Disadvantaged Children: Predictors and Outcomes of Sleep Behaviors

描述(由申请人提供)：来自弱势背景的儿童面临与健康受损风险增加相关的压力因素。《2003年全国睡眠障碍研究计划》承认：(A)社会经济地位低与获得充足睡眠的机会减少以及环境条件妨碍良好睡眠质量有关；(B)种族/族裔和社会经济地位对健康结果的不利影响可能通过睡眠减少来调节。先前的研究没有充分调查导致少数族裔和在社会经济上处于不利地位的儿童睡眠较差的具体机制(例如，家庭结构、贫困状况、接受社会服务)。到目前为止，关于这种关系的数据在幼儿中几乎没有，特别是那些来自贫困背景的儿童，他们面临着不利发展结果的最高风险。本研究旨在探讨照顾者控制的睡眠相关行为(如就寝时间及其组成部分、就寝时间的规律性、共眠)及其与社会经济弱势儿童健康结局的关系。我们建议分析两个纵向的、全国性的大样本数据集，即脆弱家庭和儿童福祉研究(FFCW；n~3000)和早期启动研究(EHS；n~1900)。这两个数据集都提供了关于睡眠相关行为、社会经济家庭特征、幼儿发育/生物医学状况以及儿童行为、认知和身体健康结果的详细、重复的测量。我们将解决以下目标：照顾者控制的睡眠相关行为目标1：描述1岁、2岁、3岁和5岁弱势儿童的照顾者控制的睡眠相关行为，以及这些行为在早期发展过程中如何变化。护理者控制的睡眠相关行为的社会和经济预测指标目标2：检验社会经济劣势(例如，母亲教育程度低、家庭贫困、单亲家庭)是否可以解释1-5岁儿童中照顾者控制的睡眠相关行为因种族和民族而产生的已知差异。目的3：调查接受社会服务(例如，儿童在早期启蒙中心注册或接受公共援助、家访、病例管理)是否与1-5岁儿童更多地使用照顾者控制的睡眠相关行为(扣除社会经济不利因素和其他家庭和家庭特征(如种族、家庭规模))有关。健康结果和照顾者控制的睡眠相关行为目标4：评估1、2和3岁的照顾者控制的睡眠相关行为与5岁时特定的行为、认知和身体健康结果的关联程度，扣除先前的儿童特征、社会经济劣势和其他家庭和家庭特征的调整。公共卫生相关性：拟议的研究集中在照顾者控制的睡眠相关行为(例如，就寝时间及其组成部分、就寝时间的规律性、共眠)以及它们与社会经济贫困儿童的行为、认知和身体健康结果的关系。了解这些关系将确定干预的目标人群，并为制定对文化敏感的计划以提高睡眠质量和儿童福祉提供信息。

DESCRIPTION (provided by applicant): Children from disadvantaged backgrounds face stressors associated with increased risk for compromised health. The 2003 National Sleep Disorders Research Plan acknowledges that: (a) low socioeconomic status is associated with diminished opportunity for adequate sleep and environmental conditions preventing good sleep quality and (b) the adverse impact of race/ethnicity and socioeconomic status on health outcomes may be mediated by decrements in sleep. Prior research has not fully investigated specific mechanisms (e.g., family structure, poverty status, receipt of social services) through which racial minorities and socioeconomically disadvantaged children experience poorer sleep. To date, little-if-any data on such relationships are available in young children, especially those from disadvantaged backgrounds who are at highest risk for adverse developmental outcomes. This research focuses on caregiver-controlled sleep-related behaviors (e.g., bedtime routine and its components, regularity of bedtime, co-sleeping) and their associations with health outcomes in socioeconomically disadvantaged young children. We propose to analyze two longitudinal, national, large-sample datasets, the Fragile Families and Child Wellbeing Study (FFCW; n~3000) and the Early Head Start Study (EHS; n~1900). Both datasets provide detailed, repeated measures of sleep-related behaviors, socioeconomic family characteristics, early childhood developmental/biomedical status, and children's behavioral, cognitive, and physical health outcomes. We will address the following aims: Caregiver-Controlled Sleep-Related Behaviors Aim 1: To describe caregiver-controlled sleep-related behaviors in disadvantaged children at ages 1, 2, 3, and 5 years old and how these behaviors change across early development. Social and Economic Predictors of Caregiver-Controlled Sleep-Related Behaviors Aim 2: To examine whether socioeconomic disadvantage (e.g., low maternal education, household poverty, single-mother households) explains known variation by race and ethnicity in caregiver-controlled sleep-related behaviors in children ages 1-5. Aim 3: To investigate whether receipt of social services (e.g., child enrolled in an Early Head Start Center or receiving public assistance, home visits, case management) is associated with increased use of caregiver- controlled sleep-related behaviors in children ages 1-5, net of adjustment for socioeconomic disadvantage and other family and household characteristics (e.g. race, family size). Health Outcomes and Caregiver-Controlled Sleep-Related Behaviors Aim 4: To assess the extent to which caregiver-controlled sleep-related behaviors at ages 1, 2, and 3 are associated with specific behavioral, cognitive, and physical health outcomes at age 5, net of adjustment for prior child characteristics, socioeconomic disadvantage, and other family and household characteristics. PUBLIC HEALTH RELEVANCE: The proposed research focuses on caregiver-controlled sleep-related behaviors (e.g., bedtime routine and its components, regularity of bedtime, co-sleeping) and their associations with behavioral, cognitive, and physical health outcomes in socioeconomically disadvantaged young children. Understanding these relationships will identify target populations for intervention and inform development of culturally- sensitive programs to promote sleep quality and child wellbeing.