Stress, Coping, and Sleep Health Study
Background:
Poor sleep is common among refugee groups worldwide. It can lead to an increased risk of heart disease, diabetes, cancer, and premature death. It can also worsen mental health disorders. Researchers have studied the mental health issues among refugees from Bhutan in the United States. Now they want to understand more about how difficulty sleeping may relate to their other health outcomes.
Objective:
To learn how the social and environmental conditions Bhutanese refugees affect their sleep health and health outcomes.
Eligibility:
Refugees aged 18 years and older of Bhutanese-Nepali or Bhutanese American descent. The participants must live in central Ohio. Also needed are people aged 18 years and older who interact with Bhutanese refugees in this region.
Design:
Participants will participate in a focus group discussion. The group will have 8 to 10 participants. It will last 60 to 90 minutes.
They will talk about their experiences as a refugee and their sleep health. Topics may include adjusting to a new culture; access to housing and health care; and experiences with differential treatment by members inside and outside of their group. The study team will audio record the discussion. They will not share the recording with anyone.
Participants will complete a short questionnaire. They will answer questions about their age, sex, language preferences, and how long they have lived in the United States.
Participants who are not refugees will take part in a virtual interview led by a member of the study team. Participants will share their experiences with adapting to a new culture, differential treatment, and other factors have affected refugees sleep. The interview will take about 1 hour.
Descripción general del estudio
Estado
Condiciones
Descripción detallada
Study Description:
This qualitative study seeks to examine the role of discrimination, acculturative stressors, and coping mechanisms in shaping the sleep health of Bhutanese refugees living in Central Ohio. Using focus group discussions (n=approximately 6) with Bhutanese refugees and key informant interviews (n=approximately 10) with community leaders, the study will examine associations between refugee-related stressors-such as trauma, discrimination, and acculturation challenges-and sleep health. It will also explore coping strategies employed in response to sleep difficulties, experiences of discrimination, and other stressors, and identify recommendations for enhanced community resources and support.
Objectives:
The primary objectives of this study include:
- Investigate associations between stressors related to being a refugee (e.g., trauma, financial strain, discrimination, acculturation, political) and various sleep health dimensions.
- Identify coping strategies used in response to difficulties with sleep, discriminatory experiences, and other stressors.
- Determine recommendations regarding the types of support and resources needed by the Bhutanese refugee community to manage stressors and support sleep health.
Endpoints:
We will confirm that our study's primary objectives have been met once data saturation is achieved-that is, when no new themes, insights, or significant patterns emerge, indicating a comprehensive understanding of our three key research objectives. Additionally, we will evaluate whether the collected data contain sufficient depth, diversity of perspectives, and contextual detail to fully address our central research questions. This assessment will involve triangulation, using various data sources (e.g., Key Informant Interviews and Focus Group Discussions) to identify areas of thematic convergence.
Tipo de estudio
Inscripción (Estimado)
Contactos y Ubicaciones
Estudio Contacto
- Nombre: Chandra L Jackson, Ph.D.
- Número de teléfono: (984) 297-3701
- Correo electrónico: chandra.jackson@nih.gov
Ubicaciones de estudio
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Ohio
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Columbus, Ohio, Estados Unidos, 43229
- Bhutanese Community of Central Ohio
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Contacto:
- Sudarshan Pyakurel
- Número de teléfono: 614-396-8965
- Correo electrónico: spyakurel@bccoh.org
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Método de muestreo
Población de estudio
This study will enroll between 48-60 adults (18+ years) living in Ohio, US for Focus Group Discussions and 10 adults (18+ years) who work with or support Bhutanese Refugees living in Ohio.
Descripción
- INCLUSION CRITERIA:
In order to be eligible to participate in a FGD for this study, an individual must meet all of the following criteria:
- Adult (aged 18 years or older) living in Ohio, US
- Self-identify as Bhutanese-Nepali or Bhutanese American
- Identify as a refugee
- Speak and understand English and/or Nepali.
- Ability to understand and the willingness to provide informed consent and participate in the FGD
In order to be eligible to participate in a KII for this study, an individual must meet all of the following criteria:
- Adult (aged 18 years or older)
- Ability to speak and understand English; Familiarity with the lives and experiences of Bhutanese refugees living in Ohio, US
- Ability to understand and the willingness to provide informed consent and participate in the virtual KII.
EXCLUSION CRITERIA:
Individuals who are unable to communicate in either English or Nepali will be excluded from FGD. Since Nepali is the primary language spoken by most Bhutanese refugees before relocation, and English is the dominant language in the United States, participants are expected to have sufficient proficiency in at least one of these languages.
Individuals who are unable to communicate in English will be excluded from KII. Given their leadership roles and interactions with the healthcare system, educational institutions, local government service providers, and nonprofit organizations in Ohio-where English is the primary language-participants are expected to have sufficient English proficiency. We will not exclude any participants that meet the inclusion criteria from participating in the study overall or in any of the study procedures.
