Understanding sleep health in Black American adults: A qualitative analysis of barriers, facilitators, and perspectives on sleep interventions.

Abstract

Objectives: Black Americans have a high prevalence of poor sleep health. Understanding their perceptions about sleep could identify determinants of poor sleep in this population and inform culturally tailored interventions. However, qualitative data are lacking. Using focus groups, we assessed Black American adults' sleep perceptions, facilitators/barriers to sleep, beliefs about sleep recommendations, and perspectives on sleep interventions.

Methods: Participants (N=36) attended online focus groups to discuss their perceptions and knowledge about sleep. A semistructured discussion guide was used to direct the conversation. Focus group data were transcribed and analyzed using a rapid analytic approach to identify themes.

Results: Mean age of participants was 34 (SD=13.1) years, and 64% identified as women. Women and men slept less than the recommended hours of sleep (average sleep duration of 6.4 and 6.9 hours, respectively). Most participants defined healthy sleep as quality over quantity and viewed sleep as an important contributor to health and well-being. Exercise, limiting screen time, and suitable sleep environments were common perceived healthy sleep facilitators. Some participants misperceived electronic use and cosleeping, maladaptive strategies to cope with stress, as facilitators. Stress, responsibilities, electronic use, and unsuitable sleep environments were barriers. Participants wished to obtain personalized, racially tailored healthy sleep recommendations through highly accessible modes of dissemination (e.g., social media, websites).

Conclusions: The findings suggest study participants valued quality sleep. However, stress, responsibilities, and sleep-hindering behaviors may contribute to poor sleep health. Targeting stress reduction, healthy sleep behaviors, and disseminating racially tailored information through accessible modes may be useful sleep intervention strategies in this community.