Project Leader:  Dr. Neha John-Henderson | Montana State University

Abstract

The American Indian population continues to suffer from some of the worst health disparities in the nation (Espey et al., 2014). This is likely in part a result of socioeconomic adversity and exposure to high levels of psychosocial stress across the lifespan. Evidence from other racial groups suggests that positive qualities in the social and familial environment may reduce the degree to which socioeconomic adversity negatively impacts health (e.g., JohnHenderson, Stellar et al., 2015).

Our previous work and related research provide evidence of both socioeconomic adversity and family environments shaping social interactions, health behaviors (e.g., sleep) and psychological and physiological reactivity to stress over the day (John-Henderson, Marsland, Kamarck, Muldoon, Manuck, 2015; Chen, Miller, Kobor, Cole, 2011; Bajaj, John-Henderson et al., 2016; John-Henderson, Stellar, et al., 2015) in ways that may contribute to health disparities.

The proposed research aims to use ecological momentary assessment (EMA) to understand how familial and socioeconomic environments predict patterns and quality of daily life experiences as they happen in real time in ways that may over time shape resilience or increased disease risk (i.e. high levels of systemic inflammation) for the American Indian people. Specifically, we will examine i) the nature and frequency of both stress exposure and social interactions, ii) how these factors are shaped by differences in socioeconomic status and family environments, and iii) how these daily life experiences shape ambulatory blood pressure, health behaviors (e.g., sleep, diet), and markers of disease risk (e.g., systemic inflammation).

The development period which will precede this research will follow the guidelines of Community Based Participatory Research (CBPR) and focus on three important goals. Initial time will be devoted to the identification of an American Indian community that is excited by these research questions and who will benefit from the findings that stem from the eventual research project. Second, with the support of Community Engagement leaders, we will work to formulate a Community Advisory Board (CAB) consisting of researchers and committed members of the community. The members of the community will act as the voice of the community, ensuring that the goals of the research reflect their specific needs and concerns. Further, CAB meetings will provide the opportunity for discussions that will be critical in informing eventual research design and methods. Finally, with continued feedback and input from the CAB and Community Engagement Leaders, along with guidance from my team of mentors, I will prepare a proposal that will be submitted to the Institutional Review Board at Montana State University. This proposal will be the basis for a pilot project which will lay the foundation for a line of research committed to furthering our understanding of the biopsychosocial nature of American Indian disparities in health.