Parenting Intervention to Improve Young Children's Sleep in Families with Low Income

点击翻译按钮获取中文摘要

One-in-three children (ages 2-4 years), and one-in-two children living in poverty, do not get adequate sleep. These concerning sleep disparities elevate children’s risk for chronic diseases, particularly among children from under-resourced populations. While behavioral sleep interventions have been effective at elongating children’s sleep, existing studies are limited because they rarely include lowincome families and typically focus more on the treatment of diagnosed sleep conditions. Insufficient attention to diversity perpetuates sleep disparities by not providing cogent support to families who may benefit most. Thus, interventions aimed at prevention need to address salient challenges experienced by low-income populations and incorporate modifiable strategies to improve unique barriers and needs. The goal of this project is to contribute to improvements in children’s sleep by pilot testing and strengthening “Sleep Tight” – a behavioral sleep intervention aimed at meeting the needs of families experiencing economic disadvantage. This project uses a community-engaged approach with parents and key stakeholders to understand and address modifiable barriers to creating optimal child sleep habits. Intervention content is designed to capitalize on community strengths and overcome distinct barriers to ensure maximum relevance. Using a pilot randomized controlled trial (RCT) design, families (N=60) are randomized to the intervention (n=30) or wait-list control (n=30) group. Intervention content is delivered by an interventionist via virtual, one-on-one sessions with each primary caregiver. Both groups are assessed at pre- and post-, and then the intervention group is also assessed at follow-up, while the wait-list control group can participate in the Sleep Tight intervention. The primary focus of the pilot RCT is to assess intervention feasibility via recruitment, retention, attendance, and acceptability metrics. The secondary goal is to assess the preliminary efficacy on intervention changes in children’s nighttime sleep duration using actigraphy to inform a future large-scale RCT. Furthermore, given links between child sleep, social-emotional functioning (e.g., problem behaviors), and obesity-related behaviors (e.g., diet, screen time, physical activity), interventions to improve child sleep have the potential to improve physical and socialemotional well-being, without directly intervening on these domains (i.e., cascading effects). As such, this project includes an exploratory aim to assess potential cascading effects on children’s socialemotional well-being and obesogenic behaviors as indicators on changes in these domains. Results of this study will contribute to the long-term goal of producing a behavioral sleep intervention that improves child sleep and impacts obesogenic behaviors and social-emotional well-being. Ultimately, this work seeks to reduce child sleep disparities for families with low-income, to promote both physical health and social-emotional development.