Optimizing a Mobile Health Platform for Sleep Promotion and Obesity Prevention in Children

总结/摘要 睡眠持续时间较短一直与儿童肥胖有关，美国科学院 儿科建议儿科医生促进睡眠作为他们预防肥胖努力的一部分。儿科 初级保健环境具有促进睡眠的巨大潜力，但在护理点缺乏时间是关键 睡眠障碍、睡眠不足和儿童肥胖在社会人口群体中的分布并不均匀。 为了克服这些障碍，需要开发移动的健康平台来提供行为睡眠促进 在家庭环境中远程进行，根据个人和环境因素进行定制，以帮助确保公平 社会人口群体的有效性。多组分睡眠促进干预措施已被 初步研究结果表明，行为睡眠干预是有效的。但这些 在儿科初级保健背景下，干预措施尚未设计用于远程交付。而且 个别组件尚未优化，这意味着某些组件可能无效或无效。 有效该研究小组的目标是为儿科护理环境设计一个移动的健康平台， 促进更长的睡眠时间，以预防儿童肥胖。他们的核心假设是， 一组最佳的干预成分，以增加睡眠时间和防止体重过度增加， 在不同社会人口背景下的平等效力。这一假设将通过以下三个方面来检验： 这一战略将以多阶段优化战略（MOST）为指导。根据目标1， 优化试验将使用创新的实验设计进行，以确定最佳组分 促进睡眠的设置。总共有四个候选成分将进行实验测试：1）睡眠目标 组件，2）数字消息传递组件，3）父母指导的激励组件，以及4）个性化的 反馈组件一个咨询委员会（家庭、青少年和临床医生）将提供反馈， 确保组分含量的可接受性。根据目标2，调查小组将确定是否最佳 促进睡眠的设置导致脂肪质量指数的增加较少。他们还将测量总能量摄入量 以及用餐的时间和组成来获得机械的见解。根据目标3，调查人员将 确定促进睡眠的最佳设置是否在个人和社区水平上具有可比性 社会人口因素。这项创新的研究将人们的注意力从睡眠不足的问题转移到了 解决睡眠不足，并代表了第一个应用程序的MOST框架工程师的移动的 健康平台，以促进睡眠，预防肥胖，这将是公平的社会人口群体。 这项拟议中的研究将极大地推进行为睡眠医学领域，并重新设想如何不足 睡眠时间和肥胖是在儿科保健中预防的。

SUMMARY/ABSTRACT Shorter sleep duration has been consistently associated with childhood obesity, and the American Academy of Pediatrics recommends that pediatricians promote sleep as part of their obesity prevention efforts. The pediatric primary care setting has enormous potential to promote sleep, but a lack of time at the point of care is a key barrier, and insufficient sleep and childhood obesity are not equally distributed across sociodemographic groups. To overcome these barriers, mobile health platforms need to be developed to deliver behavioral sleep promotion remotely in the home setting, with tailoring to individual and contextual factors to help ensure equitable effectiveness across sociodemographic groups. Multi-component sleep promotion interventions have been developed, and initial findings suggest that behavioral sleep interventions are effective. However, these interventions have not been designed for remote delivery in the pediatric primary care context. Furthermore, the individual components have not yet been optimized, meaning some components may be ineffective or counter- effective. The study team’s objective is to engineer a mobile health platform for the pediatric care setting to promote longer sleep duration for childhood obesity prevention. Their central hypothesis is that they will identify an optimal set of intervention components to increase sleep duration and prevent excess weight gain, with equitable effectiveness across sociodemographic backgrounds. This hypothesis will be tested by pursuing three specific aims and will be guided by the Multiphase Optimization Strategy (MOST) framework. Under aim 1, an optimization trial will be conducted using an innovative experimental design to determine optimal component settings for sleep promotion. A total of four candidate components will be experimentally tested: 1) a sleep goal component, 2) a digital messaging component, 3) a parent-directed incentive component, and 4) a personalized feedback component. An advisory board (family, youth, and clinicians) will provide feedback throughout to ensure acceptability of the component content. Under aim 2, the investigative team will determine if optimal settings for sleep promotion lead to lesser gains in fat mass index. They will also measure total energy intake and the timing and composition of meals to gain mechanistic insights. Under aim 3, the investigators will determine if optimal settings for sleep promotion are comparable across individual- and neighborhood-level sociodemographic factors. This innovative research shifts attention from the problem of insufficient sleep to a solution for insufficient sleep, and represents the first application of the MOST framework to engineer a mobile health platform to promote sleep for obesity prevention that will be equitable across sociodemographic groups. The proposed research will greatly advance the field of behavioral sleep medicine and reimagine how insufficient sleep duration and obesity are prevented in pediatric healthcare.