Project Description:
Sleep problems in young children are prevalent and consequential− but they are preventable and treatable. Short sleep duration begins to occur, and behavioral sleep problems (BSP) and sleep-disordered breathing (SDB) peak, in preschool-age children (3-5 years), when 25%-50% do not sleep enough, 25% have a BSP, and up to 20% have SDB. Sleep problems impair social-emotional and cognitive function, and markedly increase risk for childhood obesity. Yet, healthy sleep habits can increase sleep duration and prevent BSPs. Behavioral strategies are effective for reducing BSPs. Clinical treatment reduces or eliminates SDB.
Our over-arching goal is to empower families with the knowledge and skills needed to obtain healthy sleep, and to recognize signs of a sleep problem, via early childhood education (ECE). Our Early Childhood Sleep Education Program (ECSEP) educates teachers, children, and parents about healthy sleep in a way they can process and understand. In a trial of the ECSEP, child sleep duration rose by 30 minutes/night.
Towards the over-arching goal, the Social-Ecological model guides a multi-component study: Primary outcomes at the Individual-level are child sleep and parent knowledge, attitudes, self-efficacy and beliefs. They are encircled by interventions: At the Interpersonal level is our ECSEP, reinforced by 1-to-1 contacts. At the Organizational level is a media campaign, and agency-wide education. Community outreach will engage local providers. Policy strategies seek to impact ECE guidelines. Secondary outcomes are: classroom climate, and; inclusion of sleep health literacy in ECE guidelines. The Specific Aims of this study are to:
Aim 1) Adapt Materials and Build Capacity- For sleep health, we will create and pilot test an ECSEP-based counseling flip-chart for 1-on-1 use, along with novel print and video media. For sleep problems, we will adapt and pilot BSP protocols for use in Head Start, and physician referrals for SDB. The team will prepare Head Start agencies to deliver interventions and collect data themselves.
Aim 2) Conduct Sleep Health Literacy RCT- Using a stepped wedge randomized design, we will enroll 540 parent-child dyads from 7 Head Start agencies in New York. Agencies cross-over from control to intervention. Outcomes are a) child sleep duration, b) parent knowledge, attitudes, self-efficacy and behavior, c) child sleep difficulty and d) classroom climate.
Aim 3) Study Feasibility of Targeting Sleep Problems- We will assess the acceptability and feasibility of screening, follow-up, and referral for sleep problems in a 15% subsample. We will train Head Start staff to use screening instruments, deliver sleep problem protocols for BSPs, and offer physician referral for possible SDB.
Poor sleep in early life has effects years later. Head Start serves low-income, mainly racial/ethnic minority families, in whom sleep health disparities are greatest. These disparities are modifiable. Despite ample data on sleep problems much less work has been done on effective strategies to promote sleep as a healthy behavior, (CDC 2013). Our study meets the national health literacy goal to: "embed accurate, accessible and actionable health information in all early childhood programs, such as Head Start, (DHHS 2010)
Core Function(s):
Performing Research or Evaluation, Developing & Disseminating Information, Continuing Education/Community Training
Target Audience:
Community Trainees / Short term trainees, Family Members/Caregivers, Children/Adolescents with Disabilities/SHCN, Legislators/Policy Makers
Unserved or Under-served Populations:
Racial or Ethnic Minorities, Disadvantaged Circumstances, Limited English, Geographic Areas, Rural/Remote, Urban, Specific Groups
Primary Target Audience Geographic Descriptor:
Single-County, State, National
