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.