Bedtime Routines Intervention for Children (BRIC) using an automated text messaging system for behaviour change

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Our work concerns the activities in the last hour before bed for young children born to first time parents; so called Bedtime Routines (BTR). These activities include among others tooth brushing, reading a book, having a bath and avoiding food and drinks before bed. Having a set bedtime at a suitable hour is also very important. Establishing good bedtime routines has been shown to be really important for a number of health, wellbeing, development and social outcomes. These include dental health, healthy weight, school readiness, prosocial behaviours and overall wellness. Our research is interested in how we can help first time parents to secure a good bedtime routine. Our earlier work found that those children with poorer bedtime routines suffered more dental decay (leading to pain, sleepless nights and costs to the NHS of over £60 million in preventable dental extractions) than those with good bedtime routines. Moreover, school readiness and performance at school is closely related to a good night's sleep and reading before bed is recommended by lots of national bodies concerned with child welfare. Bedtime routines therefore offer an opportunity to influence the health and wellbeing of young children (aged under 5) in many ways simultaneously, meeting important needs for their futures. Children with good routines at bedtime will be happier, healthier and more successful at school. Most families start establishing their bedtime routines by the end of the 1st year of their child's life. Many parents manage to achieve good routines while others struggle, with first time parents being particularly vulnerable. At the moment, there is no available intervention to help parents, especially first-time parents who have no prior experience of getting their child to sleep. Our main aim is to develop, by talking to parents and professionals, a bedtime routine intervention for first time parents and their children using text messages sent to parents' mobile phones. We have already used this system with parents to monitor what happens in the lead up to children's bedtime. The parents told us that they enjoyed receiving the text messages and that they helped remind them about their routines. This made us think that text messages can potentially be a useful tool in changing routines to make them better. Text messages can be sent to every type of mobile phone with no need to own a smartphone. Also, our previous work has shown that almost every parent had a mobile phone, even those from poorer backgrounds. That finding is supported by existing statistics regarding access and use of mobile phones and text messages. In this proposed study, we are going to do two pieces of work. The first will help us design the type and frequency of the messages we send to parents and the second will test this on a group of first-time parents to see how well it works. To do the first piece of work we will talk to first time parents to find out about their children's bedtimes and find out what problems they experience and how we might help them. For example, a message might be a simple reminder that it's time to start going to bed, or a recommendation on a good reading book for their child. We found that simple text messages sent in real time were a really useful tool in our earlier work. As well as parents we will speak with experts in reading, diet, sleep and general health to make sure that we use information from them to design the messages. We will also talk to people in local authorities whose responsibility it is to fund programmes like this to make sure that our plans can be afforded and will be used. Finally, we will combine the information about changing behaviours from parents and experts and build these in to the intervention. The second piece of work will be to test our new programme with a group of first-time parents to make sure that the system is working and is acceptable and practical. We will also consider cost and savings.