Evidence map›Paper›PMID 41475160›Full record

ArticleSleep medicine2026

Exploring sleep outcomes in youth across settings: Are there differences based on rurality or medically underserved status in the ECHO cohort?

Brittany D Lancaster, Anna Wallisch, Emily A Knapp, Xuan Li, Lacey A McCormack, Kelly A Hirko, Traci A Bekelman, Christine W Hockett, ECHO Cohort Consortium

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Sleep medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Brittany D LancasterDepartment of Psychology, Mississippi State University, MS, P.O. Box 6161, Mississippi State, MS, 39762, USA. Electronic address: bdl195@msstate.edu.
Anna WallischDivision of Developmental and Behavioral Sciences, Department of Pediatrics, University of Kansas Medical Center, 2000 W. Olathe Blvd, Mailstop 4004, Kansas City, KS, 66160, USA. Electronic address: awallisch@kumc.edu.
Emily A KnappDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 700 E Pratt Street, Baltimore, MD, 21202, USA. Electronic address: eknapp2@jhu.edu.
Xuan LiDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 700 E Pratt Street, Baltimore, MD, 21202, USA. Electronic address: xli2465029@gmail.com.
Lacey A McCormackAvera Research Institute, Avera McKennan Hospital & University Health Center, 6001 S Sharon Ave, Suite 2, Sioux Falls, SD, 57106, USA; Department of Pediatrics, University of South Dakota School of Medicine, 1400 W 22nd St, Sioux Falls, SD, 57105, USA. Electronic address: lacey.mccormack@avera.org.
Kelly A HirkoDepartment of Epidemiology & Biostatistics, College of Human Medicine, Michigan State University, 909 Wilson Road, Room B601, East Lansing, MI, 48824, USA. Electronic address: hirkokel@msu.edu.
Traci A BekelmanLifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, 1890 N. Revere Court, Aurora, CO, 80045, USA. Electronic address: traci.bekelman@cuanschutz.edu.
Christine W HockettAvera Research Institute, Avera McKennan Hospital & University Health Center, 6001 S Sharon Ave, Suite 2, Sioux Falls, SD, 57106, USA; Department of Pediatrics, University of South Dakota School of Medicine, 1400 W 22nd St, Sioux Falls, SD, 57105, USA. Electronic address: christine.hockett@avera.org.
ECHO Cohort Consortium

