A Pilot Study to Improve Sleep Quality in Urban High School Students with Asthma

项目总结/摘要 背景/原理：睡眠质量差，由于睡眠卫生差，城市青少年的睡眠质量升高， 会影响功能哮喘是最常见的儿科疾病， 城市青少年夜间症状导致睡眠质量差。尽管哮喘的成功和 睡眠卫生在这一人群中，没有同时解决睡眠卫生和哮喘控制的干预措施。这 鉴于城市青少年睡眠质量差的风险很高，这一问题引起了极大的关注。过程评价是 在开发过程中往往缺乏。我们解决这些治疗和方法上的差距。 目的：本试验研究将（1）开发一个综合的，以学校为基础的干预，以改善哮喘自我， （2）评价干预的可行性， 可接受性;（3）评估干预措施对改善睡眠质量的初步证据， 纽约市和罗德岛州普罗维登斯的城市高中学生。假设：（1）干预是可行的， 青少年对治疗方案的高依从率以及他们的高 满意度评级和离职面谈的积极反应;（2）相对于对照组，离职后2个月以上 随机接受干预的青少年在以下方面会有显著改善 评估睡眠质量的结果：（1）睡眠效率;（2）夜间觉醒;和（3）睡眠持续时间。研究方法： 在第一年，我们将调整和整合两个有效的基于学校的城市青少年干预措施，我们的 团队的哮喘和睡眠卫生干预。我们将保留每一个基于指南的组件 对哮喘和睡眠质量至关重要;专家反馈，以及青少年和护理人员通过关注 这两个地点的小组也将指导干预措施的制定。在第二年，我们将进行一项随机试验， 48名患有持续性哮喘的城市青少年，他们的典型睡眠时间为/低于 推荐给这个年龄组的4所学校，2所在纽约，2所在国际扶轮。学生将在一个 学校的干预和控制，其中包括我们的哮喘干预在其原始格式，并将 随访2个月。大学生实习生将提供这两种干预措施。过程评价 将与学生、实习生和学校工作人员进行面谈，以获得以下方面的反馈： 干预程序。意义：这项研究具有很高的公共卫生意义，因为它（1）针对 睡眠质量差的高度脆弱人群-患有持续性哮喘的城市青少年;（2）适应和 整合两种有效的干预措施，开发一种同时针对哮喘的新型干预措施 控制和睡眠卫生，这有可能扩大干预效果;（3）包括一个过程 评估，弥合科学与实践之间的差距，并协助设计一个全面的随机对照试验。

PROJECT SUMMARY / ABSTRACT Background/Rationale: Poor sleep quality, which is elevated in urban adolescents due to poor sleep hygiene, impairs functioning. Asthma, the most common pediatric illness, has high prevalence and morbidity among urban adolescents. Nocturnal symptoms contribute to poor sleep quality. Despite the success of asthma and of sleep hygiene in this population, no interventions concurrently address sleep hygiene and asthma control. This is of great concern given the high risk of poor sleep quality among urban adolescents. Process evaluations are often lacking during intervention development. We address these treatment and methodological gaps. Objectives: This pilot study will (1) develop an integrated, school-based intervention to improve asthma self- management and sleep hygiene in urban high school students; (2) evaluate the intervention's feasibility and acceptability; and (3) assess the preliminary evidence of intervention effects on improving sleep quality in urban high school students in NYC and Providence, RI. Hypotheses: (1) The intervention will be feasible and acceptable as evidenced by adolescents' high rates of adherence to the treatment protocol, and their high satisfaction ratings and positive responses to exit interviews; and (2) relative to controls, over 2-months post- intervention adolescents randomized to the intervention will have significant improvement on the following outcomes assessing sleep quality: (1) sleep efficiency; (2) night awakenings; and (3) sleep duration. Methods: In Year 1 we will adapt and integrate two efficacious school-based interventions for urban adolescents, our team's asthma and sleep hygiene interventions. We will retain components of each that are guideline-based and critical for asthma and sleep quality; expert feedback, as well as adolescent and caregiver input via focus groups at both sites, will also guide intervention development. In Year 2, we will conduct a randomized trial with 48 urban adolescents with persistent asthma and whose typical sleep duration is at/below what is recommended for this age group from 4 schools, 2 in NYC and 2 in RI. Students will be randomized within a school to the intervention and control, which consists of our asthma intervention in its original format, and will be followed for 2-months. University student interns will deliver both interventions. Process evaluation interviews with students, interns, and school personnel will be conducted to obtain feedback regarding intervention procedures. Significance: This study has high public health significance because it (1) targets a highly vulnerable population for poor sleep quality – urban adolescents with persistent asthma; (2) adapts and integrates two efficacious interventions to develop a novel intervention that simultaneously targets asthma control and sleep hygiene, which has the potential to amplify intervention effects; and (3) includes a process evaluation, bridging the gap between science and practice, and aiding in the design of a full-scale RCT.