Sleep Well, Bee Well: Sleep Health Promotion Intervention in Early Head Start

项目摘要 幼儿期睡眠不足，包括睡眠时间不佳、睡眠时间不足和夜间睡眠不足 觉醒，与许多健康问题有关，如肥胖，情绪调节不良， 0-4岁儿童的发育受损和受伤风险较高。睡眠不足更普遍 在有色人种儿童和那些在经济上被边缘化的儿童中， 与高收入和非低收入儿童相比， 西班牙裔白色儿童。行为睡眠干预（BSI）可能会改善睡眠不足，但知之甚少 关于BSI在种族/族裔多样性和经济边缘化中的可行性和有效性 孩子本试验的目的是评估临床试验的可行性， BSI的初步疗效，睡眠好，蜜蜂好（SWBW）设计的种族/民族多样化， 经济上处于边缘地位的幼儿参加了联邦资助的早期开端（EHS）计划。我们选择 关注1-2.5岁的幼儿，因为这是快速认知的重要发展阶段， 语言，社会情感和运动发育;睡眠习惯在这个年龄是可塑的; 干预是解决健康差距的关键。根据睡眠的社会生态模型（SEM）， 健康，SWBW工作在组织（EHS教师-家长），人际（父母-孩子，EHS教师- 幼儿）和个体（幼儿）水平。根据社会认知理论的结构，SWBW包括 互动多媒体材料和活动，以鼓励家长和EHS之间的双向沟通 教师共同制定量身定制的睡眠健康目标，以满足就寝时间，环境和持续时间 睡眠（B.E.D）建议幼儿。我们提出了一个实用的集群随机试验，以确定 SWBW的可行性，并测试提供给一个EHS中心的SWBW的初步疗效， 另一个EHS中心，具有类似的登记和人口统计数据，将作为候补名单控制。我们将 具体目标如下：（1）确定SWBW在44个1-2.5岁家庭中的可行性 健康儿童和EHS教师从两个托儿中心;（1a）完善和标准化的SWBW 干预材料（视频，讲义，活动）;（1b）确定可行性（可接受性，需求， SWBW的实施、实用性、适应性、集成、扩展和有限功效测试 干预措施、研究设计和招募目标;（2）评价22例SWBW患者的初步疗效 干预和22个等待名单控制父母-孩子对（2a）幼儿的睡眠健康（持续时间，时间， 连续性），睡前常规和父母和EHS教师的睡眠知识和（2b）幼儿的社会情感 健康、就寝时间、父母幸福和家长-教师参与。这项试点研究的结果 将为未来更大规模的随机分组试验提供支持，该试验将充分检验其效果 在新英格兰领先协会注册的多个EHS项目中，

PROJECT SUMMARY Sleep deficiency in early childhood, including poorly timed sleep, inadequate sleep duration, and night awakenings, is associated with numerous health concerns such as adiposity, poor emotional regulation, impaired growth, and higher risk of injuries in children aged 0-4 years. Sleep deficiency is more prevalent among children of color and those who are economically marginalized and may contribute to the cycle of disadvantage and higher risk for health disparities by age 4 years compared to higher income and non- Hispanic white children. Behavioral sleep interventions (BSIs) may improve sleep deficiency, but little is known about the feasibility and efficacy of BSIs among racially/ethnically diverse and economically marginalized children. The purpose of this proposed pilot pragmatic cluster randomized trial is to evaluate the feasibility and preliminary efficacy of a BSI, Sleep Well, Bee Well (SWBW) designed for racially/ethnically diverse and economically marginalized toddlers enrolled in federally-funded Early Head Start (EHS) programs. We chose to focus on toddlers aged 1-2.5 years because this is an important developmental stage of rapid cognitive, language, social emotional, and motor development; sleep habits are malleable at this age; and early intervention is key to addressing health disparities. Based on the socioecological model (SEM) of sleep and health, SWBW works at the organizational (EHS teacher-parent), interpersonal (parent-child, EHS teacher- toddler), and individual (toddler) levels. Informed by the constructs of social cognitive theory, SWBW includes interactive multimedia materials and activities to encourage two-way communication between parents and EHS teachers to co-develop tailored sleep health goals towards meeting Bedtime, Environment, and Duration of sleep (B.E.D) recommendations for toddlers. We propose a pragmatic cluster randomized trial to determine the feasibility of SWBW and test the preliminary efficacy of SWBW provided to one EHS center compared to another EHS center with similar enrollment and demographics that will serve as a waitlist control. We will address the following specific aims: (1) Determine the feasibility of SWBW among 44 families of 1-2.5-year-old healthy children and EHS teachers from both childcare centers; (1a) refine and standardize the SWBW intervention materials (videos, handouts, activities); (1b) determine the feasibility (acceptability, demand, implementation, practicality, adaptation, integration, expansion, and limited-efficacy testing) of the SWBW intervention, study design and recruitment goals; (2) Evaluate the preliminary efficacy of SWBW in 22 intervention and 22 wait-list control parent-child dyads on (2a) toddlers' sleep health (duration, timing, continuity), bedtime routines and parent and EHS teacher sleep knowledge and (2b) toddler's social-emotional health, bedtime routines, parent well-being and parent-teacher engagement. The results from this pilot study will provide support for a future larger scale cluster randomized trial that will be fully powered to test the effects of the SWBW program in multiple EHS programs enrolled in the New England Head Start Association.