Healthy sleep habits and resulting sleep quality and quantity are critical to children's growth and development. Children who live in economically stressed urban environments are especially vulnerable to unhealthy sleep habits and their negative consequences, but families' perceptions about sleep and sleep habits and preferences regarding support for promoting healthy sleep habits are not known and interventions are urgently needed to promote healthy sleep habits and address individual, family, cultural and social factors that contribute to poor sleep habits and sleep difficulty among young children who live in economically stressed urban environments. The proposed study, guided by the Social Ecological Model, will use a community engaged (CEnR) approach to obtain foundational information in support of a community-engaged sleep promotion program for children between 6 and 36 months of age. We will address the following specific aims: (1) Examine parents' knowledge and perceptions about their 6-36 month old children's sleep and objective characteristics of sleep, including (1a) self-reported and actigraph-recorded characteristics of sleep, sleep habits, and difficulty; (1b) the contributions of sleep habits and individual, family, community, cultural/social, and health-related factors to sleep characteristics and sleep difficulty; (1c) consequences of sleep difficulty; (1d) successful and unsuccessful strategies used to promote children's sleep and sleep habits; (1e) preferences regarding sleep promotion interventions for their children; and perceptions of the optimal timing to begin sleep promotion intervention; (2) Examine pediatric primary care providers' perceptions about (2a) the importance of sleep and sleep habits for 6-36 month old children; (2b) factors that contribute to sleep habits and sleep difficulty; (2c) successful and unsuccessful approaches to promote healthy sleep habits, adequate duration and good quality sleep and assessment and management of sleep difficulty in young children within the context of their families; and (2c) barriers, facilitators, and preferences regarding sleep-promoting interventions for families with young children; (3) Collaborate with families and providers to use the information obtained in Aims 1 and 2 to develop and refine a feasible, relevant, and acceptable sleep promotion program, including procedures, protocols, patient materials, intervention fidelity plans, and delivery methods. We will use CEnR and a convergent mixed methods approach to fully engage community stakeholders (parents, pediatric health care providers) to develop a sleep promotion intervention. We expect that the results will lead to a future randomized controlled trial (RCT) that will examine the sustained effects of a community engaged sleep promotion program on sleep habits, sleep, and sleep-related outcomes among young children who live in economically stressed urban environments. Our long term goal is to disseminate and translate an efficacious sleep promotion intervention into community settings.

Public Health Relevance

Healthy sleep habits are critical to growth, development, function, and prevention of chronic conditions. However, over 30% of young children have sleep difficulty, and urban children who represent minority groups and live in economic adversity are at particular risk for sleep difficulty and its negative effects. The proposed study, guided by the Social Ecological Model, will provide the foundation to address the pressing need for community-engaged, sustainable and culturally relevant interventions to promote healthy sleep habits that address the contexts in which these families live and lead to sustained good health.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21NR016190-02
Application #
9316732
Study Section
Nursing and Related Clinical Sciences Study Section (NRCS)
Program Officer
Roary, Mary
Project Start
2016-07-15
Project End
2018-05-31
Budget Start
2017-06-01
Budget End
2018-05-31
Support Year
2
Fiscal Year
2017
Total Cost
$211,825
Indirect Cost
$80,051
Name
Yale University
Department
Type
Schools of Nursing
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520
Redeker, Nancy S; Ordway, Monica R; Banasiak, Nancy et al. (2018) Community partnership for healthy sleep: Research protocol. Res Nurs Health 41:19-29
Ordway, Monica R; Sadler, Lois S; Canapari, Craig A et al. (2017) Sleep, biological stress, and health among toddlers living in socioeconomically disadvantaged homes: A research protocol. Res Nurs Health 40:489-500