Funding

Project-005U2COD023375 · OD · DUKE UNIVERSITY · PI Linda S Adair, Phillip Brian Smith · 2016 to 2026
$215.9M
ECHODAC (Environmental Influences on Child Health Outcomes Data Analysis Center)U24OD023382 · OD · JOHNS HOPKINS UNIVERSITY · PI Diane J Catellier, LISA P JACOBSON · 2016 to 2026
$148.4M
Wisconsin Infant Study Cohort (WISC) ECHO Pediatric Follow-UpUH3OD023282 · OD · UNIVERSITY OF WISCONSIN-MADISON · PI James E. Gern · 2018 to 2026
$64.8M
The NYU Children’s Health & Environment Study: an ECHO CohortUH3OD023305 · OD · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Akhgar Ghassabian, Leonardo Trasande · 2018 to 2026
$59.5M
Mount Sinai ECHO site for Perinatal Environment and Development StudiesUH3OD023337 · OD · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KECIA Nicole CARROLL, Robert O Wright · 2018 to 2026
$54.1M
A prospective study of critical environmental exposures in formative early life that impact lifelong health in rural US children: the New Hampshire Birth Cohort StudyUH3OD023275 · OD · DARTMOUTH COLLEGE · PI MARGARET Rita KARAGAS, Juliette Madan · 2018 to 2026
$44.3M
The ECHO Measurement Core: A Framework and Resource for Assessing Environmental Exposure and Child HealthU24OD023319 · OD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Courtney K Blackwell, RICHARD GERSHON · 2016 to 2026
$43.7M
Prenatal and Early Childhood Pathways To Health:  An Integrated Model of Chemical and Social Exposures, Biological Mechanisms, and Sex-Specific Effects on Neurodevelopment and Respiratory OutcomesUH3OD023271 · OD · UNIVERSITY OF WASHINGTON · PI BUSH, NICOLE RENEE, KARR, CATHERINE J · 2018 to 2022
$37.3M
ECHO Laboratory Core at Vanderbilt for Integrated Sample Biobanking and ProcessingU24OD035523 · OD · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Suman Ranjan Das, NATASHA Bassam HALASA · 2023 to 2026
$32.8M
Environmental Influences on Childhood Outcomes in the Northern Plains Safe Passage Study CohortsUH3OD023279 · OD · AVERA MCKENNAN · PI Amy J Elliott, Christine W Hockett · 2018 to 2026
$31.7M
Lifecourse Approach to Developmental Repercussions of Environmental Agents on Metabolic and Respiratory Health (LA DREAMERs)UH3OD023287 · OD · UNIVERSITY OF SOUTHERN CALIFORNIA · PI BASTAIN, THERESA M, BRETON, CARRIE VAN DOREN · 2018 to 2022
$28.4M
Statistical Services and Methods Development ResourceU2CES026555 · NIEHS · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI GENNINGS, CHRIS · 2015 to 2025
$26.4M
NIEHS NIH HHS U24 ES026539NIEHS NIH HHS U2C ES026533NIEHS NIH HHS U2C ES026542NIEHS NIH HHS U2C ES026555NIEHS NIH HHS U2C ES026561NIEHS NIH HHS U2C ES030851NIEHS NIH HHS U2C ES030857NIEHS NIH HHS U2C ES030859NIH HHS U24 OD023319NIH HHS U24 OD023382NIH HHS U24 OD035523NIH HHS U2C OD023375NIH HHS UG3 OD035508NIH HHS UG3 OD035509NIH HHS UG3 OD035513NIH HHS UG3 OD035516NIH HHS UG3 OD035517NIH HHS UG3 OD035518NIH HHS UG3 OD035519NIH HHS UG3 OD035521NIH HHS UG3 OD035526NIH HHS UG3 OD035527NIH HHS UG3 OD035528NIH HHS UG3 OD035529NIH HHS UG3 OD035532NIH HHS UG3 OD035533NIH HHS UG3 OD035536NIH HHS UG3 OD035537NIH HHS UG3 OD035540NIH HHS UG3 OD035542NIH HHS UG3 OD035543NIH HHS UG3 OD035544NIH HHS UG3 OD035546NIH HHS UG3 OD035550NIH HHS UH3 OD023244NIH HHS UH3 OD023248NIH HHS UH3 OD023249NIH HHS UH3 OD023251NIH HHS UH3 OD023253NIH HHS UH3 OD023268NIH HHS UH3 OD023271NIH HHS UH3 OD023272NIH HHS UH3 OD023275NIH HHS UH3 OD023279NIH HHS UH3 OD023282NIH HHS UH3 OD023285NIH HHS UH3 OD023286NIH HHS UH3 OD023287NIH HHS UH3 OD023288NIH HHS UH3 OD023289NIH HHS UH3 OD023290NIH HHS UH3 OD023305NIH HHS UH3 OD023313NIH HHS UH3 OD023318NIH HHS UH3 OD023320NIH HHS UH3 OD023328NIH HHS UH3 OD023332NIH HHS UH3 OD023337NIH HHS UH3 OD023342NIH HHS UH3 OD023344NIH HHS UH3 OD023347NIH HHS UH3 OD023348NIH HHS UH3 OD023349NIH HHS UH3 OD023365NIH HHS UH3 OD023389
6 · The paper itself

Abstract

objectiveTo evaluate associations between rurality and medically underserved status with sleep outcomes (e.g., duration, bed and wake times, latency) among youth in the United States.

methodsThe study sample included 22,234 youth (aged 1-17 years) from the Environmental influences on Child Health Outcomes (ECHO) Program. Sleep was measured by parent-report questionnaire for children ages 7 and under and child-report for older children. Residential addresses and Federal Information Processing Standards codes were utilized to classify participants into two binary exposure variables: rural vs. nonrural and medically underserved vs. not medically underserved. Differences between groups for each developmental period were compared using t-tests and chi-squared tests.

resultsAcross children ages 1-12, rural youth went to bed significantly earlier (mean differences [MD] range from 18 to 52 min) and woke earlier (MD range 15-52 min) compared to non-rural youth. Children aged 1-12 living in medically underserved areas were significantly less likely to meet sleep recommendations (MD range 3.2 %-6.6 % less), and youth of all ages tended to have later bedtimes (MD range 7-30 min) compared to youth not living in medically underserved areas. DISCUSSION: This study is novel because it evaluates differences in youth sleep health based on rurality and medically underserved status in the United States. Multiple variations in children's sleep health were identified based on living in medically underserved areas while minimal differences were noted based on rurality. Future research should focus on the development or dissemination of effective programs into pre-established resources (e.g., daycares, community centers) for youth in medically underserved areas.

Indexed as

Medically Underserved AreaRural PopulationSleepAdolescentChildChild, PreschoolCohort StudiesFemaleHumansInfantMaleSurveys and QuestionnairesUnited StatesChildrenEnvironmental influences on child health outcomesMedically underservedRuralSleepUrban

Identifiers

PMID41475160
PMCPMC13043269

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.