Sleep is essential for optimal health and development, and poor sleep quality is associated with impaired functioning and poor academic performance. Poorer quality sleep has been linked with poorer health outcomes in children, such as increased asthma morbidity and risk for obesity. Asthma and obesity are two co- morbid chronic health conditions highly prevalent in Latino, urban children. Latino children are disproportionately present in urban settings, and due to their exposure to higher levels of urban and cultural stressors, and increased risk for illness-related morbidity, are at greater risk for poor sleep hygiene and quality. The goal of this R34 application is to refine and test a novel sleep hygiene intervention to improve sleep quality among Latino, middle school-aged (6th-8th graders) children in urban public school settings. We will utilize our evidence-based intervention, Sleep Smart (SS), which is delivered in group format in the school setting and is shown to improve sleep hygiene and sleep quality in urban, middle school students. Sleep Smart Latino (SSL) will be administered by trained BA-level co-facilitators from the community to a group of Latino middle school children who are at risk for poor sleep quality (11-13 years of age). The SSL intervention will be implemented in two areas that contain a high prevalence of Latino children at risk for poor sleep quality: San Juan, Puerto Rico and Providence, Rhode Island.
The first aim of this application is to refine the SS intervention and intervention procedures for the RCT/R01. Refinement will involve a) translation and cultural tailoring for Latino middle school students, b) enhancement of the parent component, and c) ensuring applicability to the urban, middle school setting in both sites (PR and RI). Focus groups and Investigators with expertise in culturally tailored interventions will provide input.
The second aim of this application is to test the feasibility of the SSL intervention and training procedures through an Open Trial, to refine intervention modules and the training approach that will be used in the RCT/R01. Middle school children and their primary caregiver (two groups of 5 students per site; 10 in PR and 10 in RI) will be included.
The third aim of this application is to test the SSL intervention through a Pilot Randomized Control Trial to provide estimates of effect size that will be used to inform the sample size for the RCT/R01. We will recruit 75 Latino children with per site, and randomly assign them to either the SSL intervention, Sleep Education plus Child Health control condition, or standard care control condition (5 groups of each condition, per site). We expect the participants in the SSL intervention will have improvement on the following primary sleep quality outcomes (improved sleep duration and sleep efficiency) as measured by actigraphy, relative to the control conditions. Secondarily, we expect [ participants in SSL will show a decrease in total daily caloric intake relative to the control conditions.]

Public Health Relevance

Sleep is essential for children's daytime functioning and health. Poorer sleep hygiene can negatively affect sleep outcomes in children. Urban Latino children are at greater risk for poor sleep hygiene and poor quality sleep due to exposure to higher levels of urban and cultural stressors. We propose to refine and test a novel school-based intervention to improve sleep hygiene and in turn, sleep quality in urban Latino middle school children. We will refine and test an existing sleep hygiene intervention that has been shown to improve sleep in urban children. A culturally and contextually tailored sleep hygiene intervention has the potential to exert greater improvements in sleep hygiene and sleep outcomes for this high-risk group.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Planning Grant (R34)
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Special Emphasis Panel (ZHL1)
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Brown, Marishka
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Rhode Island Hospital
United States
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