PROJECT SUMMARY The purpose of this Ruth L. Kirschstein National Research Service Award (NRSA) Individual Pre-Doctoral Fellowship in Nursing Research (F31) application is to provide research training for Ms. Yoo, a beginning second-year doctoral student at the University of Washington (UW). The long-term goal of this training is for Ms. Yoo to develop into an independent researcher at a research-intensive academic setting with a program of research focused on improving health outcomes of persons with inflammatory bowel disease (IBD) through the development of self-management strategies that address biological and socio-ecological factors. The costs of care and prevalence of IBD, a chronic gastrointestinal (GI) disease, have been rising in the United States. IBD symptoms (e.g., diarrhea, abdominal pain) negatively impact quality of life, work productivity, and school attendance; thus, there is a clear need to explore behavior modifications (e.g., behavior-influenced sleep-wake cycles) to mitigate the symptoms of those with IBD. Although animal models have shown the adverse effects of disrupted sleep-wake cycles on the GI system (e.g., intestinal dysbiosis), there is little research that focuses on the impact of inconsistent sleep-wake cycles on IBD health outcomes as well role of external socio-ecological factors (e.g., work and family obligations) on sleep-wake cycles of those with IBD. The aims of the proposed study that employ both quantitative and qualitative methods are to understand the relationship between rest- activity rhythm (RAR) characteristics and social jetlag with fatigue, sleep quality, GI symptoms, and disease activity, and identify the social and societal factors that impact sleep-wake cycles. Unlike most IBD sleep studies, this study will use objective actigraphy to measure RARs and social jetlag, and a qualitative portion will provide additional insight from IBD participants on socio-ecological factors that impact sleep-wake cycles which quantitative measures cannot fully capture. The socio-ecological model of health and sleep will guide the research project to consider the societal, social, and individual level impacts of sleep-wake cycles on IBD outcomes. The principal investigator will collect prospective data on 24 IBD participants from the University of Washington Medical Center's gastroenterology clinic and leverage existing data on 26 IBD participants from a previous study focused on nighttime sleep outcomes, resulting in a total of 50 participants. This award will prepare a pre-doctoral trainee through advanced coursework and direct research experience, qualitative and quantitative methods, focused analysis of RARs, and discovery of the relationships among three different concepts related to sleep-wake cycles and IBD-related health outcomes. The findings generated from this investigation will provide foundational knowledge for building a new program of research in self-management and symptom science in IBD.