Development and implementation of a digital sleep intervention for preschoolers in foster care

为寄养中的学龄前儿童开发和实施数字睡眠干预

基本信息

批准号：
10724304
负责人：
Darlynn Marie Rojo-Wissar
金额：
$ 17.52万
依托单位：
EMMA PENDLETON BRADLEY HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-01 至 2028-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10724304
关键词：
Active Learning Address Adolescent Adult Area Award Behavior Behavioral Buffers Cardiovascular Diseases Caregiver support Caregivers Caring Child Child Abuse and Neglect Child Behavior Child Development Child Nutrition Child Support Child Welfare Childhood Chronic Circadian Rhythms Collaborations Communities Conduct Clinical Trials Data Development Dissemination and Implementation Diverse Workforce Early Intervention Economic Burden Environment Evaluation Exposure to Family First Generation College Students Funding General Population Goals Grant Guidelines Health Health Status Hispanic Hospitals Institution Interruption Intervention Interview Investments Licensing Link Literature Measures Mental Depression Mental Health Mentors Mentorship Mission Modification National Heart, Lung, and Blood Institute Nursery Schools Obesity Parents Participant Patient Self-Report Physical activity Population Population Intervention Problem behavior Process Proctor framework Public Health Randomized, Controlled Trials Regulation Reporting Research Research Personnel Risk School-Age Population Sleep Sleep disturbances Stress Stressful Event Structure Surveys System Testing Training Trauma Underserved Population Vulnerable Populations Waiting Lists adverse childhood events behavior change behavioral health behavioral outcome care systems career career development community partnership community setting cost effectiveness digital digital intervention early childhood early life adversity early life exposure evidence base evidence based guidelines experience flexibility follow-up foster care foster child foster parent group intervention health disparity health economics health equity promotion health service use high risk implementation outcomes implementation science improved innovation intervention delivery intervention mapping maltreatment medical schools meetings mortality risk neglect physical conditioning post intervention programs psychosocial public health intervention recruit resilience skills sleep difficulty sleep health stressor therapy development translational scientist trauma exposure trial design

项目摘要

PROJECT SUMMARY Children in foster care (FC) are at risk for chronic health conditions, in part due to exposure to adverse childhood experiences (ACEs). Early intervention may ameliorate health disparities and economic burden associated with ACEs, with the preschool period yielding a substantially larger return on investment compared to interventions later in development. Children in FC are at high risk for sleep disturbances, which are a major contributor to the development and exacerbation of chronic health conditions, yet behavioral sleep interventions for this population are nonexistent. This K01 proposal seeks to address this critical gap in care and promote health equity in this underserved population by developing and implementing a trauma-informed digital public-health-level sleep intervention called Sleep Wizard, which we will administer to foster caregivers of preschoolers. Our innovative approach involves collaboration with a planning group of key stakeholders including FC workers and parents, and experts in sleep, trauma, health, and interventions in the context of FC. The goal of Aim 1 is to develop and digitize initial Sleep Wizard intervention content with the planning group, informed by the literature on trauma-informed care, evidence-based strategies to support healthy sleep, FC licensing regulations, and foster parent needs and experiences. In Aim 2, Sleep Wizard will be pretested by foster caregivers who will provide quantitative and qualitative data on acceptability, feasibility, and appropriateness of the intervention, which will be used to make final intervention modifications. Aim 3 will evaluate whether Sleep Wizard is associated with improvements in foster caregiver behaviors around sleep, and in child sleep from pre to post intervention, and at a 3-month follow-up. This will be the first large scale sleep intervention developed and tested in this population. Local and national stakeholders have expressed enthusiasm and have committed to involvement in the development, implementation, and evaluation of Sleep Wizard. To achieve the research plan, the PI will execute a structured comprehensive training plan to gain specialized skills in (1) Sleep, mental health, and ACEs in early childhood in the context of foster care, (2) Developing partnerships with the child welfare community, (3) Intervention development and implementation science, (4) Implementation and dissemination of digital interventions, and (5) Conducting clinical trials. Training will be overseen by an outstanding mentorship team with cross-cutting expertise in these areas and a track record of successful mentorship experiences and collaborations. Implementation of the research and training plan will also be bolstered by support from the institutional environment, namely Brown Medical School, Bradley Hospital, and two new major center grants focused on promoting the career development of early-stage investigators in 1) childhood stress, trauma, and resilience, and 2) sleep and circadian rhythms in child and adolescent mental health. This award will catapult my transition to an independent translational scientist with a career high in scientific and public health impact in early life adversity, sleep, and health.

项目概要寄养儿童 (FC) 面临慢性健康问题的风险，部分原因是接触不良环境童年经历（ACE）。早期干预可以改善健康差距和经济负担与 ACE 相关，学龄前时期的投资回报率要高得多以便在发展后期进行干预。 FC 儿童睡眠障碍的风险很高，这是一个主要的问题导致慢性健康状况的发展和恶化，但行为睡眠针对这一人群的干预措施是不存在的。该 K01 提案旨在解决护理方面的这一关键差距并通过制定和实施创伤知情计划来促进这一服务不足人群的健康公平名为“睡眠向导”的数字公共卫生级睡眠干预措施，我们将通过该干预措施来培养护理人员学龄前儿童。我们的创新方法涉及与主要利益相关者组成的规划小组的合作包括 FC 工作人员和家长，以及睡眠、创伤、健康和 FC 干预方面的专家。目标 1 的目标是与规划小组一起开发初始睡眠向导干预内容并将其数字化，参考有关创伤知情护理的文献、支持健康睡眠的循证策略、FC 许可法规以及寄养父母的需求和经验。在目标 2 中，睡眠向导将由以下人员进行预测试培养护理人员，他们将提供有关可接受性、可行性和质量的定量和定性数据干预的适当性，这将用于进行最终的干预修改。目标3将评估睡眠向导是否与改善护理人员睡眠行为有关，以及干预前后的儿童睡眠以及 3 个月的随访。这将是首次大规模在这一人群中开发并测试了睡眠干预措施。地方和国家利益相关者表示热情并致力于参与睡眠的开发、实施和评估向导。为了实现研究计划，PI将执行结构化的综合培训计划以获得 (1) 寄养背景下幼儿期的睡眠、心理健康和 ACE 方面的专业技能，(2) 与儿童福利界发展伙伴关系，(3) 干预措施的制定和实施科学，(4) 数字干预措施的实施和传播，以及 (5) 进行临床试验。培训将由优秀的指导团队监督，他们在这些领域拥有跨领域的专业知识，并且成功的指导经验和合作的记录。研究的实施和培训计划还将得到机构环境的支持，即布朗医疗学校、布拉德利医院和两个新的主要中心拨款专注于促进职业发展早期研究人员关注 1) 童年压力、创伤和复原力，以及 2) 睡眠和昼夜节律儿童和青少年的心理健康。这个奖项将推动我向独立翻译家的转变科学家，其职业对早年逆境、睡眠和健康的科学和公共健康影响很大。