Development and Pilot Testing of Sleeping Healthy/Living Healthy a Comprehensive Sleep Intervention for Adolescents in Urban SBHCs

城市SBHC青少年睡眠健康/健康生活综合睡眠干预措施的开发和试点测试

• 批准号: 10228081
• 负责人: Jean-Marie Bruzzese
• 金额: $ 25.01万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-03 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10228081
• 关键词: Acupressure; Address; Adherence; Adolescent; Adult; Aftercare; Aromatherapy; Beds; Behavior; Caffeine; Child; Chronic Disease; Clinical; Cognitive; Consensus; Development; Effectiveness; Evaluation; Face; Feedback; Focus Groups; Future; Group Interviews; Health; Health Educators; Health Personnel; Health education; High School Student; Hispanics; Human Resources; Hygiene; Hypnosis; Impairment; Inadequate Sleep Hygiene; Individual; Integrative Medicine; Intervention; Interview; Literature; Measures; Mediating; Medical center; Medicine; Meditation; Mental Health; Methodology; Methods; Minority; Modality; Motivation; Needs Assessment; New York City; Outcome; Performance; Phase; Pilot Projects; Pittsburgh Sleep Quality Index; Procedures; Process; Provider; Public Health; Randomized; Randomized Controlled Trials; Research; Risk; Schools; Services; Sleep; Sleep Deprivation; Sleep Fragmentations; Stress; Testing; Time; Treatment Efficacy; Treatment Protocols; Vulnerable Populations; Yoga; Youth; acceptability and feasibility; actigraphy; adolescent health outcomes; adolescent patient; age group; attentional control; base; body-mind; community based participatory research; design; diaries; disorder risk; disparity reduction; efficacy testing; ethnic minority population; evidence base; experience; feasibility testing; health disparity; health goals; high risk population; high school; improved; innovation; instrument; interest; intervention effect; male; mindfulness; novel; poor sleep; programs; public health priorities; racial and ethnic; racial minority; recruit; satisfaction; sleep behavior; sleep health; sleep quality; social; stressor; therapy development; treatment effect; treatment group; treatment trial; tv watching; two-arm study; urban school

Background: Poor sleep quality, which contributes to impaired functioning, is elevated in urban, ethnic/racial minority adolescents due, in part, to poor sleep hygiene. Despite successful sleep hygiene interventions in younger children, none focus on adolescents, a group with unique developmental needs. Urban adolescents face unique contextual stressors, which may contribute to ineffective use of sleep hygiene behaviors. Mind- body integrative (MBIH) approaches (e.g. yoga, meditation) improve sleep quality in adults, but are rarely applied to adolescents. MBIH has been shown to reduce stress among adolescents. Taken together, this suggests that integrating MBIH with sleep hygiene strategies has the potential for a synergistic effect on improving sleep quality. Yet no interventions concurrently use MBIH and sleep hygiene with adolescents. Process evaluations are often lacking during intervention development. We address these treatment and methodological gaps. Aims: This pilot study will: (1) develop Sleeping Healthy/Living Healthy, a school-based health center (SBHC) intervention that combines MBIH and sleep hygiene strategies to improve sleep quality in urban adolescents with poor sleep quality; (2) evaluate the feasibility and acceptability of intervention procedures; and (3) assess the preliminary intervention effects on sleep quality in urban adolescents. Hypotheses: (1) The intervention will be feasible and acceptable as evidenced by high rates of recruitment, adherence to treatment protocols, and high intervention satisfaction ratings; and (2) over [ three ] months, compared to controls, adolescents randomized to the intervention will have improvement on two primary sleep quality outcomes, (a) sleep duration and (b) sleep fragmentation (sleep efficiency and disruptions), measured objectively (actigraphs) and subjectively (using validated instruments). Methods: This study includes a development phase and a pilot individually-randomized group treatment (IRGT) phase. In Year 1 we will develop the novel integrated intervention using an iterative participatory design process. We will be guided by input from adolescents via focus groups and by interviews with SBHC medical and mental health providers, health educators, and staff. In Year 2, we will conduct an IRGT trial with [ 60 ] adolescents with insufficient sleep recruited from two SBHCs in New York City. Adolescents will be randomized 1:1 to receive the intervention or an attention control. Process evaluation interviews guided by a rigorous fidelity framework with adolescents and with SBHC providers and personnel will be conducted to obtain feedback regarding intervention procedures. Significance: This study has high public health significance because it (1) will reach urban racial and ethnic minority adolescents, a vulnerable population [ with specific needs ] greatly impacted by poor sleep quality but largely ignored in the intervention literature to date; (2) simultaneously leverages MBIH and sleep hygiene, potentially amplifying intervention effects; and (3) utilizes objective sleep quality measures and rigorous formative process evaluation. Findings from this study will guide the design of a future full-scale IRGT.

