The Social Patterning in a Multi-ethnic Population: Associations of Socioeconomic Position, Neighborhood Characteristics and Psychosocial Stressors with Sleep.

Although sleep is instrumental for health and well-being, the vast majority of adults have sleep problems at least a few nights a week or more. Poor sleep is associated with a host of chronic diseases that disproportionately affect minority populations. Evidence indicates minority populations have poorer sleep than non-Hispanic whites. Recent research suggests that socioeconomic position (SEP) neighborhood characteristics and psychosocial stressors may be novel risk factors for sleep outcomes worthy of further exploration, particularly among minority populations where research is lacking. This dissertation uses data from the Stroke Health and Risk Education (SHARE) Project and the Jackson Heart Study (JHS) to investigate the cross-sectional associations of SEP, neighborhood characteristics and psychosocial stressors with sleep outcomes (duration, sleepiness, quality) in Hispanic and African Americans. Multinomial logistic and linear regression models were used to examine the associations of each exposure with sleep duration (short vs. normal, long vs. normal, and continuous sleep duration) and sleep quality after adjustment for demographics, SEP, and risk factors. In the first analysis, we investigated associations between neighborhood characteristics (safety, disadvantage, crime) and sleep (duration and daytime sleepiness) among participants in the SHARE project, a predominantly Hispanic American population. Lower neighborhood safety was associated with a higher daytime sleepiness score after adjustment for confounders. The second analysis using JHS data investigated associations between SEP (education and income), neighborhood characteristics (social cohesion, violence, problems, disadvantage) and sleep (duration and quality) in a population of African Americans. Low individual SEP was associated with long sleep and poor sleep quality; and adverse neighborhood characteristics were associated with longer average sleep duration and poor sleep quality after adjustment for confounders. Lastly, we investigated the associations of psychosocial stressors with sleep (duration, quality) using data from the JHS. Higher levels of psychosocial stressors were associated with short sleep, shorter average sleep duration and poorer sleep quality after adjustment for confounders. The findings of this dissertation improve our understanding of the factors contributing to poor sleep among understudied racial/ethnic groups. Future studies should further examine these associations of SEP, adverse neighborhoods and psychosocial stressors and poor sleep using prospective cohort data.PhDEpidemiological ScienceUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/111512/1/daynaa_1.pd

Use of an interactive, faith-based kiosk by congregants of four predominantly, African-American churches in a metropolitan area

Chronic diseases are prevalent in ethnic communities. Churches represent a potent resource for targeted health promotion. A Faith-Based Kiosk (FBK) was developed as an informational tool and placed in four predominantly (>80%) African-American churches. Congregants were surveyed to describe Kiosk use, kiosk-user characteristics, health status, and self-reported behavior changes attributed to the kiosk. We analyzed 1,573 questionnaires. Mean age of respondents was 46.4 years and >70% were women. Older congregations (mean age > 46.1 years) had more reports of diabetes (p=0.002) and heart disease (p=0.01) than younger churches (mean age 40 years (p2 health conditions, adjusted Odds Ratio (95% Confidence Interval)=1.43 (1.0-2.0), p=0.05. Male Kiosk-users preferred to select disease-specific content, aOR=1.87 (1.10-3.17), p=0.02, while females tended to select information about supportive community resources, aOR=0.49 (0.23-1.04), p=0.062. Knowledge of Kiosk-user characteristics and the health status of a congregation, provide an opportunity for targeted, church-based health promotion

Pediatric Sleep: Current Knowledge, Gaps, and Opportunities for the Future.

This White Paper addresses the current gaps in knowledge, as well as opportunities for future studies in pediatric sleep. The Sleep Research Society's Pipeline Development Committee assembled a panel of experts tasked to provide information to those interested in learning more about the field of pediatric sleep, including trainees. We cover the scope of pediatric sleep, including epidemiological studies and the development of sleep and circadian rhythms in early childhood and adolescence. Additionally, we discuss current knowledge of insufficient sleep and circadian disruption, addressing the neuropsychological impact (affective functioning) and cardiometabolic consequences. A significant portion of this White Paper explores pediatric sleep disorders (including circadian rhythm disorders, insomnia, restless leg and periodic limb movement disorder, narcolepsy, and sleep apnea), as well as sleep and neurodevelopment disorders (e.g., autism and attention deficit hyperactivity disorder). Finally, we end with a discussion on sleep and public health policy. Although we have made strides in our knowledge of pediatric sleep, it is imperative that we address the gaps in our knowledge and the pitfalls of our methodologies. For example, more work needs to be done to assess pediatric sleep using objective methodologies (i.e., actigraphy and polysomnography), to explore sleep disparities, to improve accessibility to evidence-based treatments, and to identify potential risks and protective markers of disorders in children. Expanding trainee exposure to pediatric sleep and elucidating future directions for study will significantly improve the future of the field