杰克逊心脏研究参与者中邻里社会压力源与睡眠之间的关系：通过体育活动和心理社会压力源的中介作用
Relationships between neighborhood social stressors and sleep among Jackson Heart Study participants: mediation through physical activity and psychosocial stressors.
作者信息
Tamura Kosuke, Johnson Dayna A, Neally Sam J, Sims Mario, Powell-Wiley Tiffany M
机构信息
Socio-Spatial Determinants of Health (SSDH) Laboratory, Population and Community Health Sciences Branch, Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
出版信息
Sleep Adv. 2022 Sep 15;3(1):zpac032. doi: 10.1093/sleepadvances/zpac032. eCollection 2022.
STUDY OBJECTIVES
To examine associations between perceived neighborhood social environment (PNSE) and sleep, mediated by physical activity (PA) and psychosocial stressors.
METHODS
A sample ( = 4705) of African Americans (mean age 55.0 years; 63.4% female) enrolled in the 2000-2004 Jackson Heart Study (JHS). Four self-reported sleep outcomes were analyzed: sleep duration (minutes/night), sleep quality (high/low), short sleep (short ≤ 6 h vs recommended = 7-8 h), and long sleep (long ≥ 9 h vs recommended). PNSE factors included violence (e.g. robbery), problems (trash/litter), and social cohesion (trusting neighbors). PA and psychosocial stressors (lifetime and everyday discrimination, perceived stress, and depressive symptoms) were tested as mediators. With bootstrap-generated 95% bias-corrected confidence intervals (BC CIs), linear regression was used to test for mediation adjusting for covariates.
RESULTS
Neighborhood violence and problems were associated with sleep duration, mediated through PA ( = -1.97, 95% = -3.76, -0.60; = -1.23, 95% = -2.55, -0.27, respectively), lifetime discrimination ( = 2.61, 95% = 0.93, 4.80; = 2.25, 95% = 0.93, 3.94), perceived stress ( = -3.08, 95% = -6.20, -0.41; = -2.17, 95% = -4.33, -0.28), and depressive symptoms ( = -2.22, 95% = -5.09, -0.25; = -1.94, 95% = -4.10, -0.35). Social cohesion was positively associated with sleep duration, mediated through PA, lifetime discrimination, and perceived stress. Similar patterns were demonstrated for binary outcomes. Yet, effect sizes were relatively small. PNSE was neither directly nor indirectly associated with sleep outcomes by everyday discrimination.
CONCLUSIONS
Each PNSE factor was associated with sleep outcomes, mediated by PA and psychosocial stressors. Further research should emphasize effective community efforts to decrease adverse neighborhood conditions and psychosocial factors and increase PA; thereby reducing CVD events for African Americans.
研究目的
探讨由身体活动（PA）和心理社会压力源介导的邻里社会环境认知（PNSE）与睡眠之间的关联。
方法
对参与2000 - 2004年杰克逊心脏研究（JHS）的4705名非裔美国人（平均年龄55.0岁；63.4%为女性）进行抽样研究。分析了四项自我报告的睡眠结果：睡眠时间（分钟/晚）、睡眠质量（高/低）、短睡眠（短≤6小时与推荐的7 - 8小时相比）和长睡眠（长≥9小时与推荐的相比）。PNSE因素包括暴力（如抢劫）、问题（垃圾/杂物）和社会凝聚力（信任邻居）。PA和心理社会压力源（终身和日常歧视、感知压力和抑郁症状）作为中介变量进行测试。通过自抽样生成95%偏差校正置信区间（BC CIs），使用线性回归来测试中介作用，并对协变量进行调整。
结果
邻里暴力和问题与睡眠时间相关，通过PA（β = -1.97，95% CI = -3.76， -0.60；β = -1.23，95% CI = -2.55， -0.27，分别）、终身歧视（β = 2.61，95% CI = 0.93，4.80；β = 2.25，95% CI = 0.93，3.94）、感知压力（β = -3.08，95% CI = -6.20， -0.41；β = -2.17，95% CI = -4.33， -0.28）和抑郁症状（β = -2.22，95% CI = -5.09， -0.25；β = -1.94，95% CI = -4.10， -0.35）介导。社会凝聚力与睡眠时间呈正相关，通过PA、终身歧视和感知压力介导。二元结果也呈现出类似模式。然而，效应大小相对较小。PNSE与日常歧视导致的睡眠结果既无直接关联也无间接关联。
结论
每个PNSE因素都与睡眠结果相关，由PA和心理社会压力源介导。进一步的研究应强调有效的社区努力，以减少不良邻里条件和心理社会因素，并增加PA；从而降低非裔美国人的心血管疾病事件。
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