背景：睡眠质量较差，导致功能受损，在城市，种族/种族中升高 少数族裔青少年部分归因于睡眠不良。尽管成功睡眠卫生干预 年幼的孩子，没有一个专注于青少年，这是一个具有独特发展需求的群体。城市青少年 面对独特的上下文压力源，这可能导致睡眠卫生行为无效。头脑- 身体综合方法（MBIH）方法（例如瑜伽，冥想）改善了成人的睡眠质量，但很少 应用于青少年。 MBIH已被证明可以减轻青少年的压力。总的来说，这个 建议将MBIH与睡眠卫生策略相结合有可能对 改善睡眠质量。然而，没有干预措施同时使用MBIH和与青少年的睡眠卫生。 在干预开发过程中通常缺乏过程评估。我们解决这些治疗方法 方法论差距。目的：这项试点研究将：（1）发展健康/生活健康，以学校为基础 结合MBIH和睡眠卫生策略以提高睡眠质量的健康中心（SBHC）干预措施 睡眠质量较差的城市青少年； （2）评估干预的可行性和可接受性 程序； （3）评估城市青少年睡眠质量的初步干预影响。 假设：（1）干预将是可行的，可以接受，这是由高招聘率所证明的， 遵守治疗方案和高干预满意度等级； （2） 三 ]几个月， 与对照组相比，随机分配干预的青少年将在两个初级睡眠上有所改善 质量结果，（a）睡眠持续时间和（b）睡眠碎片（睡眠效率和干扰），测量 客观地（Actraphs）和主观（使用经过验证的工具）。方法：本研究包括 发展阶段和一个单独随机的小组治疗（IRGT）阶段。在第一年，我们将 使用迭代参与设计过程开发新颖的整合干预措施。我们将受到指导 青少年通过焦点小组的意见以及通过与SBHC医疗和心理健康提供者的访谈， 健康教育者和员工。在第二年，我们将进行IRGT试验[ 60 ]睡眠不足的青少年 从纽约市的两个SBHC招募。青少年将被随机分为1：1，以接受干预或 注意力控制。流程评估访谈以与青少年严格的忠实框架为指导 并将与SBHC提供者和人员一起获得有关干预的反馈 程序。意义：这项研究具有很高的公共卫生意义，因为它（1）将达到城市种族 和少数民族青少年，脆弱人群[ 有特定的需求 ]受到睡眠不佳的极大影响 质量，但在迄今为止的干预文献中很大程度上被忽略了； （2）同时利用MBIH和睡眠 卫生，潜在的增强干预效果； （3）利用客观的睡眠质量措施和 严格的形成过程评估。这项研究的发现将指导未来全尺度IRGT的设计。

项目成果

Sleeping Healthy, Living Healthy: Using Iterative, Participatory Processes to Develop and Adapt an Integrated Sleep Hygiene/Mind-Body Integrative Health Intervention for Urban Adolescents.

健康睡眠，健康生活：利用迭代、参与性流程为城市青少年制定和调整综合睡眠卫生/身心综合健康干预措施。

• DOI: 10.1177/15248399231184453
• 发表时间: 2023
• 期刊: Health promotion practice
• 影响因子: 1.9
• 作者: Garbers,Samantha;Ancheta,AprilJ;Gold,MelanieA;Maier,Malia;Bruzzese,Jean-Marie
• 通讯作者: Bruzzese,Jean-Marie

'Our mind could be our biggest challenge': A qualitative analysis of urban adolescents' sleep experiences and opportunities for mind-body integrative health approaches to improve sleep.

• DOI: 10.1016/j.pecinn.2023.100130
• 发表时间: 2023-12
• 期刊: PEC innovation
• 作者: Maier, Malia C;Scharf, Jodi Y;Gold, Melanie A;Ancheta, April J;Bruzzese, Jean-Marie;Garbers, Samantha
• 通讯作者: Garbers, Samantha

Mind-Body Integrative Health (MBIH) Interventions for Sleep among Adolescents: A Scoping Review of Implementation, Participation and Outcomes.

• DOI: 10.1007/s40894-021-00176-z
• 发表时间: 2022-12
• 期刊: ADOLESCENT RESEARCH REVIEW
• 影响因子: 4.7
• 作者: Garbers, Samantha;Umar, Nawal Q.;Hand, Rachel E.;Usseglio, John;Gold, Melanie A.;Bruzzese, Jean-Marie
• 通讯作者: Bruzzese, Jean-Marie