Implementing Evidence-Based Behavioral Sleep Intervention in Urban Primary Care

在城市初级保健中实施循证行为睡眠干预

基本信息

批准号：
9789367
负责人：
Ariel A Williamson
金额：
$ 13.15万
依托单位：
CHILDREN'S HOSP OF PHILADELPHIA
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-20 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9789367
关键词：
Address Adherence Attention Attitude Behavior Behavior Therapy Behavioral Belief Caregivers Caring Child Child Behavior Child Development Childhood Clinical Conduct Clinical Trials Data Development Development Plans Doctor of Philosophy Education Effectiveness Effectiveness of Interventions Emotional Evaluation Exposure to Family Future Goals Health Health Promotion Health Services Impairment Institute of Medicine (U.S.)Intervention Intervention Studies Interview Knowledge Low income Measurement Mental Health Mentors Methods Mission National Institute of Child Health and Human Development Nurses Outcome Pediatric Hospitals Pennsylvania Philadelphia Primary Health Care Procedures Process Psychologist Public Health Randomized Randomized Controlled Trials Readiness Reporting Research Research Methodology Research Personnel Resources Risk Schools Sleep Sleep Deprivation Sleep Disorders Sleep disturbances Sleeplessness Social Workers Socioeconomic Status Structure Testing Training Treatment Efficacy Universities Youth adequate sleep base behavioral health behavioral outcome care providers career career development early childhood evidence base experience follow-up implementation science implementation trial improved intervention effect low socioeconomic status lower income families medical specialties neurobehavioral novel strategies pediatrician physical conditioning pragmatic trial programs randomized trial recruit research to practice response service delivery skills sleep health social socioeconomic disadvantage stressor treatment as usual

项目摘要

PROJECT SUMMARY/ABSTRACT This K23 proposal will address a critical need for accessible, evidence-based behavioral sleep interventions for lower-socioeconomic status (SES) children, and will prepare the applicant, Ariel Williamson, PhD, to become an independent investigator with expertise in behavioral interventions for lower-SES children in primary care. Behavioral sleep problems, including insomnia and insufficient sleep, are associated with adverse physical, neurobehavioral, and social-emotional outcomes. Sleep problems impact 20-30% of young children and disproportionately impact lower-SES children. There is little research on behavioral sleep interventions with lower-SES youth, and no studies have examined these interventions in primary care, an accessible setting. This project will adapt and pilot Sleep Well – Be Well, an effective behavioral sleep intervention, so that its contents and service delivery methods are appropriate for lower-SES preschoolers and the primary care context. Aim 1 is to identify attitudes, beliefs, and behaviors that are critical for adapting and implementing Sleep Well – Be Well for lower-SES preschoolers in primary care. This aim involves collecting qualitative and quantitative data from lower-SES caregivers of preschoolers with sleep problems (N = 30) and primary care providers (N = 20 pediatricians, nurses, and integrated behavioral health clinicians [social workers and psychologists]). Aim 2 is to iteratively adapt as needed and pilot Sleep Well – Be Well. Aim 1 results, pilot testing with lower-SES caregiver- child dyads (N = 18), and input from an advisory panel of caregivers and primary care providers will guide needed adaptations and the potential development of new approaches. Aim 3 is to conduct a pilot randomized controlled trial of the adapted intervention to examine intervention acceptability; feasibility of recruitment, randomization, and measurement procedures; treatment engagement and adherence; and the magnitude of intervention effects. Lower-SES preschoolers (N = 80) will be randomly assigned to intervention or to enhanced usual care (sleep education), with assessments of objective and caregiver-reported child sleep, as well as child behavior, at pretreatment, posttreatment, and 3-month follow-up. The proposed research and the career development plan will support Dr. Williamson’s training goals to acquire skills and knowledge in: (1) qualitative and mixed methods for intervention adaptation and development; (2) the conduct of clinical, and especially pragmatic, trials; and (3) the application of implementation science methods and frameworks to primary care research. The resources of Children’s Hospital of Philadelphia and University of Pennsylvania, and an expert team of interdisciplinary mentors and consultants, will provide an outstanding context to launch Dr. Williamson’s career. This project will also provide necessary data for Dr. Williamson’s future R01 submission of a large-scale effectiveness- implementation trial of a behavioral sleep intervention in primary care. This project aligns with NICHD’s priorities, as it focuses on behavioral intervention in primary care and behavioral health promotion for lower-SES children.

项目摘要/摘要该K23提案将解决对可访问的，基于证据的行为睡眠干预措施的关键需求低社会经济状况（SES）儿童，并将准备申请人Ariel Williamson博士成为一名独立研究者在初级保健中低调儿童的行为干预方面具有专业知识。行为睡眠问题，包括失眠和睡眠不足，与身体不良有关，神经行为和社会情感结果。睡眠问题影响20-30％的幼儿和不成比例地影响下SES儿童。关于行为睡眠干预的研究很少低调的青年，没有研究检查初级保健中的这些干预措施，这是一种可访问的环境。这项目将适应和飞行员睡眠良好 - 要好好，有效的行为睡眠干预措施，以便其内容服务提供方法适用于低知名的学龄前儿童和初级保健环境。目标1 是确定与会者，对适应和实施睡眠至关重要的与会者，和行为 - 保持良好对于初级保健中的初级学龄前儿童。此目的涉及从中收集定性和定量数据患有睡眠问题（n = 30）和初级保健提供者（n = 20 儿科医生，护士和综合行为健康临床医生[社会工作者和心理学家]）。目标2是迭代地根据需要进行适应，然后飞行员睡得很好 - 要好。 AIM 1结果，通过低SES护理人员进行试验测试 - 儿童二元组（n = 18），以及护理人员和初级保健提供者的咨询小组的投入将指导所需适应和新方法的潜在发展。 AIM 3是进行飞行员随机控制对研究干预的可接受性的审判；招聘，随机化的可行性，和测量程序；治疗参与和依从性；以及干预效果的大小。下级学龄前儿童（n = 80）将随机分配给干预或增强常规护理（睡眠教育），评估客观和照顾者报告的儿童睡眠以及儿童行为，预处理，治疗后和3个月的随访。拟议的研究和职业发展计划将支持威廉姆森博士的培训目标，以获取以下方面的技能和知识：（1）定性和混合方法用于干预适应和发展；（2）临床，尤其是务实的试验的行为；（3）实施科学方法和框架在初级保健研究中的应用。资源费城儿童医院和宾夕法尼亚大学，以及跨学科的专家团队导师和顾问将提供出色的背景，以启动威廉姆森博士的职业生涯。这个项目将还为威廉姆森博士的未来R01提交大规模有效性提供了必要的数据 - 初级保健行为睡眠干预的实施试验。该项目符合NICHD的优先事项，由于它着重于低SES儿童的初级保健和行为健康促进的行为干预。