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

项目摘要 非裔美国妇女冠心病（CHD）相关死亡率高得惊人， 与所有其他种族/族裔群体的妇女相比，这种过度负担已经持续了几十年， 而且在年轻到中年的女性中呈上升趋势。新的证据表明睡眠障碍 (e.g.,睡眠持续时间短，睡眠连续性差）可能是非洲裔美国人CHD风险的重要驱动因素 然而，由于大多数关于非洲裔美国妇女睡眠障碍的研究都集中在 与其他种族/族裔群体的妇女相比， 这可能会促进和保护非洲裔美国妇女的睡眠障碍。此类信息 将是关键的发展有针对性的干预措施，以改善睡眠，并最终减少冠心病 这一人群的风险。拟议中的项目旨在研究是否以及如何"转移"-一本小说， 一种假设在非裔美国妇女中很突出的社会文化现象--可能影响睡眠 这群人之间的矛盾。轮班被定义为一种看似适应性的做法， 妇女从事自我改变行为，以适应主流社会，并适应非洲- 美国男人虽然在定性研究和非裔美国人的轶事记录， 虽然过去30年来妇女的经验，但最近才出现了关于转变的实证研究， 没有一个国家把重点放在健康方面。我们有令人信服的初步数据显示， 女性，表明转移的报告（例如，改变说话方式，贬低成就，自我， 沉默）与主观睡眠障碍和体重指数（BMI）有关，不能解释为 抑郁情绪、歧视或其他慢性压力源。根据这些初步数据，我们将 研究变化、日常心理过程和睡眠之间的潜在相互关系 在400名35 - 54岁的非洲裔美国妇女从一系列SES背景的干扰。移位和 主观睡眠质量将通过有效的问卷进行测量，睡眠持续时间和连续性将 在基线时的14天内通过腕动计进行评估， 暂时性，12个月随访时。为了让我们更深入地了解 可能会导致夜间睡眠障碍，报告日常压力，负面影响， 在14天期间，通过每日日记与活动记录仪评估同时评估警戒。 最后，我们将检验我们的假设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，或通过促进积极的弹性因素得到改善 社会互动和自我照顾（情感支持，宗教服务出席，自我同情）。一个 探索性目的还将检查移位，睡眠障碍和CHD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.