Sleep Health Disparities and Socioecological Risk Factors Among Montana Youth

Project Leader Cara Palmer, Ph.D.
MSU Department of Psychology
cara.palmer@montana.edu 

Insufficient sleep is one of the most common yet modifiable public health problems facing adolescents, and rates of poor sleep have continually increased over the last decade. Understanding sleep health disparities may be especially relevant for adolescents living in rural communities across Montana, where access to health care is limited and rates of mental health difficulties directly impacted by sleep are high (e.g., depressive symptoms, suicide). However, the prevalence of sleep problems and the unique barriers and socioecological factors that predict sleep health among rural teens are still poorly understood.

This two-year pilot project examined sleep in one rural Montana community. Using a community-based participatory approach and a combination of interviews and focus groups, in Year 1 Dr. Palmer developed and refined a socioecological model of sleep to identify key community-, family-, and individual-level influences on sleep health in rural adolescents. The second-year project continued ongoing collection of intensive objective sleep and mental health data (actigraphy, cortisol, clinical assessments) in this community. This project also expanded knowledge by targeting a representative adolescent sample across multiple regions of Montana to complete a structured interview and surveys to examine rates of sleep disorders, sleep health characteristics, barriers to sleep-based care and education, and to capture socioecological risk and protective factors that may vary across and within rural communities.

The long-term goal of this project is to inform translational research to reduce sleep health disparities and downstream mental health difficulties among underserved, rural adolescents. Specific aims for this project included: 1) determine associations between sleep and mental health among adolescents in one rural Montana community using an intensive, multi-method design; 2) examine rates of sleep health disparities and barriers to sleep-based education and health care among a large, representative sample of Montana adolescents; and 3) identify key community-, family-, and individual-level risk and protective factors for adolescent sleep health across the state.

Overall, data collected from this project will provide quantitative statewide epidemiological data related to a broad range of adolescent sleep health disparities and identify modifiable targets for prevention and intervention in at-risk rural youth.