American Indian/Alaska Natives (AI/ANs) are one of the most at-risk racial/ethnic groups in the United States for adverse cardiometabolic (CM) and behavior health (BH) outcomes, including cardiovascular disease (CVD), diabetes, obesogenic behaviors and alcohol and other drug (AOD) use problems. Urban AI/ANs constitute over two-thirds of the total AI/AN population and represent a highly disenfranchised and marginalized population who may be at particular risk for CM and BH problems, but they have been significantly under-represented in health studies. Adolescence is a critical developmental period for understanding the emergence of CM and BH problems in vulnerable populations, as behavioral health risk factors often begin in adolescence and early onset of CM dysregulation and BH problems can set the stage for widening health disparities that continue long into adulthood. Sleep is an important but understudied risk factor that may contribute to CM and BH problems in adolescents, but no prior studies have investigated the role of sleep in contributing to health disparities in urban AI/AN youth. The current proposal builds on our team?s extensive experience conducting research with urban AI/AN youth and provides a comprehensive, mixed method approach to investigate the role of sleep disturbances in contributing to health behaviors and clinically relevant health outcomes in a culturally sensitive, community-informed, and integrated framework. Specifically, this project incorporates a longitudinal assessment of objectively and subjectively measured sleep, multiple dimensions of BH problems, including tobacco, caffeine, and alcohol and other drug use, physical inactivity and electronic media use, measured CM risk factors, and qualitative methods to better understand the social and cultural context of sleep in urban AI/AN youth and the influence on downstream BH and CM problems. Outcomes from this work will address several key knowledge gaps, which are crucial to better understand pervasive health disparities among urban AI/AN youth, to identify which youth are most at risk, and to inform a future novel and culturally- sensitive intervention within this underserved community.

Public Health Relevance

Urban American Indian/Alaska Native (AI/AN) adolescents experience significant health disparities, including increased risk for cardiometabolic and behavioral health problems, yet this group has been significantly under- represented in health research. The current study will fill several critical gaps in the knowledge base with substantial implications for public health by being the first to examine how sleep disturbances contribute to adverse cardiometabolic and behavioral health outcomes in urban AI/AN youth. Understanding the emergence of health disparities in adolescence and identifying novel targets of prevention and intervention is critical to reduce pervasive health inequities in this vulnerable population.

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Research Project (R01)
Project #
5R01MD012190-03
Application #
9660343
Study Section
Biobehavioral Mechanisms of Emotion, Stress and Health Study Section (MESH)
Program Officer
Das, Rina
Project Start
2017-08-10
Project End
2022-03-31
Budget Start
2019-04-01
Budget End
2020-03-31
Support Year
3
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Rand Corporation
Department
Type
DUNS #
006914071
City
Santa Monica
State
CA
Country
United States
Zip Code
90401
Berger, Aaron T; Widome, Rachel; Troxel, Wendy M (2018) SCHOOL START TIME AND PSYCHOLOGICAL HEALTH IN ADOLESCENTS. Curr Sleep Med Rep 4:110-117