Predicting Sleep, Smoking and Lung Health Disparities in at-risk Black African American Adults

项目摘要 黑人/非裔美国人(Baas)更有可能报告睡眠时间不足(&lt；7小时) 和其他睡眠不足(例如，睡眠质量差)，并患有晚期慢性 阻塞性肺疾病(COPD)，比吸烟相似的非西班牙裔白人(NHW) 行为。睡眠不足与：(1)持续吸烟，以及(2) 健康成年人的肺功能受损。因此，睡眠不足可能是一种“上游” 初级和/或二级预防目标，以解决烟草使用方面的种族差异和 慢性阻塞性肺疾病的发病和进展。未知的是多层次的(即，个人、社会和 环境)预测睡眠时间不足和其他睡眠不足的因素 不同时间的BAA，以及睡眠不足在多大程度上预示着更差的健康结果 例如，BAA吸烟者持续吸烟和肺功能恶化。要解决这些问题 知识差距，我们将进行一项多学科的5年前瞻性观察研究， 将登记并跟踪480名目前吸烟者、年龄较大的BA的代表性样本 &gt；39岁，有前驱症状(黄金0期)或早期COPD(黄金1-2期)。 我们将前瞻性地检查关键的个人、社会和环境变量， 客观测量睡眠指标、烟草使用、炎症标志物和肺功能 这个健康状况截然不同的样本。纵向混合、分类回归、结构性 方程建模将定义睡眠的关键预测因素(和未来的干预目标 BAA的缺陷以及睡眠不足(和其他睡眠)的程度 缺乏)与吸烟和炎症标志物相互作用以预测肺恶化 功能。这项工作的预期结果是定义以下项目的多级别风险表型 在这种截然不同的健康中，睡眠不足、持续吸烟和肺功能恶化 中年BAA吸烟者。这项工作直接与NIMHD相一致，并推动了NIMHD 开展和支持研究少数群体健康和健康差距的使命。

Project Abstract Black/African American's (BAAs) are more likely to report insufficient sleep duration (<7 hours) and other sleep deficiencies (e.g., poor sleep quality), and to have advanced Chronic Obstructive Pulmonary Disease (COPD), than Non-Hispanic Whites (NHW) with similar smoking behaviors. Insufficient sleep has been related to: (1) continued cigarette smoking, and (2) impaired lung function in healthy adults. Thus, sleep deficiencies could be an “upstream” primary and/or secondary prevention target to address racial disparities in tobacco use and COPD onset and progression. Not known are the multi-level (i.e., individual, social and environmental) factors that predict insufficient sleep duration and other sleep deficiencies in BAA's across time, and the extent to which sleep deficiencies predict poorer health outcomes such as continued tobacco use and worsening lung function in BAA smokers. To address these knowledge gaps, we will conduct a multi-disciplinary 5-year prospective observational study that will enroll and follow a representative sample of 480 BAAs who are current smokers, are aged >39 years, and who have prodromal (GOLD stage 0) or early stage COPD (GOLD stage 1-2). We will prospectively examine key individual, social, and environmental variables in concert with objectively measured sleep metrics, tobacco use, inflammatory markers, and lung function in this health disparate sample. Longitudinal mixed, classification and regression, and structural equation modeling will define key predictors (and future intervention targets) of sleep deficiencies in BAA's as well as delineate the extent to which insufficient sleep (and other sleep deficiencies) interact with tobacco use and inflammation markers to predict worsening lung function. The expected outcome from this work is to define multi-level phenotypes of risk for sleep deficiencies, continued tobacco use, and worsening lung function in this health disparate population of mid-life BAA smokers. This work directly aligns with, and advances the NIMHD mission to conduct and support research in minority health and health disparities.