0238 Neighborhood Determinants of Sleep and the Moderating Role of Cultural Factors Among American Indian and Alaska Native Adolescents

Abstract

Abstract Introduction Increasing evidence suggests the neighborhood social environment may be an important predictor of sleep, yet this has not been explored among urban American Indian and Alaska Native (AI/AN) adolescents, a population that faces significant health disparities due to exposure to historic and contemporary stressors. This study aimed to examine the association between neighborhood social environment and sleep among Native adolescents as well as the moderating role of cultural factors in this association. Methods The sample included 133 AI/AN adolescents (age 12 to 16) residing in urban settings in California (57.1% female, Mage=14.03, SDage=1.35). Perceived neighborhood social environment included safety and cohesion. Perceived cultural factors included identification with Native culture (e.g., I feel a strong attachment towards my tribal group) and historical loss (e.g., Losing our culture). Sleep duration, efficiency, and wake after sleep onset (WASO) were measured via actigraphy. Subjective sleep disturbance was measured via questionnaire. Age, sex, mother’s education, depression, anxiety, and body mass index (BMI) were included as covariates. Results Greater neighborhood safety was significantly associated with lower sleep disturbance (b = -2.17, SE = .8, p = .008), higher sleep efficiency (b = -2.17, SE = .8, p = .008), and lower WASO (b = -2.17, SE = .8, p = .008), even after covariate adjustment. Neighborhood cohesion was not associated with any sleep outcomes. Cultural factors moderated the association between neighborhood social environment and sleep outcomes (p’s<.05 for moderation). Specifically, both neighborhood safety and cohesion predicted lower sleep disturbance only among individuals with greater cultural identity. Further, neighborhood safety predicted greater sleep efficiency and lower WASO only among individuals with greater historical loss. Conclusion Findings from this study move the field forward in understanding sleep health among AI/AN adolescents and address the moderating role of culture between neighborhood environment and sleep. The association between neighborhood social environment and sleep outcomes was more robust for urban AI/AN adolescents who more strongly identified with their Native culture and who reported thinking about historical loss more frequently. Research should consider intersecting aspects of social context in predicting sleep outcomes, particularly among groups that face sleep and other health disparities. Support (if any)