Children (individuals under 18) are excluded from this study because the knowledge sought is not relevant to this population. This study investigates the relationship between sleep quality and experiences of discrimination among Bhutanese-Nepali refugees in Ohio, as well as the coping mechanisms adults use to manage discrimination-related stress, particularly as it pertains to sleep.
The constructs under investigation, including perceived discrimination, its psychosocial impact, and adaptive coping strategies, are anchored in the adult experience of resettlement and the stressors associated with adult social and occupational life. Children's experiences of discrimination, sleep patterns, and coping mechanisms differ substantially from those of adults in both nature and context, and findings from an adult sample would not be generalizable to a pediatric population. For these reasons, the inclusion of children would not yield scientifically meaningful data relevant to the study aims.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Modelos observacionales: ECOLOGIC_OR_COMMUNITY
- Perspectivas temporales: CROSS_SECTIONAL
Cohortes e Intervenciones
Grupo / Cohorte |
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US Bhutanese
Those self-identifying as Bhutanese living in central Ohio. |
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Investigate associations between stressors related to being a refugee (e.g., trauma, financial strain, discrimination, acculturation, political) and various sleep health dimensions.
Periodo de tiempo: Will use qualitative best practices to determine when study objectives have been sufficiently achieved.
|
We will confirm that our study's primary objectives have been met once data saturation is achieved-that is, when no new themes, insights, or significant patterns emerge, indicating a comprehensive understanding of our three key research objectives. Additionally, we will evaluate whether the collected data is sufficiently rich and detailed to fully address our central research questions. This assessment will involve triangulation using various data sources (e.g., Key Informant Interviews and Focus Group Discussions) to identify areas of thematic convergence |
Will use qualitative best practices to determine when study objectives have been sufficiently achieved.
|
|
Identify coping strategies used in response to difficulties with sleep, discriminatory experiences, and other stressors.
Periodo de tiempo: Will use qualitative best practices to determine when study objectives have been sufficiently achieved.
|
We will confirm that our study's primary objectives have been met once data saturation is achieved-that is, when no new themes, insights, or significant patterns emerge, indicating a comprehensive understanding of our three key research objectives. Additionally, we will evaluate whether the collected data is sufficiently rich and detailed to fully address our central research questions. This assessment will involve triangulation using various data sources (e.g., Key Informant Interviews and Focus Group Discussions) to identify areas of thematic convergence |
Will use qualitative best practices to determine when study objectives have been sufficiently achieved.
|
|
Determine recommendations regarding the types of support and resources needed by the Bhutanese refugee community to manage stressors and support sleep health.
Periodo de tiempo: Will use qualitative best practices to determine when study objectives have been sufficiently achieved.
|
We will confirm that our study's primary objectives have been met once data saturation is achieved-that is, when no new themes, insights, or significant patterns emerge, indicating a comprehensive understanding of our three key research objectives. Additionally, we will evaluate whether the collected data is sufficiently rich and detailed to fully address our central research questions. This assessment will involve triangulation using various data sources (e.g., Key Informant Interviews and Focus Group Discussions) to identify areas of thematic convergence |
Will use qualitative best practices to determine when study objectives have been sufficiently achieved.
|
Colaboradores e Investigadores
Investigadores
- Investigador principal: Chandra L Jackson, Ph.D., National Institute of Environmental Health Sciences (NIEHS)
Publicaciones y enlaces útiles
Publicaciones Generales
- Liu RT, Steele SJ, Hamilton JL, Do QBP, Furbish K, Burke TA, Martinez AP, Gerlus N. Sleep and suicide: A systematic review and meta-analysis of longitudinal studies. Clin Psychol Rev. 2020 Nov;81:101895. doi: 10.1016/j.cpr.2020.101895. Epub 2020 Aug 8.
- Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: A systematic review of empirical tests. Soc Sci Med. 2022 Jan;292:114523. doi: 10.1016/j.socscimed.2021.114523. Epub 2021 Nov 2.
- Scott AJ, Webb TL, Martyn-St James M, Rowse G, Weich S. Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials. Sleep Med Rev. 2021 Dec;60:101556. doi: 10.1016/j.smrv.2021.101556. Epub 2021 Sep 23.
- Patton MQ. Enhancing the quality and credibility of qualitative analysis. Health Serv Res. 1999 Dec;34(5 Pt 2):1189-208.
- Misra SM, Nepal VP, Banerjee D, Giardino AP. Chronic Health Conditions, Physical Activity and Dietary Behaviors of Bhutanese Refugees: A Houston-Based Needs Assessment. J Immigr Minor Health. 2016 Dec;18(6):1423-1431. doi: 10.1007/s10903-015-0282-1.
- Jou YC, Pace-Schott EF. Call to action: Addressing sleep disturbances, a hallmark symptom of PTSD, for refugees, asylum seekers, and internally displaced persons. Sleep Health. 2022 Dec;8(6):593-600. doi: 10.1016/j.sleh.2022.09.003. Epub 2022 Oct 27.
