COBRE Center for Sleep and Circadian Rhythms in Child and Adolescent Mental Health

项目摘要 大多数孕妇睡眠紊乱、睡眠不足，增加了不良健康的风险。 对母亲及其婴儿的后果，包括妊娠和分娩并发症以及 慢性疾病，如严重的抑郁症和体重保持/肥胖。按照惯例，围产期睡眠障碍 混乱一直被认为是意料之中的和难以解决的，但最近的研究表明，行为间干扰 安眠药能有效改善孕妇和产后的睡眠。然而，高效、可扩展 为孕妇和新妈妈量身定做的睡眠干预措施很少。本行政副刊 女性健康研究寻求在合作实验室开发一种高保真、循证的睡眠干预- 与与围产期妇女接触的直接护理人员进行了演讲，并收集了关于 将由此产生的干预措施提供给孕妇和新父母。我们为期一年的试点项目的基础是 RE-AIM框架，并将评估覆盖范围、有效性、采用、实施和维护 这一模型的维度，为未来大规模的R01混合有效性-实施试验做准备。在……里面 第一阶段，我们将用英语和西班牙语制作简短的、基于证据的教育视频，重点放在IM- 证明围产期睡眠，并将其映射到免费的公开移动应用程序CBTi Coach中的模块。VID- EOS将与直接护理人员和一家视频制作公司合作制作和完善，该公司 社区参与体验。与围产期妇女一起工作的直接护理人员将接受培训 提供干预(目标n=35)。在第二阶段，直接护理人员将被邀请使用干预措施 报告睡眠问题的客户，我们将研究在员工和客户(目标n=20)中的实施情况。我们 将以完成培训的合格工人和参加培训的合格女性的比例来衡量REACH 加入干预行动。将通过检查可行性和可接受性来评估工人的有效性，如 以及训练前后的睡眠知识。在围产期妇女中，我们将用以下方法来衡量有效性 定性可接受性测量和失眠严重程度指数(ISI)的变化。收养将被定义为 我们从中吸引直接护理人员进行培训的社区机构/项目的数量。我们将评估 在直接护理人员中实施，使用关于他们干预经验的定性数据，即， 对未来使用的期望、障碍、促进者和计划。围产期妇女的实施措施将 量化(即关于视频观看、总体应用程序使用和特定应用程序元素使用的元数据)和 定性(对可接受性和实用性的看法)。我们将通过检查持续使用率来评估维护- 直接护理人员的客户登记人数和围产期妇女继续使用应用程序的比率。这位亲王- 项目将使我们能够完善我们的干预，为未来的大规模有效性做准备--实施 将一种强大的、免费的行为睡眠干预整合到为高收入女性提供服务的环境中的试验 风险人群包括社会经济地位低的人、农村地区的家庭和军人家庭。

Project Summary Disrupted, insufficient sleep occurs in the majority of pregnant women and increases the risk of negative health consequences for mothers and their infants, including pregnancy and childbirth complications as well as chronic illnesses, such as major depression and weight retention/obesity. Conventionally, perinatal sleep dis- turbances have been viewed as expected and intractable, but recent studies demonstrate that behavioral inter- ventions are effective for improving sleep in pregnant and postpartum women. Nevertheless, efficient, scalable sleep interventions that are tailored to expectant and new mothers are scarce. This Administrative Supplement for Research on Women’s Health seeks to develop a high-fidelity, evidence-based sleep intervention in collab- oration with direct care workers who engage with perinatal women and to collect preliminary data regarding delivery of the resulting intervention to expectant and new parents. Our one-year pilot project is grounded in the RE-AIM framework, and will assess the Reach, Effectiveness, Adoption, Implementation, and Maintenance dimensions of this model to prepare for a large-scale future R01 hybrid effectiveness-implementation trial. In Phase 1, we will develop short, evidence-based, educational videos in English and Spanish that focus on im- proving perinatal sleep and that map onto modules in the free, publicly-available mobile app, CBTi Coach. Vid- eos will be produced and refined in cooperation with direct care workers and a video production company with community engagement experience. Direct care workers who work with perinatal women will then be trained to deliver the intervention (target n=35). In Phase 2, direct care workers will be invited to use the intervention with clients who report sleep problems and we will study implementation in workers and clients (target n=20). We will measure reach as the proportions of eligible workers who complete training and of eligible women who en- roll in the intervention. Effectiveness will be assessed in workers by examining feasibility and acceptability as well as sleep knowledge before and after the training. In perinatal women we will measure effectiveness with qualitative acceptability measures and change in insomnia severity index (ISI). Adoption will be defined as the number of community agencies/programs from which we draw direct care workers for training. We will evaluate implementation in direct care workers using qualitative data about their experiences with the intervention, i.e., expectations, barriers, facilitators, and plans for future use. Implementation measures in perinatal women will be quantitative (i.e., meta-data regarding video viewing, overall app use and use of specific app elements) and qualitative (perceptions of acceptability and utility). We will assess maintenance by examining rates of contin- ued enrollment of clients by direct care workers and rates of continued app use in perinatal women. This pro- ject will allow us to perfect our intervention in preparation for a future large-scale effectiveness-implementation trial of the integration of a powerful, free, behavioral sleep intervention into settings that serve women in high- risk populations including those with low socioeconomic status, families in rural areas, and military families.