Sleep Well, Bee Well: Sleep Health Promotion Intervention in Early Head Start

项目总结 儿童早期睡眠不足，包括睡眠不及时、睡眠持续时间不足和夜间睡眠不足 觉醒与许多健康问题有关，如肥胖、情绪调节不良、 0-4岁儿童的生长发育受损，受伤风险较高。睡眠不足更为普遍 在有色人种儿童和那些在经济上被边缘化的儿童中，他们可能有助于 与高收入和非低收入儿童相比，4岁儿童健康差距的劣势和风险更高 西班牙裔白人儿童。行为睡眠干预(BSI)可能会改善睡眠不足，但知之甚少 关于在种族/民族多样性和经济边缘化群体中实施BSI的可行性和有效性 孩子们。这项拟议的试点语用集群随机试验的目的是评估 BSI、睡眠好、蜜蜂好(SWBW)为种族/民族多样性和 经济上处于边缘地位的蹒跚学步的儿童参加了联邦资助的早期启动计划(EHS)。我们选择了 重点关注1-2.5岁的幼儿，因为这是快速认知的重要发展阶段， 语言、社会情感和运动发展；睡眠习惯在这个年龄段是可塑性的；以及早期 干预是解决健康差距的关键。基于睡眠和睡眠的社会生态模型 健康，SWBW在组织(EHS教师-家长)、人际(亲子、EHS教师- 幼儿)和个人(幼儿)水平。受社会认知理论结构的启发，SWBW包括 互动多媒体资料及活动，鼓励家长与EHS双向沟通 教师共同制定量身定制的睡眠健康目标，以满足睡前、环境和持续时间的要求 儿童睡眠(B.E.D)建议。我们提出了一种实用的整群随机试验来确定 SWBW的可行性，并测试向一个EHS中心提供SWBW的初步效果 另一个注册人数和人口统计相似的EHS中心将作为等待名单控制。我们会 解决以下具体目标：(1)在44个1-2.5岁的家庭中确定SWBW的可行性 来自两个托儿中心的健康儿童和EHS教师；(1a)细化和标准化SWBW 干预材料(视频、讲义、活动)；(1b)确定可行性(可接受性、需求、 SWBW的实施性、实用性、适应性、集成性、扩展和有限效力测试 干预措施、研究设计和招募目标；(2)对22个月的SWBW的初步疗效进行评估 干预和22个等待名单控制亲子二元对(2a)幼儿的睡眠健康(持续时间，时间， 连续性)、就寝习惯、家长和EHS老师的睡眠知识以及(2b)幼儿的社交情绪 健康、睡前作息、家长幸福感和家长-教师参与度。这项初步研究的结果 将为未来更大规模的集群随机试验提供支持，该试验将全面启动以测试效果 在新英格兰Head Start协会登记的多个EHS计划中的SWBW计划。

PROJECT SUMMARY Sleep deficiency in early childhood, including poorly timed sleep, inadequate sleep duration, and night awakenings, is associated with numerous health concerns such as adiposity, poor emotional regulation, impaired growth, and higher risk of injuries in children aged 0-4 years. Sleep deficiency is more prevalent among children of color and those who are economically marginalized and may contribute to the cycle of disadvantage and higher risk for health disparities by age 4 years compared to higher income and non- Hispanic white children. Behavioral sleep interventions (BSIs) may improve sleep deficiency, but little is known about the feasibility and efficacy of BSIs among racially/ethnically diverse and economically marginalized children. The purpose of this proposed pilot pragmatic cluster randomized trial is to evaluate the feasibility and preliminary efficacy of a BSI, Sleep Well, Bee Well (SWBW) designed for racially/ethnically diverse and economically marginalized toddlers enrolled in federally-funded Early Head Start (EHS) programs. We chose to focus on toddlers aged 1-2.5 years because this is an important developmental stage of rapid cognitive, language, social emotional, and motor development; sleep habits are malleable at this age; and early intervention is key to addressing health disparities. Based on the socioecological model (SEM) of sleep and health, SWBW works at the organizational (EHS teacher-parent), interpersonal (parent-child, EHS teacher- toddler), and individual (toddler) levels. Informed by the constructs of social cognitive theory, SWBW includes interactive multimedia materials and activities to encourage two-way communication between parents and EHS teachers to co-develop tailored sleep health goals towards meeting Bedtime, Environment, and Duration of sleep (B.E.D) recommendations for toddlers. We propose a pragmatic cluster randomized trial to determine the feasibility of SWBW and test the preliminary efficacy of SWBW provided to one EHS center compared to another EHS center with similar enrollment and demographics that will serve as a waitlist control. We will address the following specific aims: (1) Determine the feasibility of SWBW among 44 families of 1-2.5-year-old healthy children and EHS teachers from both childcare centers; (1a) refine and standardize the SWBW intervention materials (videos, handouts, activities); (1b) determine the feasibility (acceptability, demand, implementation, practicality, adaptation, integration, expansion, and limited-efficacy testing) of the SWBW intervention, study design and recruitment goals; (2) Evaluate the preliminary efficacy of SWBW in 22 intervention and 22 wait-list control parent-child dyads on (2a) toddlers' sleep health (duration, timing, continuity), bedtime routines and parent and EHS teacher sleep knowledge and (2b) toddler's social-emotional health, bedtime routines, parent well-being and parent-teacher engagement. The results from this pilot study will provide support for a future larger scale cluster randomized trial that will be fully powered to test the effects of the SWBW program in multiple EHS programs enrolled in the New England Head Start Association.