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Advancing Engagement and Efficacy of Interventions for Co-Morbid Sleep and BehaviorProblems in Young Children

提高幼儿共病睡眠和行为问题干预措施的参与度和有效性

基本信息

批准号：
10612901
负责人：
Amanda Tarullo
金额：
$ 65.7万
依托单位：
BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-05-04 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10612901
关键词：
Acute Address Behavior Behavior Therapy Child Child Behavior Child Health Development Disparity Early Intervention Enrollment Family Functional disorder Health Health Benefit Home visitation Household Hygiene Income Intervention Low income Maintenance Measures Mental Health Motivation Outcome Parents Poverty Problem behavior Randomized Randomized, Controlled Trials Reduce health disparities Rest Risk Safety Self Determination Sleep Sleep Disorders Symptoms System Testing Toddler Transact Treatment Efficacy active control aged barrier to care behavioral health behavioral health intervention behavioral outcome checkup examination comorbidity design early childhood emotion regulation evidence base health disparity health equity high risk improved innovation intervention effect lower income families novel strategies physical conditioning post intervention preference prevent response sleep health social stigma socioeconomics stressor successful intervention trial design

项目摘要

PROJECT SUMMARY/ABSTRACT Socioeconomic health disparities in sleep and behavior problems are evident from early childhood. Young children in low-income families are at high risk of sleep and behavior problems, which often co-occur and predict long-term poor mental and physical health. These problems cause added strain in families that are already facing multiple poverty-related stressors, and family dysfunction in turn contributes to persistence and worsening of sleep and behavior problems. Engaging the family is essential to treating co-morbid sleep and behavior problems and preventing entrenched health disparities. Family interventions enhance child health outcomes; moreover, because child sleep, child behavior, and family functioning are intertwined, a successful intervention that addresses either sleep or behavior may lead to improvements both within and across domains. However, low-income families are often reluctant to seek or accept early intervention. Difficulty enrolling and retaining families undermines potential health benefits. Stigma associated with treating behavior problems also discourages families from accepting treatment. This project determines how best to overcome barriers to treatment in low-income families of children with co-morbid sleep and behavior problems. We compare how low-income families respond to two empirically-supported home visiting interventions, one treating sleep and the other treating behavior. Both are designed to address cultural, motivational, and logistical barriers to engagement. We also take the innovative approach of testing whether giving families a choice between a sleep or behavior intervention, so that the initial frame with which they enter the intervention relationship is one of self-determination, enhances family engagement and child outcomes. With a randomized, controlled trial design, we test effects of intervention (sleep vs. behavior), engagement, and family input (choice vs. assigned) on child symptoms and family functioning, and assess which intervention families most prefer, engage with, and value. We will enroll 500 low-income toddlers with co-morbid sleep and behavior problems, randomized to 4 home-visiting interventions: sleep, behavior, family choice (sleep or behavior), and an active control. At baseline and at 1, 5, and 9 months post- intervention, we will assess child sleep and behavior and family functioning. We will measure family preference, engagement, and perceived value of each intervention. Aim 1 is to examine effects of evidence- based sleep and behavior interventions in young low-income children with co-morbid sleep and behavior problems on child sleep and behavior and family functioning. Aim 2 is to determine whether parents prefer, engage with, and value a sleep or behavior intervention more. Aim 3 is to examine if giving families a choice of intervention results in higher engagement, higher perceived value and better family and child outcomes than assignment to intervention. By informing best practices for engaging low-income families to treat co-morbid sleep and behavior problems, results will be critical to reducing health disparities for children living in poverty.

项目总结/文摘