Increasing Sleep Health Literacy in Head Start: A Social-Ecological Approach

提高睡眠健康素养：社会生态方法

• 批准号: 9245182
• 负责人: KAREN A. BONUCK
• 金额: $ 63.58万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE, INC
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9245182
• 关键词: Increasing; Sleep; Health; Literacy; Head

 DESCRIPTION (provided by applicant): Inadequate and/or poor quality sleep in early childhood impairs social-emotional and cognitive function (via effects on the developing brain), and markedly increases obesity risk (via hormonal and endocrine effects). Short sleep duration, behavioral sleep problems and sleep-disordered breathing peak at 20%-50%, during the preschool years (ages 3-5). Healthy sleep habits increase sleep duration and prevent behavioral sleep problems. Awareness of sleep-disordered breathing symptoms leads to timely treatment for it. Despite ample data on sleep problems "...much less work has been done on effective strategies to promote sleep as a healthy behavior (CDC 2013)". This study's overarching goal is to empower families of preschool children with the knowledge and skills needed for healthy sleep, and to recognize a sleep problem. It builds on our work in Head Start, an early childhood education (ECE) program for disadvantaged preschool children and their families: Our Early Childhood Sleep Education Program (ECSEP(tm)) educates Head Start teachers, children, and parents about healthy sleep in a way they can process and understand. In a randomized controlled trial, the children in the ECSEP group slept 30 minutes longer/night. As well, our UCLA Health Care Institute's structured approach to low literacy health training in Head Start (to reduce ER visits, obesity, etc.) has reached >100,000 families. The proposed study will implement a Social-Ecological web of multi-level interventions to reinforce the ECSEP, and to promote healthy sleep throughout ECE. Within Head Start, we will create new delivery platforms (print & video, family visits) that 'amplify' the ECSEP. Beyond Head Start, we will educate communities, and partner with stakeholders on strategies designed to embed `sleep health literacy' in ECE policy. This project will: 1) Adapt sleep education material into additional multi media formats, and; apply the Health Care Institute model to train Head Start staff to mount interventions and collect data. 2) Enroll 540 parent-child dyads from 7 Head Start agencies in New York in a stepped wedge randomized controlled trial. We will analyze trial effects on primary outcomes: a) child sleep duration, b) parent knowledge, attitudes, self-efficacy and behavior, and c) child sleep difficulties. 3) Assess the feasibility of screening and guidance for sleep problems (vs. sleep health) for a future efficacy study. Secondary outcomes are: classroom behaviors, policy change, and process data. Poor sleep in early development has ramifications for years to come, perhaps through adulthood. Head Start serves low-income, mainly racial-ethnic minority families, in whom sleep health disparities are greatest-- but are modifiable. This study joins together proven methods of delivering health literacy (Health Care Institute) and sleep health (ECSEP) programs in Head Start. Intervening at every level of the Social-Ecological model maximizes the study's reach and sustainability. Integrating sleep health literacy into ECE nationwide could ultimately benefit upwards of 4 million children. The potential impact upon human health is far-reaching.

 描述（由申请人提供）：幼儿期睡眠不足和/或质量差会损害社交情绪和认知功能（通过影响发育中的大脑），并显着增加肥胖风险（通过荷尔蒙和内分泌影响）。行为性睡眠问题和睡眠呼吸障碍在学龄前阶段（3-5 岁）达到峰值，健康的睡眠习惯可以延长睡眠时间并预防行为性睡眠问题。尽管有关睡眠问题的数据充足，但“……在促进睡眠作为一种健康行为的有效策略方面所做的工作却少得多”（CDC 2013）。为学龄前儿童的家庭提供健康睡眠所需的知识和技能，并认识到睡眠问题。它建立在我们 Head Start 的工作之上，这是一项针对弱势学龄前儿童及其家庭的幼儿教育 (ECE) 计划：我们的早期教育。儿童睡眠教育计划 (ECSEP(tm)) 以他们能够理解和理解的方式向教师、儿童和家长提供有关健康睡眠的教育。在一项随机对照试验中，ECSEP 组的孩子每晚的睡眠时间也延长了 30 分钟。我们的加州大学洛杉矶分校医疗保健研究所针对低识字率健康培训的结构化方法（以减少急诊室就诊、肥胖等）已惠及超过 100,000 个家庭。拟议的研究将实施一个多层次干预措施的社会生态网络。加强 ECSEP，并在整个 ECE 范围内促进健康睡眠。在 Head Start 范围内，我们将创建新的交付平台（印刷版和视频、家庭探访），以“扩大”ECSEP。除了 Head Start 之外，我们还将教育社区并与利益相关者合作。旨在将“睡眠健康素养”纳入儿童早教政策的战略 该项目将： 1) 将睡眠教育材料改编成更多内容。 媒体格式，以及；应​​用医疗保健研究所模型来培训 Head Start 工作人员进行干预并收集数据 2) 在一项阶梯式楔形随机对照试验中招募来自纽约 7 个 Head Start 机构的 540 名亲子组合。试验对主要结局的影响：a) 儿童睡眠持续时间，b) 家长知识、态度、自我效能和行为，以及 c) 儿童睡眠困难 3) 评估筛查和指导睡眠问题（与睡眠健康）的可行性。未来的功效研究的次要结果是：课堂行为、政策变化和过程数据。早期发育不良的影响可能会持续到成年期。这项研究将健康素养（卫生保健研究所）和睡眠健康（ECSEP）计划结合在一起，在社会生态模型的各个层面进行干预。这这项研究的影响范围和可持续性将睡眠健康素养纳入全国范围的儿童早教项目最终将使超过 400 万儿童受益，这对人类健康的潜在影响是深远的。