Implementing Evidence-Based Behavioral Sleep Intervention in Urban Primary Care

在城市初级保健中实施循证行为睡眠干预

基本信息

批准号：
9789367
负责人：
Ariel A Williamson
金额：
$ 13.15万
依托单位：
CHILDREN'S HOSP OF PHILADELPHIA
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-20 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9789367
关键词：
Address Adherence Attention Attitude Behavior Behavior Therapy Behavioral Belief Caregivers Caring Child Child Behavior Child Development Childhood Clinical Conduct Clinical Trials Data Development Development Plans Doctor of Philosophy Education Effectiveness Effectiveness of Interventions Emotional Evaluation Exposure to Family Future Goals Health Health Promotion Health Services Impairment Institute of Medicine (U.S.)Intervention Intervention Studies Interview Knowledge Low income Measurement Mental Health Mentors Methods Mission National Institute of Child Health and Human Development Nurses Outcome Pediatric Hospitals Pennsylvania Philadelphia Primary Health Care Procedures Process Psychologist Public Health Randomized Randomized Controlled Trials Readiness Reporting Research Research Methodology Research Personnel Resources Risk Schools Sleep Sleep Deprivation Sleep Disorders Sleep disturbances Sleeplessness Social Workers Socioeconomic Status Structure Testing Training Treatment Efficacy Universities Youth adequate sleep base behavioral health behavioral outcome care providers career career development early childhood evidence base experience follow-up implementation science implementation trial improved intervention effect low socioeconomic status lower income families medical specialties neurobehavioral novel strategies pediatrician physical conditioning pragmatic trial programs randomized trial recruit research to practice response service delivery skills sleep health social socioeconomic disadvantage stressor treatment as usual

项目摘要

PROJECT SUMMARY/ABSTRACT This K23 proposal will address a critical need for accessible, evidence-based behavioral sleep interventions for lower-socioeconomic status (SES) children, and will prepare the applicant, Ariel Williamson, PhD, to become an independent investigator with expertise in behavioral interventions for lower-SES children in primary care. Behavioral sleep problems, including insomnia and insufficient sleep, are associated with adverse physical, neurobehavioral, and social-emotional outcomes. Sleep problems impact 20-30% of young children and disproportionately impact lower-SES children. There is little research on behavioral sleep interventions with lower-SES youth, and no studies have examined these interventions in primary care, an accessible setting. This project will adapt and pilot Sleep Well – Be Well, an effective behavioral sleep intervention, so that its contents and service delivery methods are appropriate for lower-SES preschoolers and the primary care context. Aim 1 is to identify attitudes, beliefs, and behaviors that are critical for adapting and implementing Sleep Well – Be Well for lower-SES preschoolers in primary care. This aim involves collecting qualitative and quantitative data from lower-SES caregivers of preschoolers with sleep problems (N = 30) and primary care providers (N = 20 pediatricians, nurses, and integrated behavioral health clinicians [social workers and psychologists]). Aim 2 is to iteratively adapt as needed and pilot Sleep Well – Be Well. Aim 1 results, pilot testing with lower-SES caregiver- child dyads (N = 18), and input from an advisory panel of caregivers and primary care providers will guide needed adaptations and the potential development of new approaches. Aim 3 is to conduct a pilot randomized controlled trial of the adapted intervention to examine intervention acceptability; feasibility of recruitment, randomization, and measurement procedures; treatment engagement and adherence; and the magnitude of intervention effects. Lower-SES preschoolers (N = 80) will be randomly assigned to intervention or to enhanced usual care (sleep education), with assessments of objective and caregiver-reported child sleep, as well as child behavior, at pretreatment, posttreatment, and 3-month follow-up. The proposed research and the career development plan will support Dr. Williamson’s training goals to acquire skills and knowledge in: (1) qualitative and mixed methods for intervention adaptation and development; (2) the conduct of clinical, and especially pragmatic, trials; and (3) the application of implementation science methods and frameworks to primary care research. The resources of Children’s Hospital of Philadelphia and University of Pennsylvania, and an expert team of interdisciplinary mentors and consultants, will provide an outstanding context to launch Dr. Williamson’s career. This project will also provide necessary data for Dr. Williamson’s future R01 submission of a large-scale effectiveness- implementation trial of a behavioral sleep intervention in primary care. This project aligns with NICHD’s priorities, as it focuses on behavioral intervention in primary care and behavioral health promotion for lower-SES children.

项目概要/摘要这项 K23 提案将满足以下人群对易于使用、基于证据的行为睡眠干预的迫切需求：社会经济地位较低（SES）的儿童，并将帮助申请人 Ariel Williamson 博士做好成为一名独立调查员，在初级保健中对社会经济地位较低的儿童进行行为干预方面具有专业知识。行为性睡眠问题，包括失眠和睡眠不足，与身体不良、睡眠问题影响 20-30% 的幼儿和儿童。对社会经济地位较低的儿童的影响尤为严重，但很少有关于行为睡眠干预的研究。社会经济地位较低的青少年，并且没有研究在初级保健这一易于获得的环境中检验这些干预措施。该项目将调整和试点“Sleep Well – Be Well”（一种有效的行为睡眠干预措施），以便其内容服务提供方法适合社会经济地位较低的学龄前儿童和初级保健目标 1。是确定对于适应和实施“睡好觉”至关重要的态度、信念和行为针对初级保健中社会经济地位较低的学龄前儿童该目标涉及收集来自以下机构的定性和定量数据。有睡眠问题的学龄前儿童的社会经济地位较低的照顾者 (N = 30) 和初级保健提供者 (N = 20 目标 2 是根据需要迭代调整并试点睡眠良好 - 目标 1 结果，与社会经济地位较低的护理人员进行试点测试。儿童二人组（N = 18），护理人员和初级保健提供者咨询小组的意见将指导所需的目标 3 是进行随机对照试验。试验调整后的干预措施，以检查干预措施的可接受性；和测量程序；治疗参与度和依从性；以及干预效果的程度。社会经济地位较低的学龄前儿童 (N = 80) 将被随机分配接受干预或加强常规护理（睡眠教育），对客观的和护理人员报告的儿童睡眠以及儿童行为进行评估，治疗前、治疗后和3个月的随访建议的研究和职业发展计划。将支持威廉姆森博士的培训目标，以获得以下方面的技能和知识：（1）定性和混合方法用于干预措施的调整和发展；(2) 进行临床试验，特别是实用试验；以及 (3) 将实施科学方法和框架应用于初级保健研究。费城儿童医院和宾夕法尼亚大学跨学科专家团队导师和顾问将为威廉姆森博士的职业生涯提供良好的背景。也为Williamson博士未来提交大规模有效性的R01提供必要的数据—— 在初级保健中实施行为睡眠干预试验该项目符合 NICHD 的优先事项，因为它的重点是初级保健中的行为干预和低社会经济地位儿童的行为健康促进。