Examining the Role of Sleep Disturbances in Contributing to Health Risk Behaviors and Cardiometabolic Outcomes in Urban Native American Youth

Project Summary/Abstract: The coronavirus pandemic poses unprecedented challenges for people across the lifespan, including youth,and are likely more pronounced for those who live with poverty and health inequities. American Indian/ AlaskanNatives (AI/ANs) are one of the highest risk racial/ ethnic groups for health disparities, and they are aparticularly vulnerable group for adverse health and socioeconomic impacts of the novel coronavirus pandemic(COVID-19). Only one prior study to date retrospectively assessed the long-term psychosocial impact ofquarantine on youth and families following an infectious disease outbreak (H1N1 or SARS), and none haveassessed the impact on youth in the midst of the pandemic. AI/AN adolescents experience disproportionatelyhigh rates of comorbidities known to exacerbate the negative effects of the novel coronavirus, including heartdisease, diabetes, obesity, as well as behavioral health problems, including depression and alcohol and otherdrug (AOD) use problems, which may be exacerbated during stay-at-home orders. This application is beingsubmitted in response to NOT MD-20-019 Notice of Special Interest: Competitive and AdministrativeSupplements for the Impact of COVID-19 Outbreak on Minority Health and Health Disparities. Our aims are asfollows: Aim 1a. Using two waves of data (baseline and during the coronavirus pandemic), we will examinechanges in individual (e.g., technology use), family (e.g., conflict and cohesion), community (e.g., sense ofcommunity), and cultural (e.g., engagement in cultural activities) risk and protective factors, and changes insleep, risk-taking and mental health (depression, anxiety, and post-traumatic stress disorder, PTSD). Aim 1b:Using two waves of data, we will examine how changes in risk and protective factors influence changes insleep, risk-taking behaviors, mental health. For example, we hypothesize that increases in food insecurity willbe associated with greater increases in sleep problems, risk-taking behaviors and mental health problems,whereas increases in engagement in cultural activities will be associated with better outcomes. Aim 2. Usingthe newly added COVID-19 specific questions, we will examine the association between COVID-19 relatedknowledge, risk perception, and behavioral responses, and challenges related to COVID-19 public healthmeasures (e.g., being affected by school closings) and sleep, risk-taking behaviors, and mental health. Aim 3.Randomly select a subsample (N=25) of adolescents and administer qualitative interviews to examine how thecoronavirus outbreak has affected AI/AN adolescent sleep habits, routines, and behaviors. This study willfacilitate better understanding of how to plan support services and prevention measures for this underservedgroup of adolescents. Our findings will also move the field forward as this is the only study of sleep health inthe context of the coronavirus among urban AI/AN youth.