Development and implementation of a digital sleep intervention for preschoolers in foster care

项目总结 寄养(FC)儿童面临慢性健康状况的风险，部分原因是暴露在不利的环境中 童年经历(A)。早期干预可能会改善健康差距和经济负担 与A相关，与学龄前阶段相比，投资回报明显更高 发展后期的干预措施。FC中的儿童睡眠障碍的风险很高，这是一种主要的 导致慢性健康状况发展和恶化的因素，但行为睡眠 对这一人群的干预是不存在的。这份K01提案旨在解决医疗保健方面的这一关键差距 并通过制定和实施创伤信息系统促进这一未得到充分服务的人群的健康公平 数字公共健康级别的睡眠干预，称为睡眠向导，我们将对其进行管理，以培养照顾者 学龄前儿童。我们的创新方法涉及与主要利益相关者的规划小组合作 包括FC工作者和父母，以及FC背景下的睡眠、创伤、健康和干预方面的专家。 目标1的目标是与规划小组一起开发和数字化初始睡眠向导干预内容， 根据创伤知情护理、支持健康睡眠的循证战略的文献，FC 许可法规，以及养父母的需求和经验。在AIM 2中，睡眠向导将通过以下方式进行预先测试 培养护理人员，提供有关可接受性、可行性和可接受性的定量和定性数据 干预的适当性，将用于进行最终干预修改。目标3将 评估睡眠向导是否与改善照顾者的睡眠行为有关， 并在干预前、干预后和3个月的随访中观察儿童睡眠情况。这将是第一次大规模的 睡眠干预是在这一人群中开发和测试的。地方和国家利益攸关方已表示 热情，并致力于参与睡眠的开发、实施和评估 巫师。为了实现研究计划，PI将执行结构化的综合培训计划，以获得 (1)在寄养背景下的睡眠、心理健康和幼儿时期的A级的专门技能，(2) 发展与儿童福利界的伙伴关系，(3)制定和实施干预措施 科学，(4)实施和传播数字干预，以及(5)进行临床试验。 培训将由一支在这些领域拥有交叉专业知识的优秀指导团队监督，并将 成功的导师经验和合作的跟踪记录。研究和实践的实施 培训计划也将得到机构环境的支持，即Brown Medical 学校、布拉德利医院和两个新的主要中心赠款，重点是促进职业发展 1)儿童压力、创伤和弹性，以及2)睡眠和昼夜节律的早期调查 儿童和青少年心理健康。这一奖项将推动我向独立翻译的过渡 科学家在科学和公共健康方面有很高的职业生涯，对早年生活中的逆境、睡眠和健康有影响。

PROJECT SUMMARY Children in foster care (FC) are at risk for chronic health conditions, in part due to exposure to adverse childhood experiences (ACEs). Early intervention may ameliorate health disparities and economic burden associated with ACEs, with the preschool period yielding a substantially larger return on investment compared to interventions later in development. Children in FC are at high risk for sleep disturbances, which are a major contributor to the development and exacerbation of chronic health conditions, yet behavioral sleep interventions for this population are nonexistent. This K01 proposal seeks to address this critical gap in care and promote health equity in this underserved population by developing and implementing a trauma-informed digital public-health-level sleep intervention called Sleep Wizard, which we will administer to foster caregivers of preschoolers. Our innovative approach involves collaboration with a planning group of key stakeholders including FC workers and parents, and experts in sleep, trauma, health, and interventions in the context of FC. The goal of Aim 1 is to develop and digitize initial Sleep Wizard intervention content with the planning group, informed by the literature on trauma-informed care, evidence-based strategies to support healthy sleep, FC licensing regulations, and foster parent needs and experiences. In Aim 2, Sleep Wizard will be pretested by foster caregivers who will provide quantitative and qualitative data on acceptability, feasibility, and appropriateness of the intervention, which will be used to make final intervention modifications. Aim 3 will evaluate whether Sleep Wizard is associated with improvements in foster caregiver behaviors around sleep, and in child sleep from pre to post intervention, and at a 3-month follow-up. This will be the first large scale sleep intervention developed and tested in this population. Local and national stakeholders have expressed enthusiasm and have committed to involvement in the development, implementation, and evaluation of Sleep Wizard. To achieve the research plan, the PI will execute a structured comprehensive training plan to gain specialized skills in (1) Sleep, mental health, and ACEs in early childhood in the context of foster care, (2) Developing partnerships with the child welfare community, (3) Intervention development and implementation science, (4) Implementation and dissemination of digital interventions, and (5) Conducting clinical trials. Training will be overseen by an outstanding mentorship team with cross-cutting expertise in these areas and a track record of successful mentorship experiences and collaborations. Implementation of the research and training plan will also be bolstered by support from the institutional environment, namely Brown Medical School, Bradley Hospital, and two new major center grants focused on promoting the career development of early-stage investigators in 1) childhood stress, trauma, and resilience, and 2) sleep and circadian rhythms in child and adolescent mental health. This award will catapult my transition to an independent translational scientist with a career high in scientific and public health impact in early life adversity, sleep, and health.