Increasing Sleep Health Literacy in Head Start: A Social-Ecological Approach

 描述（由申请人提供）：儿童早期睡眠不足和/或质量差会损害社会情感和认知功能（通过对发育中的大脑的影响），并显着增加肥胖风险（通过激素和内分泌影响）。睡眠时间短，行为睡眠问题和睡眠呼吸障碍的高峰在学龄前（3-5岁）为20%-50%。健康的睡眠习惯可以增加睡眠时间，预防行为性睡眠问题。睡眠呼吸障碍症状的意识导致及时治疗。尽管有充足的数据对睡眠问题“.在促进睡眠作为一种健康行为的有效策略方面所做的工作要少得多（CDC 2013）。这项研究的总体目标是使学龄前儿童的家庭获得健康睡眠所需的知识和技能，并认识到睡眠问题。它建立在我们的工作在头开始，早期儿童教育（ECE）计划为弱势学龄前儿童及其家庭：我们的早期儿童睡眠教育计划（ECSEP（tm））教育头开始教师，儿童和家长关于健康的睡眠，他们可以处理和理解的方式。在一项随机对照试验中，ECSEP组的儿童每晚多睡30分钟。此外，我们的加州大学洛杉矶分校卫生保健研究所的结构化方法，以低识字健康培训的头开始（以减少急诊室访问，肥胖等）。已覆盖超过10万个家庭。拟议的研究将实施一个多层次干预的社会生态网络，以加强ECSEP，并促进整个ECE的健康睡眠。在开端，我们将创建新的交付平台（打印和视频，家庭访问），“放大”ECSEP。除了“先声夺人”之外，我们还将教育社区，并与利益攸关方合作制定旨在将“睡眠健康知识”纳入欧洲经委会政策的战略。该项目将：1）将睡眠教育材料改编成额外的多媒体 媒体格式，以及;应用卫生保健研究所的模式，培训开端工作人员安装干预措施和收集数据。2)从纽约的7个Head Start机构招募了540对父母-孩子进行一项阶梯楔形随机对照试验。我们将分析试验对主要结局的影响：a）儿童睡眠时间，B）父母的知识、态度、自我效能和行为，以及c）儿童睡眠困难。3)评估筛查和指导睡眠问题（与睡眠健康）的可行性，以用于未来的疗效研究。次要结果是：课堂行为，政策变化和过程数据。早期发育中的睡眠不足会对未来几年产生影响，也许会影响到成年期。Head Start服务于低收入，主要是少数民族家庭，他们的睡眠健康差异最大-但可以改变。这项研究结合了在Head Start中提供健康素养（卫生保健研究所）和睡眠健康（ECSEP）计划的成熟方法。在社会生态模型的每一个层面进行干预，最大限度地提高了研究的范围和可持续性。将睡眠健康知识纳入全国的幼儿教育，最终将使400多万儿童受益。对人类健康的潜在影响是深远的。

 DESCRIPTION (provided by applicant): Inadequate and/or poor quality sleep in early childhood impairs social-emotional and cognitive function (via effects on the developing brain), and markedly increases obesity risk (via hormonal and endocrine effects). Short sleep duration, behavioral sleep problems and sleep-disordered breathing peak at 20%-50%, during the preschool years (ages 3-5). Healthy sleep habits increase sleep duration and prevent behavioral sleep problems. Awareness of sleep-disordered breathing symptoms leads to timely treatment for it. Despite ample data on sleep problems "...much less work has been done on effective strategies to promote sleep as a healthy behavior (CDC 2013)". This study's overarching goal is to empower families of preschool children with the knowledge and skills needed for healthy sleep, and to recognize a sleep problem. It builds on our work in Head Start, an early childhood education (ECE) program for disadvantaged preschool children and their families: Our Early Childhood Sleep Education Program (ECSEP(tm)) educates Head Start teachers, children, and parents about healthy sleep in a way they can process and understand. In a randomized controlled trial, the children in the ECSEP group slept 30 minutes longer/night. As well, our UCLA Health Care Institute's structured approach to low literacy health training in Head Start (to reduce ER visits, obesity, etc.) has reached >100,000 families. The proposed study will implement a Social-Ecological web of multi-level interventions to reinforce the ECSEP, and to promote healthy sleep throughout ECE. Within Head Start, we will create new delivery platforms (print & video, family visits) that 'amplify' the ECSEP. Beyond Head Start, we will educate communities, and partner with stakeholders on strategies designed to embed `sleep health literacy' in ECE policy. This project will: 1) Adapt sleep education material into additional multi media formats, and; apply the Health Care Institute model to train Head Start staff to mount interventions and collect data. 2) Enroll 540 parent-child dyads from 7 Head Start agencies in New York in a stepped wedge randomized controlled trial. We will analyze trial effects on primary outcomes: a) child sleep duration, b) parent knowledge, attitudes, self-efficacy and behavior, and c) child sleep difficulties. 3) Assess the feasibility of screening and guidance for sleep problems (vs. sleep health) for a future efficacy study. Secondary outcomes are: classroom behaviors, policy change, and process data. Poor sleep in early development has ramifications for years to come, perhaps through adulthood. Head Start serves low-income, mainly racial-ethnic minority families, in whom sleep health disparities are greatest-- but are modifiable. This study joins together proven methods of delivering health literacy (Health Care Institute) and sleep health (ECSEP) programs in Head Start. Intervening at every level of the Social-Ecological model maximizes the study's reach and sustainability. Integrating sleep health literacy into ECE nationwide could ultimately benefit upwards of 4 million children. The potential impact upon human health is far-reaching.