Promoting Sleep to Prevent Substance Use in Adolescence

描述(由申请者提供)：青少年药物使用很普遍，并与一系列不良后果有关，如学习成绩较差、危险的性行为、精神健康问题和发展成药物使用障碍的风险增加。这项拟议的研究的目的是试行一种普遍的干预措施，通过改善睡眠来防止青少年使用药物。这种间接预防药物使用的方法是建立在几条证据基础上的：a)很少有直接针对预防高中人群使用药物的方案被发现是有效的；b)多项横断面和前瞻性研究报告了青少年早产时睡眠不足并预测了药物使用；c)多种可改变的因素导致了目前青少年睡眠不足的流行(例如，使用技术到深夜，从工作日到周末不规律的睡眠-醒来时间表)以及d)以前针对青少年的睡眠干预在改善睡眠方面取得了可喜的结果。我们将试行“睡眠健身”(SF)干预。 儿童基金会是一项针对9年级城市青少年(14至16岁；n=300)的8期、可扩展、以学校为基础的预防方案。SF干预借鉴了经验支持的针对睡眠问题的干预措施，适应于有效地促进健康的睡眠模式。本研究在学校采用整群随机实验设计(在课堂水平上随机)来检验我们的假设，即SF干预在改善睡眠、物质使用和选定的心理健康结果(焦虑、抑郁)方面将比心理教育(PE)控制条件更有效。结果测量将在基线、干预后以及6个月和12个月后进行评估。我们将进一步研究物质使用的减少是否与睡眠和心理健康的改善有关。所有结果分析都将控制感知到的压力。作为R34应用程序的一部分进行的研究旨在通过以下方式为未来的大规模干预测试提供信息：a)在不同的高中环境中建立干预的可行性、研究设计和措施；b) 为结果和潜在的主持人产生初步的效果大小估计；以及c)进一步调整干预措施，以达到最大的效果，包括让每所学校的学生参与，以澄清行为改变的动机“杠杆”。这项拟议的研究计划是第一次测试一种普遍干预措施，以促进睡眠作为减少物质启动和使用的一种手段。如果是积极的，这一发现将对公共卫生或青少年健康促进以及城市青少年睡眠、药物使用和心理健康之间的互动关系产生重大影响。

DESCRIPTION (provided by applicant): Adolescent substance use is prevalent and associated with a broad range of adverse outcomes such as poorer academic performance, risky sexual behavior, mental health problems and increased risk of developing a substance use disorder. The aim of the proposed research is to pilot test a universal intervention to prevent substance use in youth by improving sleep. This indirect approach to substance use prevention is predicated on several lines of evidence: a) few programs directly targeting prevention of substance use in high school populations have been found to be effective, b) multiple cross-sectional and prospective studies have reported that insufficient sleep in youth predates and predicts substance use, c) multiple modifiable factors contribute to the current epidemic of insufficient sleep among youth (e.g., use of technology late into the night, irregular sleep-wake schedules from weekdays to weekends) and d) previous sleep interventions for youth have yielded promising results for improving sleep. We will pilot the 'Sleep Fitness' (SF) intervention. SF is an 8 session, scale-able, school-based prevention program for urban adolescents attending 9th grade (ages 14 to 16; n=300). The SF intervention draws on empirically- supported interventions for sleep problems, adapted to be effective in promoting healthful sleep patterns. The study uses a cluster-randomized experimental design (randomized at classroom level) in schools to test our hypotheses that the SF intervention will be more effective than a Psycho-education (PE) control condition in achieving improvements in sleep, substance use, and selected mental health outcomes (anxiety, depression). Outcome measures will be assessed at baseline, post-intervention, and 6 and 12 months later. We will further examine if reductions in substance use are mediated by improvements in sleep and mental health. All outcome analyses will control for perceived stress. The research conducted as part of this R34 application is intended to inform future large-scale testing of the intervention via: a) Establishig the feasibility of the intervention, study design, and measures in diverse high school settings; b) Generating initial effect size estimates for outcomes and potential moderators; and c) Further adaptation of the intervention for maximal effectiveness, including involvement of students at each school to clarify motivational "levers" for behavior change. The proposed program of research is the first to test a universal intervention to promote sleep as a means of reducing substance initiation and use. If positive, the findings will have major public health implications or adolescent health promotion as well as for the interactive relationships among sleep, substance use, and mental health among urban teenagers.