Sleep Disruption in New Parents: An intervention Trial

描述（由申请人提供）：新父母的睡眠中断：一项干预试验。这一竞争性延续的建议来自于一项对第一个婴儿出生后的新父母的研究。之前的样本来自夫妇付费参加的分娩课程；该样本将从为社会经济地位较低的有伴侣和无伴侣妇女举办的免费分娩课程中招募。主要目的仍然是测试环境行为干预对睡眠、疲劳和幸福指标（婚姻满意度、母性能力、压力和应对能力）的影响。干预措施将在分娩前实施，让母亲有时间适应。压力和应对框架再次用于测试干预措施，以尽量减少新妈妈睡眠中断的压力。假设将使用重复测量方差分析来检验，以确定平均组差异。预计：1)低收入母亲组（n=60）在各时间点的睡眠维持水平均显著高于对照组（n=60）；2)与对照组相比，实验组在所有产后时间点（4,8和12周）的疲劳程度明显降低，角色能力明显提高。增加了一个新的假设，以解决先前父母对8周龄婴儿睡眠与免疫接种有关的担忧：接受免疫接种后婴儿易怒管理准备策略的母亲，与对照组相比，婴儿在夜间醒来的时间显着减少。第二个目的是描述低收入母亲将这种干预纳入其家庭生活的过程，并与先前中高收入父母的样本相比，评估其对其他首次母亲的可行性。在之前的样本中，很少有母亲按照严格规定的时间返回工作岗位。将确定母亲重返工作岗位前后对一揽子干预措施的满意程度。从这一目标样本中获得的更普遍的结果将用于制定一套教育干预方案，分发给所有准备为人父母的成年人。

DESCRIPTION (provided by applicant): Sleep Disruption in New Parents: An Intervention Trial. This competitive continuation proposal follows from a study of new fathers and mothers after the birth of their first infant. The previous sample was recruited from childbirth classes for which couples paid a fee; this sample will be recruited from free childbirth classes held for partnered and unpartnered women in lower socio-economic status. The primary aim remains to test effects of an environmental-behavioral intervention on sleep, fatigue, and measures of well-being (marital satisfaction, maternal competence, stress, and coping). The intervention will be introduced prior to delivery to allow mothers time to adapt. A stress and coping framework is again utilized to test the intervention to minimize the stress of sleep disruption for new mothers. Hypotheses will be tested using repeated measures analysis of variance to determine mean group differences. It is expected that: 1) The experimental group of low-income mothers (n=60) will have significantly higher sleep maintenance than controls (n=60) at all time points; 2) The experimental group will report significantly lower fatigue and higher role competence compared to controls at all postpartum time points (4, 8, & 12 weeks). A new hypothesis is added to address prior parental concerns about infant sleep at 8 weeks of age in relation to immunizations: Mothers who receive preparatory strategies to manage infant irritability post immunization will have infants with significantly less wake time during the night compared to controls. A secondary aim is to describe the process by which low-income mothers incorporate this intervention into their family life and evaluate its feasibility for other first-time mothers compared to the prior sample of middle and upper income parents. In the prior sample, few mothers returned to work at rigidly scheduled hours. Level of satisfaction with the intervention package will be ascertained for mothers before and after returning to work. More generalizable results from this targeted sample will be used to develop an educational intervention package for distribution to all adults preparing for parenthood.