Addressing sleep health disparities from within: A community-engaged study to understanding sleep and cardiometabolic disease risk among women of color

摘要 有色人种女性患心脏代谢性疾病(如心血管疾病、糖尿病、 高血压)。尽管流行病学研究表明睡眠时间短，睡眠质量差 增加心脏代谢性疾病的风险，很少有研究检查睡眠时间短和 从有色人种女性的角度来看，睡眠质量很差。这个项目建立在我们团队与 犹他州社区面孔，一个连接犹他州大学和犹他州卫生部的组织 有四个当地有色人种社区(黑人/非裔美国人，西班牙裔/拉丁裔，夏威夷土著/太平洋岛民 和非洲移民/难民)。我们的团队之前完成了为期12个月的社区卫生工作者(CHW) 对485名妇女进行了改善饮食和体力活动的健康干预；然而，结果是 表示睡眠是一种未得到满足的需求(41%的人报告睡眠时间为7小时，但只有12%的人对此感兴趣 改善睡眠)。我们的结果和其他研究表明，需要更多的研究来了解睡眠是如何产生的 被有色人种女性生活中的其他责任和要求所折衷。为了解决这一差距，我们正在 提出社区参与的混合方法研究，以促进对时间利用方式的理解 影响有色人种女性的睡眠和心脏代谢性疾病风险。我们的研究将利用三个步骤 过程：在目标1中，我们将从收集CHW中的定性数据(焦点小组)开始，以进行深入的 理解女性如何平衡睡眠和其他需求，从她们作为社区的角度 作为值得信赖的前线公共卫生工作者；在目标2中，我们将利用重点小组的成果 对来自四个参与社区的400名有色人种妇女进行实地研究，以检查 时间使用、睡眠、饮食、体力活动和心脏代谢健康之间的关系以及使用创新 了解时间权衡对睡眠和心脏代谢影响的统计建模技术 在目标3中，我们将使用干预地图框架来综合重点小组的结果 和实地研究，并与我们的社区咨询委员会一起计划下一步的干预措施。这项研究是 在探索睡眠中未被充分研究的机制方面具有创新性，即评估人群的睡眠健康 通常不包括在睡眠研究中(夏威夷原住民/太平洋岛民、非洲移民/难民)，以及 我们与CHW的合作，这些一线公共卫生工作者在睡眠研究中未得到充分利用。我们的 长期的合作伙伴关系支持可行性、对社区的有用性以及我们快速翻译的能力 结果是改善有色人种女性的睡眠和心脏代谢性疾病风险的干预措施。

Abstract Women of color have increased rates of cardiometabolic disorders (e.g., cardiovascular disease, diabetes, hypertension). Although epidemiologic studies demonstrate short sleep duration and poor sleep quality increase cardiometabolic disease risk, few studies have examined mechanisms of short sleep duration and poor sleep quality from the perspectives of women of color. This project builds on our team’s collaboration with Community Faces of Utah, an organization that links the University of Utah and Utah Department of Health with four local communities of color (Black/African American, Hispanic/Latinx, Native Hawaiian/Pacific Islander and African Immigrant/Refugee). Our team previously completed a 12-month community health worker (CHW) delivered wellness intervention in 485 women that improved diet and physical activity; however, results indicated sleep was an unmet need (41% reported sleep duration <7 hours but only 12% were interested in sleep improvement). Our results and others suggest that more research is needed to understand how sleep is traded off for other responsibilities and demands in the lives of women of color. To address this gap, we are proposing a community engaged mixed-methods study to advance the understanding of how time use affects sleep and cardiometabolic disease risk among women of color. Our study will utilize a 3-step process: In Aim 1, we will begin by collecting qualitative data (focus groups) among CHWs for an in-depth understanding of how women balance sleep and other demands, both from their perspectives as community members and as trusted front-line public-health workers; In Aim 2, we will utilize results from the focus groups to conduct a field study among 400 women of color from the four participating communities to examine the relationships between time use, sleep, diet, physical activity, and cardiometabolic health and use innovative statistical modeling techniques to understand the impact of time trade-offs on sleep and cardiometabolic health; and in Aim 3, we will use an intervention mapping framework to integrate the results of the focus groups and field study, and plan the next step interventions with our community advisory board. This study is innovative in exploration of an understudied mechanism in sleep, evaluation of sleep health in populations often not included in sleep research (Native Hawaiians/Pacific Islanders, African Immigrant/ Refugees), and in our collaboration with CHWs, front-line public health workers who are underutilized in sleep research. Our long-standing partnerships support feasibility, usefulness to the community and our ability to rapidly translate results into interventions to improve sleep and cardiometabolic disease risk among women of color.