A Sleep Hygiene Intervention to Improve Sleep Health in Urban, Latino Middle School Children - Project Summary/Abstract: Sleep is essential for optimal health and development. Poor sleep is associated with impaired functioning and academic performance, and worse health outcomes in children. Latino children are disproportionately present in urban settings, and due to their exposure to higher levels of urban and cultural stressors, are at greater risk for poor sleep hygiene and quality. Over the past 3 years, we have demonstrated the acceptability, feasibility and preliminary efficacy of a novel sleep hygiene intervention, SIESTA (School Intervention to Enhance Latino Students’ Time Asleep) for improving sleep hygiene and sleep duration in urban Latino middle schoolers in two geographic areas with a high proportion of urban Latino children at increased risk for poor sleep health: Providence, Rhode Island, and San Juan, Puerto Rico. SIESTA involves 4 group sessions administered in school to Latino middle schoolers (6th-8th grade) and two child-caregiver sessions administered remotely by a bilingual (English/Spanish) trained facilitator from the community. The goal of this application is to administer a two-site hybrid type 1 effectiveness-implementation design to evaluate SIESTA’s effects on a larger-scale- for addressing Latino middle schooler’s sleep health, while also assessing implementation determinants. The first aim of the proposed work is to evaluate SIESTA through a large-scale RCT with urban middle school students in Providence, RI and San Juan, Puerto Rico. We will enroll 150 Latino children per site (N=300), and randomly assign them either to the SIESTA intervention, or to the Sleep Education plus Child Health attention-control condition (9 groups of each of the two conditions, per site; 8-9 students per group). We will evaluate treatment effects on primary sleep outcomes such as sleep duration, efficiency and sleep onset latency and on secondary sleep outcomes involving sleep hygiene behaviors, the sleep environment and sleep-related disturbances and impairment. Assessments will occur prior to, immediately following, and at 4, 8, and 12 months after the intervention. Over 1 year, we expect SIESTA participants will have improved sleep outcomes, sleep hygiene behaviors and less sleep-related impairment than Controls. The second aim is to identify implementation determinants and preliminary implementation outcomes of SIESTA to prepare for future large-scale implementation in other urban school settings. We will conduct a mixed methods process evaluation with input from community partners using the RE-AIM framework throughout and following administration of the RCT. The proposed work builds on a 20-year collaboration between our research teams in RI and PR, and an investment in advancing knowledge of multi-level factors affecting pediatric health disparities in children through evidence-based, sustainable interventions. SIESTA has the potential to improve sleep outcomes in urban Latino children and their daytime functioning, and to address a critical gap of the need for tailored and effective sleep hygiene interventions for children at greater risk for poor sleep health.
