Sustainable Habits for Encouraging Even Teen Sleep (SHEETS): A Digital Intervention to Enhance Sleep Regularity and Psychiatric Health in Adolescents

鼓励青少年睡眠的可持续习惯（表）：增强青少年睡眠规律和精神健康的数字干预

• 批准号: 10551895
• 负责人: Naomi N Duke
• 金额: $ 24.15万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10551895
• 关键词: Adherence; Adolescence; Adolescent; Aftercare; Age; Arousal; Attention; Beds; Behavioral; Caring; Childhood; Clinical Trials; Communities; Control Groups; Development; Diagnostic; Disease; Education; Effectiveness; Emotional; Exhibits; Feedback; Foundations; Future; Goals; Habits; Health; Health Services; Health behavior change; Intervention; Intervention Studies; Interview; Life Cycle Stages; Link; Longevity; Measures; Mediating; Mediator; Medicine; Mental Depression; Mental Health; Mental disorders; Modeling; Monitor; Motivation; Outcome; Parents; Pattern; Performance; Persons; Population Heterogeneity; Positioning Attribute; Preparation; Prevention; Preventive care; Primary Care; Process; Psychiatry; Psychoses; Randomized, Controlled Trials; Reporting; Research; Research Domain Criteria; Risk; Risk Factors; Schedule; Science; Sleep; Sleep disturbances; Social Environment; Social Work; Sociology; Symptoms; System; Teenagers; Time; Translations; Work; Youth; acceptability and feasibility; actigraphy; active control; active control group; behavioral health; behavioral health intervention; comparison control; conduct problem; critical developmental period; critical period; diagnostic biomarker; digital; digital health; digital intervention; digital platform; effectiveness evaluation; follow-up; functional outcomes; improved; improvement on sleep; innovation; patient retention; poor sleep; post intervention; practice setting; preventive intervention; primary care practice; primary care setting; psychosocial; recruit; satisfaction; sensor; severe mental illness; sleep behavior; sleep health; sleep pattern; social; social culture; tailored messaging; therapy development; tool; trial design; uptake; wearable device

More than two-thirds of U.S. adolescents exhibit unhealthy sleep patterns. Sleep, which is a construct in the Arousal and Regulatory domain of RDoC, is a critical process supporting psychiatric health during adolescence. Specifically, sleep disturbances appear to represent a transdiagnostic risk factor for onset of internalizing and externalizing disorders as well as interfere with academic and social performance during this critical developmental period. Thus, preventative interventions to improve sleep among adolescents are necessary to support psychiatric health and functioning across the lifespan. Efficacious behavioral sleep strategies exist for adolescents. However, there has been limited translation of what is known to work in research and subspecialty care settings to community preventive and primary care practice settings, where most adolescents access social and health services. As well, much of the anticipatory guidance in primary care focuses on sleep duration, which may be difficult to improve upon for adolescents navigating multiple academic and extracurricular demands. In contrast, another critical aspect of sleep, the regularity of sleep-wake patterns, is associated with a range of psychiatric health and functional outcomes, and these relationships are shown to be independent of duration, suggesting enhancing sleep regularity may improve adolescent psychiatric outcomes even if duration remains constant. Recognizing the powerful connections between sleep, psychiatric wellness, and psychosocial function, there is a critical need to take efficacious behavioral strategies to improve sleep regularity among youth, and to optimize the delivery system to reach diverse youth in the primary care setting, the point of access for most youth seeking support for emotional and mental health. For the proposed project, we will evaluate the feasibility and acceptability of a 6-week digital sleep regularity intervention (Sustainable Habits for Encouraging Even Teen Sleep; SHEETS) among a diverse population of adolescents, ages 13-15 years, and will explore a range of socio-environmental drivers of sleep regularity as they relate to intervention uptake. SHEETS uses a digital platform to deliver education on sleep regularity as a health prevention tool, motivational messaging, support for setting goals for consistent bed- and wake-times, and self- monitoring. Wearable sleep sensors (Garmin wristwatches) provide real-time feedback to adolescents about their sleep regularity. We will also evaluate the short-term effectiveness of SHEETS on sleep regularity, sleep practices, and psychiatric health (i.e., internalizing and externalizing symptoms, psychosocial function) among adolescents receiving health services in a primary care pediatric practice compared to an active control group, and will explore sleep regularity as a mediator of the relationship between SHEETS participation and better psychiatric health. Findings from this study will inform proposal development for an adequately-powered randomized controlled trial (RCT) designed to optimize and evaluate scalable, easily disseminated digital sleep interventions that are acceptable and effective for youth living in a range of sociocultural contexts.

超过三分之二的美国青少年表现出不健康的睡眠模式。睡眠，这是一个结构 RDoC 的唤醒和调节领域是支持精神健康的关键过程 青春期。具体而言，睡眠障碍似乎代表了睡眠障碍发作的跨诊断风险因素。 在此期间内化和外化障碍以及干扰学业和社会表现 关键发育时期。因此，改善青少年睡眠的预防性干预措施 对于支持整个生命周期的精神健康和功能是必要的。有效的行为睡眠 存在针对青少年的策略。然而，已知有效的翻译还很有限。 研究和亚专科护理机构到社区预防和初级护理实践机构，其中 大多数青少年获得社会和保健服务。同样，初级保健中的许多预期指导 重点关注睡眠持续时间，这对于青少年来说可能很难改善 以及课外的要求。相比之下，睡眠的另一个重要方面，即睡眠-觉醒模式的规律性， 与一系列精神健康和功能结果相关，这些关系被证明 与持续时间无关，表明增强睡眠规律可以改善青少年精神病 即使持续时间保持不变，也会产生结果。认识到睡眠与精神疾病之间的强大联系 健康和心理社会功能，迫切需要采取有效的行为策略来改善 青少年的睡眠规律，并优化提供系统，以在初级保健中覆盖不同的青少年 环境，这是大多数年轻人寻求情感和心理健康支持的切入点。对于提议的 项目中，我们将评估为期 6 周的数字睡眠规律干预的可行性和可接受性 （鼓励青少年睡眠的可持续习惯；表）在不同的青少年群体中， 年龄 13-15 岁，并将探索一系列睡眠规律的社会环境驱动因素，因为它们与 干预的吸收。 SHEETS 使用数字平台提供有关睡眠规律作为健康的教育 预防工具、激励性信息、支持设定一致的就寝和起床时间目标以及自我 监控。可穿戴睡眠传感器（Garmin 手表）向青少年提供实时反馈 他们的睡眠规律。我们还将评估 SHEETS 对睡眠规律、睡眠的短期效果 实践和精神健康（即内化和外化症状、心理社会功能） 与积极对照组相比，在初级保健儿科诊所接受卫生服务的青少年， 并将探索睡眠规律作为床单参与与更好之间关系的中介 精神健康。这项研究的结果将为提案的制定提供信息，以实现动力充足的方案 旨在优化和评估可扩展、易于传播的数字睡眠的随机对照试验 (RCT) 对于生活在各种社会文化背景下的青年来说可接受且有效的干预措施。