Bedtime Routines Intervention for Children (BRIC) using an automated text messaging system for behaviour change

我们的工作涉及第一次为父母所生的幼儿在睡前最后一个小时的活动，即所谓的睡前例行公事(BTR)。这些活动包括刷牙、看书、洗澡和睡前不吃不喝。在适当的时间有固定的就寝时间也是非常重要的。建立良好的就寝习惯已被证明对许多健康、幸福、发展和社会结果非常重要。这些指标包括牙齿健康、健康体重、入学准备情况、亲社会行为和整体健康状况。我们的研究感兴趣的是，我们如何帮助第一次为人父母的人确保良好的就寝习惯。我们早期的工作发现，那些睡前习惯较差的儿童比那些睡前习惯较好的儿童患上更多的龋齿(导致疼痛、失眠和NHS在可预防的拔牙方面花费超过6000万GB)。此外，就学准备和在学校的表现与良好的睡眠密切相关，许多关心儿童福利的国家机构建议睡前阅读。因此，睡前习惯提供了一个机会，可以同时以多种方式影响幼儿(5岁以下)的健康和福祉，满足他们未来的重要需求。睡前有良好作息习惯的孩子在学校会更快乐、更健康、更成功。大多数家庭在孩子出生的第一年结束时就开始建立他们的就寝习惯。许多父母成功地完成了良好的例行公事，而另一些人则在挣扎，第一次为人父母的人尤其脆弱。目前，还没有可用的干预措施来帮助父母，特别是第一次当父母的人，他们之前没有让孩子入睡的经验。我们的主要目标是通过与父母和专业人士交谈，为首次使用发送到父母手机的短信的父母及其子女制定一种睡前常规干预措施。我们已经与家长一起使用了这个系统来监控孩子就寝前发生的事情。这位家长告诉我们，他们喜欢收到短信，并帮助提醒他们自己的日常生活。这让我们认为，短信可能会成为改变日常生活方式的有用工具，让它们变得更好。短信可以发送到任何类型的手机，而不需要拥有智能手机。此外，我们之前的研究表明，几乎每个父母都有手机，即使是那些背景较差的父母也是如此。这一结论得到了有关获取和使用手机和短信的现有统计数据的支持。在这项拟议的研究中，我们将做两项工作。第一个将帮助我们设计发送给父母的信息的类型和频率，第二个将在一组首次为人父母的人身上进行测试，看看它的效果如何。为了完成第一项工作，我们将与第一次为人父母的人交谈，了解他们孩子的就寝时间，找出他们遇到的问题，以及我们可以如何帮助他们。例如，一条信息可能是一个简单的提醒，告诉他们该睡觉了，或者是给他们的孩子推荐一本好书。我们发现，在我们早期的工作中，实时发送的简单文本消息是一个非常有用的工具。除了父母，我们还将与阅读、饮食、睡眠和一般健康方面的专家交谈，以确保我们使用他们提供的信息来设计信息。我们还将与地方当局的人交谈，他们负责为这样的项目提供资金，以确保我们的计划能够负担得起并将得到使用。最后，我们将结合来自父母和专家的关于改变行为的信息，并将这些信息纳入干预措施。第二项工作是与一群首次为人父母的人一起测试我们的新计划，以确保该系统有效、可接受和实用。我们还将考虑成本和节约。

Our work concerns the activities in the last hour before bed for young children born to first time parents; so called Bedtime Routines (BTR). These activities include among others tooth brushing, reading a book, having a bath and avoiding food and drinks before bed. Having a set bedtime at a suitable hour is also very important. Establishing good bedtime routines has been shown to be really important for a number of health, wellbeing, development and social outcomes. These include dental health, healthy weight, school readiness, prosocial behaviours and overall wellness. Our research is interested in how we can help first time parents to secure a good bedtime routine. Our earlier work found that those children with poorer bedtime routines suffered more dental decay (leading to pain, sleepless nights and costs to the NHS of over £60 million in preventable dental extractions) than those with good bedtime routines. Moreover, school readiness and performance at school is closely related to a good night's sleep and reading before bed is recommended by lots of national bodies concerned with child welfare. Bedtime routines therefore offer an opportunity to influence the health and wellbeing of young children (aged under 5) in many ways simultaneously, meeting important needs for their futures. Children with good routines at bedtime will be happier, healthier and more successful at school. Most families start establishing their bedtime routines by the end of the 1st year of their child's life. Many parents manage to achieve good routines while others struggle, with first time parents being particularly vulnerable. At the moment, there is no available intervention to help parents, especially first-time parents who have no prior experience of getting their child to sleep. Our main aim is to develop, by talking to parents and professionals, a bedtime routine intervention for first time parents and their children using text messages sent to parents' mobile phones. We have already used this system with parents to monitor what happens in the lead up to children's bedtime. The parents told us that they enjoyed receiving the text messages and that they helped remind them about their routines. This made us think that text messages can potentially be a useful tool in changing routines to make them better. Text messages can be sent to every type of mobile phone with no need to own a smartphone. Also, our previous work has shown that almost every parent had a mobile phone, even those from poorer backgrounds. That finding is supported by existing statistics regarding access and use of mobile phones and text messages. In this proposed study, we are going to do two pieces of work. The first will help us design the type and frequency of the messages we send to parents and the second will test this on a group of first-time parents to see how well it works. To do the first piece of work we will talk to first time parents to find out about their children's bedtimes and find out what problems they experience and how we might help them. For example, a message might be a simple reminder that it's time to start going to bed, or a recommendation on a good reading book for their child. We found that simple text messages sent in real time were a really useful tool in our earlier work. As well as parents we will speak with experts in reading, diet, sleep and general health to make sure that we use information from them to design the messages. We will also talk to people in local authorities whose responsibility it is to fund programmes like this to make sure that our plans can be afforded and will be used. Finally, we will combine the information about changing behaviours from parents and experts and build these in to the intervention. The second piece of work will be to test our new programme with a group of first-time parents to make sure that the system is working and is acceptable and practical. We will also consider cost and savings.