COBRE Center for Sleep and Circadian Rhythms in Child and Adolescent Mental Health

项目摘要 大多数孕妇都会出现睡眠中断和不足的情况，并增加了负面健康的风险。 对母亲及其婴儿的后果，包括妊娠和分娩并发症， 慢性疾病，如重度抑郁症和体重保持/肥胖症。传统上，围产期睡眠障碍- turraphs已被视为预期和棘手的，但最近的研究表明，行为间， 静脉注射对改善孕妇和产后妇女的睡眠有效。然而，高效、可扩展 针对孕妇和新妈妈的睡眠干预措施很少。本行政补充文件 妇女健康研究的目的是在合作中开发一种高保真的、以证据为基础的睡眠干预措施， 与从事围产期妇女的直接护理人员进行演讲，并收集有关以下方面的初步数据： 向准父母和新父母提供由此产生的干预。我们为期一年的试点项目是基于 RE-AIM框架，并将评估覆盖范围、有效性、采用、实施和维护 这一模型的尺寸，以准备一个大规模的未来R 01混合的有效性实施试验。在 第一阶段，我们将开发简短的，以证据为基础的，英语和西班牙语的教育视频，重点是IM- 证明围产期睡眠，并映射到免费的模块，公开的移动的应用程序，CBTi教练。Vid 将与直接护理工作者和一家录像制作公司合作制作和完善eos， 社区参与经验。然后，将对从事围产期妇女工作的直接护理人员进行培训， 实施干预（目标n=35）。在第二阶段，将邀请直接护理人员使用干预措施， 报告睡眠问题的客户，我们将研究在工人和客户中的实施情况（目标n=20）。我们 将衡量完成培训的合格工人和参加培训的合格妇女的比例， 在干预中滚动。将通过检查可行性和可接受性来评估工人的有效性， 以及训练前后的睡眠知识。在围产期妇女中，我们将用以下指标衡量有效性： 定性可接受性测量和失眠严重程度指数（ISI）的变化。收养将被定义为 社区机构/方案的数量，我们从这些机构/方案中吸引直接护理人员进行培训。我们将评估 在直接护理人员中使用有关其干预经验的定性数据，即， 期望、障碍、促进者和未来使用计划。在围产期妇女中的执行措施将 是定量的（即，关于视频观看、整体应用程序使用和特定应用程序元素使用的元数据），以及 定性（可接受性和实用性的看法）。我们将通过检查持续时间的比率来评估维护情况- 直接护理人员的客户登记和围产期妇女继续使用app的比率。这个亲- 该项目将使我们能够完善我们的干预措施，为未来大规模有效实施做好准备 将一种强大的、免费的、行为睡眠干预整合到为高血压妇女服务的环境中的试验， 风险人群，包括社会经济地位低的人、农村家庭和军人家庭。

Project Summary Disrupted, insufficient sleep occurs in the majority of pregnant women and increases the risk of negative health consequences for mothers and their infants, including pregnancy and childbirth complications as well as chronic illnesses, such as major depression and weight retention/obesity. Conventionally, perinatal sleep dis- turbances have been viewed as expected and intractable, but recent studies demonstrate that behavioral inter- ventions are effective for improving sleep in pregnant and postpartum women. Nevertheless, efficient, scalable sleep interventions that are tailored to expectant and new mothers are scarce. This Administrative Supplement for Research on Women’s Health seeks to develop a high-fidelity, evidence-based sleep intervention in collab- oration with direct care workers who engage with perinatal women and to collect preliminary data regarding delivery of the resulting intervention to expectant and new parents. Our one-year pilot project is grounded in the RE-AIM framework, and will assess the Reach, Effectiveness, Adoption, Implementation, and Maintenance dimensions of this model to prepare for a large-scale future R01 hybrid effectiveness-implementation trial. In Phase 1, we will develop short, evidence-based, educational videos in English and Spanish that focus on im- proving perinatal sleep and that map onto modules in the free, publicly-available mobile app, CBTi Coach. Vid- eos will be produced and refined in cooperation with direct care workers and a video production company with community engagement experience. Direct care workers who work with perinatal women will then be trained to deliver the intervention (target n=35). In Phase 2, direct care workers will be invited to use the intervention with clients who report sleep problems and we will study implementation in workers and clients (target n=20). We will measure reach as the proportions of eligible workers who complete training and of eligible women who en- roll in the intervention. Effectiveness will be assessed in workers by examining feasibility and acceptability as well as sleep knowledge before and after the training. In perinatal women we will measure effectiveness with qualitative acceptability measures and change in insomnia severity index (ISI). Adoption will be defined as the number of community agencies/programs from which we draw direct care workers for training. We will evaluate implementation in direct care workers using qualitative data about their experiences with the intervention, i.e., expectations, barriers, facilitators, and plans for future use. Implementation measures in perinatal women will be quantitative (i.e., meta-data regarding video viewing, overall app use and use of specific app elements) and qualitative (perceptions of acceptability and utility). We will assess maintenance by examining rates of contin- ued enrollment of clients by direct care workers and rates of continued app use in perinatal women. This pro- ject will allow us to perfect our intervention in preparation for a future large-scale effectiveness-implementation trial of the integration of a powerful, free, behavioral sleep intervention into settings that serve women in high- risk populations including those with low socioeconomic status, families in rural areas, and military families.