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。2003年国家睡眠障碍研究计划承认：（a）低社会经济地位与充足睡眠的机会减少和环境条件阻止良好的睡眠质量有关，（B）种族/民族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介导。以前的研究还没有充分研究具体的机制（例如，家庭结构、贫困状况、接受社会服务），从而使少数民族和社会经济弱势儿童的睡眠质量较差。到目前为止，关于这种关系的数据很少，如果有的话，在幼儿中，特别是那些来自弱势背景的儿童，他们是最有可能出现不良发展结果的。这项研究的重点是控制睡眠相关的行为（例如，睡前常规及其组成部分，就寝时间的规律性，共同睡眠）及其与社会经济弱势幼儿健康结果的关系。我们建议分析两个纵向的，全国性的，大样本的数据集，脆弱家庭和儿童福利研究（FFCW; n~3000）和早期领先研究（EHS; n~1900）。这两个数据集都提供了详细的、重复的睡眠相关行为、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岁的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中如何变化。看护者控制的睡眠相关行为的社会和经济预测因素目标2：检查社会经济劣势（例如，母亲受教育程度低、家庭贫困、单身母亲家庭）解释了1-5岁儿童中由母亲控制的睡眠相关行为在种族和民族方面的已知差异。目标3：调查是否接受社会服务（例如，在1-5岁的儿童中，参加早期开端中心或接受公共援助、家访、病例管理的儿童与护理者控制的睡眠相关行为的使用增加相关，不考虑社会经济劣势和其他家庭和家庭特征（例如种族、家庭规模）的调整。健康结果和照顾者控制的睡眠相关行为目的4：评估1岁，2岁和3岁时照顾者控制的睡眠相关行为与5岁时特定行为，认知和身体健康结果的相关程度，调整之前的儿童特征，社会经济劣势以及其他家庭和家庭特征。公共卫生相关性：拟议的研究重点是与睡眠相关的行为（例如，睡前常规及其组成部分，睡前规律性，共同睡眠）及其与社会经济弱势幼儿的行为，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，并为制定文化敏感的计划提供信息，以促进睡眠质量和儿童福祉。

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.