Faculty Bibliography

Introduction: Little has been done to examine within/between group predictors and mediators of race/ethnic differences in sleep health outcomes, due to COVID-19 exposure. We evaluated the effect of COVID-19 exposure on sleep quality in a multiracial/ethnic sample of New York residents.
Method(s): We conducted a cross-sectional study among adults exposed to COVID-19 across New York State from September to November of 2020. Comparisons of participant characteristics e.g., mean scores by race/ethnicity status were made using one-way ANOVA for continuous variables, and chi-square tests for categorical variables. Associations between social determinants of health (employment, location), Trauma Coping Self-Efficacy (CES-T), and sleep quality (Pittsburgh Sleep Quality Index-PSQI) were examined using multilinear regression analysis stratified by race/ethnicity.
Result(s): Of the 541 participants, 373 (68.9%) were female; mean age was 40.9 years (SD=15), 198 (36.6%) identified as Whites, 111 (20.5%) as Black, 97 (17.9%) as Hispanics, and 135(25%) identified as either Asians, Native-Americans, Pacific-Islanders. Sex was the strongest predictor [beta = 1.335; p < .05] of sleep quality, but only among Whites. Trauma Coping Self-Efficacy was negatively associated with sleep quality among Asian, Native-American, or Pacific- Islander participants [beta = -.114; p < .05 ]; Black [beta = -.099; p < .05] and White participants [beta = -0.79; p < .05] but not among Latinos/ as [beta = -.058; p = 0.71].
Conclusion(s): Coping Self-Efficacy moderated the effect of COVID-19 on sleep quality among some, but not all, racial/ethnic groups. While CSE-T scores during the first wave of COVID-19 acted as a protective factor for sleep quality among Asians, Native-Americans, and Pacific- Islanders, White and Black participants, this was not the case for Latinos/as/Hispanics residing in New York. Clinical interventions that are tailored for racial/ethnic, community and cultural needs may help to mitigate sleep problems associated with COVID-19 exposure

Our study examines the acceptability and feasibility of Moshi, an audio-based mobile application, among children 3-8 years old using a parent-child dyadic approach. Our 10-day within-subject pre-post study design consisted of five nights of a normal bedtime routine and a subsequent five nights exposed to one story on the Moshi application during the intervention. Each five-night period spanned three weeknights and two weekend nights. The Short-Form Children's Sleep Habits Questionnaire (SF-CSHQ) was used to measure children's sleep at baseline and post-intervention. The PROMIS, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were used to assess parents' sleep. Among the 25 child-parent dyads, the mean child age was 4 (SD = 1.23) and 63% were male (n = 15). Mean parent age was 35 (SD = 5.83), 84% were female (n = 21), and 48.0% were Black (n = 12). For child-only comparisons, mean post-SF-CSHQ measures were lower compared to baseline. A trend in parent sleep is reported. This study shows the potential of an audio-based mobile sleep aid to improve sleep health in a racially diverse parent and child dyad sample.

Patient health literacy is vital to clinical trial engagement. Knowledge and beliefs about clinical trials may contribute to patient literacy of clinical trials, influencing engagement, enrollment and retention. We developed and assessed a survey that measures clinical trial health knowledge and beliefs, known as the Clinical trial HEalth Knowledge and belief Scale (CHEKS). The 31 survey items in CHEKS represent knowledge and beliefs about clinical trial research (n = 409) in 2017. We examined item-scale correlations for the 31 items, eliminated items with item-scale correlations less than 0.30, and then estimated internal consistency reliability for the remaining 25 items. We used the comparative fit index (CFI) and the root mean squared error of approximation (RMSEA) to evaluate model fit. The average age of the sample was 34 (SD = 15.7) and 48% female. We identified 6 of the 31 items that had item-scale correlations (corrected for overlap) lower than 0.30. Coefficient alpha for the remaining 25 items was 0.93 A one-factor categorical confirmatory factor analytic model with 16 correlated errors was not statistically significant (chi-square = 10011.994, df = 300, p &lt; 0.001) but fit the data well (CFI = 0.95 and RMSEA = 0.07). CHEKS can assess clinical trial knowledge and beliefs.

Objective/UNASSIGNED:The study objective was to examine predictors of sleep disturbance and strain among caregivers of persons living with dementia (PLWD). Methods/UNASSIGNED:This cross-sectional study utilized a sample of community-dwelling older adults and their family caregivers drawn from the 2017 National Health and Aging Trends Study and National Study of Caregiving. Multivariable logistic regression was used to assess the association between caregiver and PLWD characteristics and a composite measure of caregiving strain. High caregiving strain was defined as a total score of ≥ 5 on the 6 caregiving strain items (e.g., emotional difficulty, no time for self). We used multivariable proportional odds models to examine predictors of caregiver sleep-related outcomes (trouble falling back to sleep and interrupted sleep), after adjusting for other caregiver and PLWD factors. Results/UNASSIGNED:Of the 1,142 family caregivers, 65.2% were female, 15% were Black, and 14% were Hispanic. Average age was 60 years old. Female caregivers were more likely to report high level of strain compared to male caregivers (OR: 2.61, 95% CI = 1.56, 4.39). Compared to non-Hispanic Whites, non-Hispanic Black and Hispanic caregivers had reduced odds of reporting greater trouble falling back asleep [OR = 0.55, CI (0.36, 0.82) and OR = 0.56, CI (0.34, 0.91), respectively]. The odds of reporting greater trouble falling back asleep was significantly greater among caregivers with high blood pressure vs. caregivers without high blood pressure [OR = 1.62, CI (1.12, 2.33)]. Conclusion/UNASSIGNED:In this cross-sectional study, caregivers with greater sleep difficulty (trouble falling back asleep) were more likely to report having high blood pressure. We found no racial/ethnic differences in interrupted sleep among caregivers to PLWD. These results suggest that interventions to improve sleep among caregivers to PLWD may decrease poor cardiovascular outcomes in this group.

Objective and Objective/UNASSIGNED:Obstructive Sleep Apnea (OSA) is a highly prevalent disorder that disparately affects racial/ethnic minorities. OSA functional health literacy can contribute to health disparities. Documenting poor OSA functional health literacy is needed to inform research agendas, policy, and advocacy efforts. The objective of this study is to develop a scale for measuring OSA functional health literacy among diverse audiences and a variety of reading levels and to ascertain its reliability and validity. Methods/UNASSIGNED:Development of the 18-item Survey of OSA Functional Health Literacy (SOFHL) was guided by literature review and input from experts. A convenience sample of persons enrolled in a clinical trial completed the survey (n=194). The psychometric evaluation was conducted using factor analysis to identify the number of dimensions in the SOFHL and their relationship to other domains that are relevant to OSA functional health literacy. Results/UNASSIGNED:Internal consistency reliability (alpha) was estimated for the resulting scale and correlations with educational attainment and income completed. All respondents were Black and 29% reported average household income less than $10,000 USD. Confirmatory factor analysis provided support for two dimensions: OSA general knowledge (alpha=0.81) and self-efficacy for OSA self-management (alpha=0.71). Conclusions/UNASSIGNED:Higher educational attainment and socioeconomic status were associated with better OSA functional health literacy. These results provide preliminary support for the SOFHL, a measure that can be used to assess OSA functional health literacy.