Development and Pilot Testing of Sleeping Healthy/Living Healthy a Comprehensive Sleep Intervention for Adolescents in Urban SBHCs

城市SBHC青少年睡眠健康/健康生活综合睡眠干预措施的开发和试点测试

基本信息

批准号：
10228081
负责人：
Jean-Marie Bruzzese
金额：
$ 25.01万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-03 至 2023-02-28
项目状态：
已结题

项目摘要

Background: Poor sleep quality, which contributes to impaired functioning, is elevated in urban, ethnic/racial minority adolescents due, in part, to poor sleep hygiene. Despite successful sleep hygiene interventions in younger children, none focus on adolescents, a group with unique developmental needs. Urban adolescents face unique contextual stressors, which may contribute to ineffective use of sleep hygiene behaviors. Mind- body integrative (MBIH) approaches (e.g. yoga, meditation) improve sleep quality in adults, but are rarely applied to adolescents. MBIH has been shown to reduce stress among adolescents. Taken together, this suggests that integrating MBIH with sleep hygiene strategies has the potential for a synergistic effect on improving sleep quality. Yet no interventions concurrently use MBIH and sleep hygiene with adolescents. Process evaluations are often lacking during intervention development. We address these treatment and methodological gaps. Aims: This pilot study will: (1) develop Sleeping Healthy/Living Healthy, a school-based health center (SBHC) intervention that combines MBIH and sleep hygiene strategies to improve sleep quality in urban adolescents with poor sleep quality; (2) evaluate the feasibility and acceptability of intervention procedures; and (3) assess the preliminary intervention effects on sleep quality in urban adolescents. Hypotheses: (1) The intervention will be feasible and acceptable as evidenced by high rates of recruitment, adherence to treatment protocols, and high intervention satisfaction ratings; and (2) over [ three ] months, compared to controls, adolescents randomized to the intervention will have improvement on two primary sleep quality outcomes, (a) sleep duration and (b) sleep fragmentation (sleep efficiency and disruptions), measured objectively (actigraphs) and subjectively (using validated instruments). Methods: This study includes a development phase and a pilot individually-randomized group treatment (IRGT) phase. In Year 1 we will develop the novel integrated intervention using an iterative participatory design process. We will be guided by input from adolescents via focus groups and by interviews with SBHC medical and mental health providers, health educators, and staff. In Year 2, we will conduct an IRGT trial with [ 60 ] adolescents with insufficient sleep recruited from two SBHCs in New York City. Adolescents will be randomized 1:1 to receive the intervention or an attention control. Process evaluation interviews guided by a rigorous fidelity framework with adolescents and with SBHC providers and personnel will be conducted to obtain feedback regarding intervention procedures. Significance: This study has high public health significance because it (1) will reach urban racial and ethnic minority adolescents, a vulnerable population [ with specific needs ] greatly impacted by poor sleep quality but largely ignored in the intervention literature to date; (2) simultaneously leverages MBIH and sleep hygiene, potentially amplifying intervention effects; and (3) utilizes objective sleep quality measures and rigorous formative process evaluation. Findings from this study will guide the design of a future full-scale IRGT.

背景：睡眠质量差会导致功能受损，在城市、民族/种族中发病率更高部分青少年的睡眠卫生状况不佳。尽管睡眠卫生干预措施取得了成功年龄较小的儿童，没有关注青少年，这是一个具有独特发展需求的群体。城市青少年面临独特的环境压力，这可能导致睡眠卫生行为的无效使用。头脑- 身体整合 (MBIH) 方法（例如瑜伽、冥想）可改善成人的睡眠质量，但很少见适用于青少年。 MBIH 已被证明可以减轻青少年的压力。综合起来，这表明将 MBIH 与睡眠卫生策略相结合可能会产生协同效应改善睡眠质量。然而，还没有针对青少年同时使用 MBIH 和睡眠卫生的干预措施。干预措施开发过程中往往缺乏过程评估。我们解决这些治疗和方法论上的差距。目标：这项试点研究将：(1) 开发“健康睡眠/健康生活”，一项以学校为基础的项目健康中心 (SBHC) 的干预措施结合了 MBIH 和睡眠卫生策略，以改善睡眠质量睡眠质量较差的城市青少年； (2)评估干预的可行性和可接受性程序； (3)评估城市青少年睡眠质量的初步干预效果。假设：(1) 高招募率证明干预措施是可行且可接受的，遵守治疗方案和高干预满意度；和（2）超过[ 三 ] 个月，与对照组相比，随机接受干预的青少年的两项主要睡眠将得到改善测量的质量结果，(a) 睡眠持续时间和 (b) 睡眠碎片（睡眠效率和中断）客观（活动记录仪）和主观（使用经过验证的仪器）。方法：本研究包括开发阶段和试点单独随机分组治疗（IRGT）阶段。在第一年，我们将使用迭代参与设计过程开发新颖的综合干预措施。我们将遵循通过焦点小组以及与 SBHC 医疗和心理健康提供者的访谈收集青少年的意见，健康教育者和工作人员。在第 2 年，我们将与 [ 60 ] 睡眠不足的青少年从纽约市的两家 SBHC 招募。青少年将按照 1:1 的比例随机分配接受干预或注意力控制。在严格的青少年忠诚度框架的指导下进行评估访谈并与 SBHC 提供者和人员一起获取有关干预的反馈程序。意义：这项研究具有很高的公共卫生意义，因为它 (1) 将影响城市种族以及少数民族青少年等弱势群体[ 有特定需求 ] 睡眠不好影响很大质量，但迄今为止在干预文献中基本上被忽视； (2)同时利用MBIH和睡眠卫生，可能会放大干预效果； (3) 采用客观的睡眠质量衡量标准严格的形成过程评估。这项研究的结果将指导未来全面 IRGT 的设计。