- Lies J, Mellor A, Jobson L, Drummond SPA. Prevalence of sleep disturbance and its relationships with mental health and psychosocial issues in refugees and asylum seekers attending psychological services in Australia. Sleep Health. 2019 Aug;5(4):335-343. doi: 10.1016/j.sleh.2019.06.002. Epub 2019 Jul 16.
- Lies J, Drummond SPA, Jobson L. Longitudinal investigation of the relationships between trauma exposure, post-migration stress, sleep disturbance, and mental health in Syrian refugees. Eur J Psychotraumatol. 2020 Nov 19;11(1):1825166. doi: 10.1080/20008198.2020.1825166.
- Subedi P, Li C, Gurung A, Bizune D, Dogbey MC, Johnson CC, Yun K. Mental health first aid training for the Bhutanese refugee community in the United States. Int J Ment Health Syst. 2015 May 9;9:20. doi: 10.1186/s13033-015-0012-z. eCollection 2015.
- Aernout E, Benradia I, Hazo JB, Sy A, Askevis-Leherpeux F, Sebbane D, Roelandt JL. International study of the prevalence and factors associated with insomnia in the general population. Sleep Med. 2021 Jun;82:186-192. doi: 10.1016/j.sleep.2021.03.028. Epub 2021 Apr 2.
- Baskaran A, Marogi E, Bitar R, Attarian H, Saadi A. Improving Sleep Health Among Refugees: A Systematic Review. Neurol Clin Pract. 2023 Apr;13(2):e200139. doi: 10.1212/CPJ.0000000000200139. Epub 2023 Mar 14.
- Hagaman AK, Sivilli TI, Ao T, Blanton C, Ellis H, Lopes Cardozo B, Shetty S. An Investigation into Suicides Among Bhutanese Refugees Resettled in the United States Between 2008 and 2011. J Immigr Minor Health. 2016 Aug;18(4):819-827. doi: 10.1007/s10903-015-0326-6.
- Ao T, Shetty S, Sivilli T, Blanton C, Ellis H, Geltman PL, Cochran J, Taylor E, Lankau EW, Lopes Cardozo B. Suicidal Ideation and Mental Health of Bhutanese Refugees in the United States. J Immigr Minor Health. 2016 Aug;18(4):828-835. doi: 10.1007/s10903-015-0325-7.
- Polcher K, Calloway S. Addressing the Need for Mental Health Screening of Newly Resettled Refugees: A Pilot Project. J Prim Care Community Health. 2016 Jul;7(3):199-203. doi: 10.1177/2150131916636630. Epub 2016 Mar 4.
- Torres L, Driscoll MW, Voell M. Discrimination, acculturation, acculturative stress, and Latino psychological distress: a moderated mediational model. Cultur Divers Ethnic Minor Psychol. 2012 Jan;18(1):17-25. doi: 10.1037/a0026710.
- Zhang M, Gurung A, Anglewicz P, Baniya K, Yun K. Discrimination and Stress Among Asian Refugee Populations During the COVID-19 Pandemic: Evidence from Bhutanese and Burmese Refugees in the USA. J Racial Ethn Health Disparities. 2022 Apr;9(2):589-597. doi: 10.1007/s40615-021-00992-y. Epub 2021 Mar 2.
- Salinas M, Salinas JL. "We Are from Nowhere": A Qualitative Assessment of the Impact of Collective Trauma from the Perspective of Resettled Bhutanese Refugees. Health Equity. 2021 Oct 28;5(1):762-769. doi: 10.1089/heq.2020.0116. eCollection 2021.
- Maleku A, Soukenik E, Haran H, Kirsch J, Pyakurel S. Conceptualizing Mental Health Through Bhutanese Refugee Lens: Findings from a Mixed Methods Study. Community Ment Health J. 2022 Feb;58(2):376-393. doi: 10.1007/s10597-021-00835-4. Epub 2021 May 15.
- Richter K, Baumgartner L, Niklewski G, Peter L, Kock M, Kellner S, Hillemacher T, Buttner-Teleaga A. Sleep disorders in migrants and refugees: a systematic review with implications for personalized medical approach. EPMA J. 2020 May 13;11(2):251-260. doi: 10.1007/s13167-020-00205-2. eCollection 2020 Jun.
- Chattu VK, Chattu SK, Spence DW, Manzar MD, Burman D, Pandi-Perumal SR. Do Disparities in Sleep Duration Among Racial and Ethnic Minorities Contribute to Differences in Disease Prevalence? J Racial Ethn Health Disparities. 2019 Dec;6(6):1053-1061. doi: 10.1007/s40615-019-00607-7. Epub 2019 Jul 1.
- Zhang J, He M, Wang X, Jiang H, Huang J, Liang S. Association of sleep duration and risk of mental disorder: a systematic review and meta-analysis. Sleep Breath. 2024 Mar;28(1):261-280. doi: 10.1007/s11325-023-02905-1. Epub 2023 Aug 29.
Fechas de registro del estudio
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Términos relacionados con este estudio
Palabras clave
Otros números de identificación del estudio
- 10002390
- 002390-E
Plan de datos de participantes individuales (IPD)
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Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
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