Development and implementation of a digital sleep intervention for preschoolers in foster care

项目摘要 寄养儿童（FC）面临慢性健康状况的风险，部分原因是接触不良环境。 童年经历（ACE）早期干预可以改善健康差距和经济负担 与ACE相关，与学龄前阶段相比， 到发展后期的干预。FC儿童睡眠障碍的风险很高，这是一个主要的问题。 导致慢性健康状况的发展和恶化，但行为睡眠 对这一群体的干预措施不存在。K01提案旨在解决护理中的这一关键差距 并通过制定和实施创伤知情的 数字公共卫生水平的睡眠干预称为睡眠向导，我们将管理，以促进护理人员 学龄前儿童我们的创新方法包括与主要利益相关者的规划小组合作 包括FC工作人员和父母，以及睡眠，创伤，健康和FC背景下的干预专家。 目标1的目标是与规划小组一起开发并验证初始睡眠向导干预内容， 通过创伤知情护理文献，支持健康睡眠的循证策略，FC 许可证条例，以及养父母的需求和经验。在目标2中，睡眠向导将由以下人员进行预测试： 培养照顾者，他们将提供有关可接受性、可行性和 干预的适当性，将用于进行最终干预修改。目标3将 评估睡眠向导是否与寄养照顾者睡眠行为的改善相关， 从干预前到干预后以及3个月随访时的儿童睡眠。这将是第一次大规模的 在这一人群中开发并测试了睡眠干预。地方和国家利益攸关方表示， 热情，并致力于参与睡眠的开发，实施和评估 向导.为了实现研究计划，PI将执行结构化的综合培训计划，以获得 专业技能（1）睡眠，心理健康，并在寄养的情况下在幼儿期ACE，（2） 发展与儿童福利界的伙伴关系，（3）制定和实施干预措施 科学，（4）数字干预措施的实施和传播，以及（5）进行临床试验。 培训将由一个在这些领域具有跨领域专门知识的优秀导师团队监督， 成功的指导经验和合作的跟踪记录。执行研究和 培训计划也将得到机构环境的支持，即布朗医疗 学校，布拉德利医院，和两个新的主要中心赠款集中在促进职业发展的 早期研究人员在1）童年压力，创伤和恢复力，2）睡眠和昼夜节律， 儿童和青少年心理健康。这个奖项将弹射我的过渡到一个独立的翻译 科学家，在科学和公共卫生方面的职业生涯对早期生活逆境，睡眠和健康的影响很高。

PROJECT SUMMARY Children in foster care (FC) are at risk for chronic health conditions, in part due to exposure to adverse childhood experiences (ACEs). Early intervention may ameliorate health disparities and economic burden associated with ACEs, with the preschool period yielding a substantially larger return on investment compared to interventions later in development. Children in FC are at high risk for sleep disturbances, which are a major contributor to the development and exacerbation of chronic health conditions, yet behavioral sleep interventions for this population are nonexistent. This K01 proposal seeks to address this critical gap in care and promote health equity in this underserved population by developing and implementing a trauma-informed digital public-health-level sleep intervention called Sleep Wizard, which we will administer to foster caregivers of preschoolers. Our innovative approach involves collaboration with a planning group of key stakeholders including FC workers and parents, and experts in sleep, trauma, health, and interventions in the context of FC. The goal of Aim 1 is to develop and digitize initial Sleep Wizard intervention content with the planning group, informed by the literature on trauma-informed care, evidence-based strategies to support healthy sleep, FC licensing regulations, and foster parent needs and experiences. In Aim 2, Sleep Wizard will be pretested by foster caregivers who will provide quantitative and qualitative data on acceptability, feasibility, and appropriateness of the intervention, which will be used to make final intervention modifications. Aim 3 will evaluate whether Sleep Wizard is associated with improvements in foster caregiver behaviors around sleep, and in child sleep from pre to post intervention, and at a 3-month follow-up. This will be the first large scale sleep intervention developed and tested in this population. Local and national stakeholders have expressed enthusiasm and have committed to involvement in the development, implementation, and evaluation of Sleep Wizard. To achieve the research plan, the PI will execute a structured comprehensive training plan to gain specialized skills in (1) Sleep, mental health, and ACEs in early childhood in the context of foster care, (2) Developing partnerships with the child welfare community, (3) Intervention development and implementation science, (4) Implementation and dissemination of digital interventions, and (5) Conducting clinical trials. Training will be overseen by an outstanding mentorship team with cross-cutting expertise in these areas and a track record of successful mentorship experiences and collaborations. Implementation of the research and training plan will also be bolstered by support from the institutional environment, namely Brown Medical School, Bradley Hospital, and two new major center grants focused on promoting the career development of early-stage investigators in 1) childhood stress, trauma, and resilience, and 2) sleep and circadian rhythms in child and adolescent mental health. This award will catapult my transition to an independent translational scientist with a career high in scientific and public health impact in early life adversity, sleep, and health.