Stress, Coping, and Sleep Health Study

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.

• INCLUSION CRITERIA:

In order to be eligible to participate in a FGD for this study, an individual must meet all of the following criteria:

1. Adult (aged 18 years or older) living in Ohio, US
2. Self-identify as Bhutanese-Nepali or Bhutanese American
3. Identify as a refugee
4. Speak and understand English and/or Nepali.
5. 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:

1. Adult (aged 18 years or older)
2. Ability to speak and understand English; Familiarity with the lives and experiences of Bhutanese refugees living in Ohio, US
3. 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.