0898 Social Vulnerability and Sleep Health in Young Adults with Type 1 Diabetes

Abstract Introduction Young adults aged 18 to 26 years with type 1 diabetes (T1D) are at high risk for social vulnerability and poor sleep health (sleep disturbance and shorter sleep duration) due to social, economic, and geographic shifts. However, the role of social vulnerability in the sleep health of young adults with T1D is not well understood. The purpose of this quantitative descriptive study was to examine the association between indicators of individual- and neighborhood- level social vulnerability and sleep health among young adults with T1D. Methods The Centers for Disease Control/Agency for Toxic Substances and Disease Registry Social Vulnerability Index was used to measure neighborhood-level social vulnerability (socioeconomic status, housing type/characteristics, racial and ethnic minority status, and transportation). Individual-level social vulnerability was measured with a 7-item composite based on the National Patient Social Determinants of Health Risk Assessment Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (race, ethnicity, education, language, income, employment, and stress). Sleep disturbance was measured with the 4-item Patient-Reported Outcomes Measurement Information System was used to measure sleep disturbance and research grade actigraphy over 14 days. Results Forty-four young adults with T1D (38.6% female, mean age 20.9 years, mean A1C 8.6%) completed the baseline measures of a 12-week interventional study. Higher individual level social vulnerability was associated with higher sleep disturbance in the unadjusted and adjusted models (B = .414, p < .001, R2 = .171; B = .446, p = .010, R2 = .218). Higher neighborhood level social vulnerability was associated with shorter actigraphy-derived sleep duration in the unadjusted models (B = -.326, p = .043, R2 = .106); however, the association was no longer significant in the adjusted models (p = .068). Models were adjusted for sex, T1D duration, and BMI. The associations between individual level social vulnerability and sleep duration or neighborhood level social vulnerability and sleep disturbances were not significant. Conclusion More research is warranted to better understand the intricate relationship and role of multiple individual and neighborhood-level social drivers in the sleep health of young adults with T1D. Support (if any) National Institute of Nursing Research R00NR018886 & Dean’s Legacy Fellowship Case Western Reserve University.