{"title":"Exploring Social-Ecological Pathways From Sexual Identity to Sleep Among Chinese Women: Structural Equation Modeling Analysis.","authors":"Chanchan Wu, Pui Hing Chau, Edmond Pui Hang Choi","doi":"10.2196/53549","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Women and sexual minority individuals have been found to be at higher risk for experiencing poor sleep health compared to their counterparts. However, research on the sleep health of sexual minority women (SMW) is lacking in China.</p><p><strong>Objective: </strong>This study aimed to examine sleep quality and social support for Chinese women with varied sexual identities, and then investigate the in-depth relationships between sexual identity and sleep.</p><p><strong>Methods: </strong>This was a cross-sectional web-based survey. All participants completed a structured questionnaire containing a set of sociodemographic items referring to the social-ecological model of sleep health, the Pittsburgh Sleep Quality Index, the Social Support Rating Scale, and social relationships and environment domains of the World Health Organization Quality of Life-abbreviated short version. Pearson correlation coefficients were used to examine the relationship between sleep quality and social support as well as the two domains of quality of life. Structural equation modeling analysis was used to explore the social-ecological relationships.</p><p><strong>Results: </strong>A total of 250 cisgender heterosexual women (CHW) and 259 SMW were recruited from July to September 2021. A total of 241 (47.3%) women experienced poor sleep quality and the rate was significantly higher in SMW than in CHW (55.2% vs 39.2%, P<.001). Around one-fifth of SMW reported low levels of social support, which was significantly higher than that of CHW (21.6% vs 5.6%, P<.001). Pearson correlations showed that overall sleep quality was significantly negatively associated with social support with weak correlations (r=-0.26, P<.001). The final structural equation modeling analysis with satisfactory fit indices identified 6 social-ecological pathways, showing that alcohol use, objective support, utilization of support, and perceived social relationship and environment quality of life played important roles in the sleep quality of individuals from their sexual identity.</p><p><strong>Conclusions: </strong>SMW experienced poorer sleep quality compared to CHW. Further research is recommended to address the modifiable factors affecting sleep and then implement tailored sleep improvement programs.</p>","PeriodicalId":14765,"journal":{"name":"JMIR Public Health and Surveillance","volume":"11 ","pages":"e53549"},"PeriodicalIF":3.5000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774323/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JMIR Public Health and Surveillance","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2196/53549","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Women and sexual minority individuals have been found to be at higher risk for experiencing poor sleep health compared to their counterparts. However, research on the sleep health of sexual minority women (SMW) is lacking in China.
Objective: This study aimed to examine sleep quality and social support for Chinese women with varied sexual identities, and then investigate the in-depth relationships between sexual identity and sleep.
Methods: This was a cross-sectional web-based survey. All participants completed a structured questionnaire containing a set of sociodemographic items referring to the social-ecological model of sleep health, the Pittsburgh Sleep Quality Index, the Social Support Rating Scale, and social relationships and environment domains of the World Health Organization Quality of Life-abbreviated short version. Pearson correlation coefficients were used to examine the relationship between sleep quality and social support as well as the two domains of quality of life. Structural equation modeling analysis was used to explore the social-ecological relationships.
Results: A total of 250 cisgender heterosexual women (CHW) and 259 SMW were recruited from July to September 2021. A total of 241 (47.3%) women experienced poor sleep quality and the rate was significantly higher in SMW than in CHW (55.2% vs 39.2%, P<.001). Around one-fifth of SMW reported low levels of social support, which was significantly higher than that of CHW (21.6% vs 5.6%, P<.001). Pearson correlations showed that overall sleep quality was significantly negatively associated with social support with weak correlations (r=-0.26, P<.001). The final structural equation modeling analysis with satisfactory fit indices identified 6 social-ecological pathways, showing that alcohol use, objective support, utilization of support, and perceived social relationship and environment quality of life played important roles in the sleep quality of individuals from their sexual identity.
Conclusions: SMW experienced poorer sleep quality compared to CHW. Further research is recommended to address the modifiable factors affecting sleep and then implement tailored sleep improvement programs.
背景：研究发现，女性和性少数群体与同龄人相比，睡眠健康状况不佳的风险更高。然而，国内对性少数女性睡眠健康的研究还很缺乏。目的：本研究旨在了解中国不同性别认同女性的睡眠质量和社会支持状况，并探讨性别认同与睡眠的深层关系。方法：采用基于网络的横断面调查。所有参与者都完成了一份结构化问卷，其中包含一组社会人口学项目，涉及睡眠健康的社会生态模型、匹兹堡睡眠质量指数、社会支持评级量表和世界卫生组织生活质量（简称简称）的社会关系和环境领域。Pearson相关系数被用来检验睡眠质量和社会支持以及生活质量的两个领域之间的关系。采用结构方程模型分析探讨了社会生态关系。结果：从2021年7月至9月共招募了250名顺性异性恋女性（CHW）和259名异性恋女性（SMW）。共有241名（47.3%）女性睡眠质量较差，其中重度睡眠组的比例明显高于重度睡眠组（55.2% vs 39.2%）。建议进一步研究以解决影响睡眠的可变因素，然后实施量身定制的睡眠改善计划。
期刊介绍：
JMIR Public Health & Surveillance (JPHS) is a renowned scholarly journal indexed on PubMed. It follows a rigorous peer-review process and covers a wide range of disciplines. The journal distinguishes itself by its unique focus on the intersection of technology and innovation in the field of public health. JPHS delves into diverse topics such as public health informatics, surveillance systems, rapid reports, participatory epidemiology, infodemiology, infoveillance, digital disease detection, digital epidemiology, electronic public health interventions, mass media and social media campaigns, health communication, and emerging population health analysis systems and tools.
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