检查轮班、睡眠障碍和冠心病风险之间的联系。

PROJECT SUMMARY African-American women have strikingly high rates of coronary heart disease (CHD)-related death and disability compared to women of all other racial/ethnic groups. This excess burden has persisted for decades, and is on the rise among young to middle-aged women. Emerging evidence suggests that sleep disturbance (e.g., short sleep duration, poor sleep continuity) may be an important driver of CHD risk in African-American women; however, because most research on sleep disturbance in African-American women has focused on comparisons to women from other racial/ethnic groups, there are substantial gaps in knowledge about factors that might promote and protect against sleep disturbance within African-American women. Such information will be critical for the development of targeted intervention efforts to improve sleep and ultimately reduce CHD risk in this population. The proposed project is designed to examine whether and how “Shifting” -- a novel, sociocultural phenomenon hypothesized to be salient among African-American women-- might impact sleep disturbance among this group. Shifting is defined as a seemingly adaptive practice in which African-American women engage in self-altering behaviors to both fit in with dominant society and accommodate African- American men. Although documented in qualitative studies and anecdotal accounts of African-American women’s experiences over the past 30 years, empirical studies of shifting have only recently emerged, and none have focused on health. We have compelling preliminary data on early middle aged African-American women, indicating that reports of Shifting (e.g., changing speech patterns, downplaying accomplishments, self- silencing) are associated with subjective sleep disturbance and body mass index (BMI), not explained by depressed affect, or discriminatory or other chronic stressors. Building on this preliminary data, we will examine the prospective interrelationships among shifting, day-to-day psychological processes, and sleep disturbance in 400 African-American women aged 35-54 from a range of SES backgrounds. Shifting and subjective sleep quality will be measured with validated questionnaires, and sleep duration and continuity will be assessed via actigraphy over the course of 14 days at baseline, and in order to shed some light on temporality, at a 12-month follow up. In order to provide us with a more in-depth understanding of how shifting might contribute to sleep disturbance on a night-to-night basis, reports of day-to-day stress, negative affect and vigilance will be assessed via daily diaries concurrent with the actigraphy assessment over the 14-day period. Finally, we will examine whether our hypothesized relationships are exacerbated by socioeconomic status (SES), which might increase the likelihood of Shifting, or ameliorated by resilience factors that promote positive social interactions and self-care (emotional support, religious service attendance, self-compassion). An exploratory Aim will also examine linkages between Shifting, sleep disturbance, and CHD risk.