Development and implementation of a digital sleep intervention for preschoolers in foster care - PROJECT SUMMARY Children in foster care (FC) are at risk for chronic health conditions, in part due to exposure to early life adversity. Early intervention may help reduce long-term health issues and the economic burden associated with early life adversity, with the preschool period yielding a substantially larger return on investment compared to interventions administered later in development. A major contributor to the development and exacerbation of chronic health conditions are sleep disturbances, which are common among children in FC, yet widely accessible sleep interventions for this population are nonexistent. This K01 proposal aims to address this critical gap in care through the development and implementation of a trauma-informed digital public-health-level sleep intervention, Nurturing Sleep, which will be administered to foster caregivers of young children ages 36-71 months. Our innovative approach involves collaboration with FC workers and parents, and experts in sleep, trauma, health, and interventions in the context of FC. The goal of Aim 1 is to collaboratively develop and digitize initial Nurturing Sleep intervention content, 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, Nurturing Sleep will be pretested by foster caregivers who will provide qualitative feedback on the intervention, which will be used to make final intervention modifications. Aim 3 will evaluate whether Nurturing Sleep 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 Nurturing Sleep. To achieve the research plan, the PI will execute a structured comprehensive training plan to gain specialized skills in (1) Sleep, mental health, and adversity in early childhood in the context of FC, (2) Developing partnerships with the child welfare community, (3) Intervention development and implementation science, (4) Implementation and dissemination of digital interventions, and (5) Designing, conducting, and analyzing 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 plans will also be bolstered by support from the institutional environment, namely Bradley Hospital, Brown Medical School, and two 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 principal investigator Dr. Darlynn Rojo-Wissar’s transition to an independent translational scientist with a career high in scientific and public health impact in early life adversity, sleep, and health.
