# Measurement of Nature Contact: The Influence of Cultural Practices on Sleep Health and Chronic Disease among Rural and Urban American Indians

> **NIH NIH R01** · WASHINGTON STATE UNIVERSITY · 2021 · $124,053

## Abstract

PROJECT SUMMARY
Researchers have called for a deeper understanding of how social, cultural and environmental factors
influence chronic disease and sleep health outcomes. The parent grant –American Indian CHronic disEase
RIsk and Sleep Health (AI- CHERISH; R01MD014035)—aims to estimate the prevalence of sleep problems
and their associations with specific cardiovascular and metabolic risk factors, as well as the qualitative
characterization of cultural factors related to sleep health among participants recruited from American Indian
(AI) participants previously enrolled in the Strong Heart Family Study (SHFS). This Diversity Supplement uses
secondary analysis of quantitative data to develop a geographical variable (RUCA), and to test associations
and interactions between this variable, sleep health, and chronic disease risk factors. It also uses secondary
qualitative data to develop a measure of cultural practices involving nature contact. This new measure will be
tested for interaction effects on associations between the RUCA variable and sleep problems. This
Supplement will enhance the parent study’s ability to meet each of its specific aims through deepening
understanding of geographic variations in sleep health as well as through enhancing understanding of specific
cultural features key to sleep health by urbanicity and rurality, characterized by the creation of a rural-urban
commuting area (RUCA) variable. Findings will enhance our understanding of geographic variation in sleep
health and chronic disease outcomes, as well of culturally appropriate psychometric instruments that may help
identify pathways for prevention and treatment. Findings will also contribute to a limited body of literature on
the health benefits of nature contact among AIs.
Dr. Fernandez’ long-term goal is to obtain the training and skills needed to become an independent mixed-
methods investigator to address health disparities among American Indian and Alaska Native (AI/AN)
populations, with a specific emphasis on measurement development. In collaboration with her mentoring team,
she proposes 2 years of research and career development activities designed to achieve this goal. Dr.
Fernandez’ research and career development activities include a comprehensive literature review; formal
coursework in statistical methods and participation in the NIMHD Health Disparities Research Institute; grant
writing training and manuscript preparation; data analysis; and the submission of a competitive Mentored
Research Scientist Development Award (K01) application.

## Key facts

- **NIH application ID:** 10381317
- **Project number:** 3R01MD014035-03S1
- **Recipient organization:** WASHINGTON STATE UNIVERSITY
- **Principal Investigator:** Lonnie A. Nelson
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $124,053
- **Award type:** 3
- **Project period:** 2019-05-13 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10381317

## Citation

> US National Institutes of Health, RePORTER application 10381317, Measurement of Nature Contact: The Influence of Cultural Practices on Sleep Health and Chronic Disease among Rural and Urban American Indians (3R01MD014035-03S1). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/10381317. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*