Enhancing a Technology and Digital Media Use Intervention to Address Youth Sleep Problems - PROJECT SUMMARY/ABSTRACT Over half of adolescents obtain insufficient sleep duration (less than age-based guidance) on school nights, while 10-40% report difficulty falling/staying asleep and poor sleep quality, all of which are linked to mental health problems. While TDM use is highly prevalent in adolescence and a critical factor in sleep problems, few effective sleep interventions address TDM use and can be scaled in primary care, an accessible setting where families often raise sleep and TDM use concerns in pediatrician visits. Our prior randomized trial found that pediatricians can deliver brief TDM-related counseling with positive youth and family outcomes. These findings contributed to the American Academy of Pediatrics (AAP) Family Media Plan (FMP), a highly accessible online tool to support families’ TDM use rule creation. However, the FMP does not address sleep beyond age- appropriate duration guidance. Our long-term goal is to implement feasible, effective, and scalable interventions to address adolescent TDM use-related sleep problems. This R34 project’s goal is to optimize and evaluate a Sleep-enhanced Family Media Plan (sFMP) for early adolescents’ sleep problems, in partnership with the AAP’s large, sociodemographically diverse practice-based Pediatric Research in Office Settings (PROS) network. In Aim 1, we will use community-engaged and human-centered design methods to iteratively adapt and refine the FMP into a Sleep-enhanced Family Media Plan (sFMP) that addresses early adolescent sleep problems, supports effective family sFMP use, and trains pediatricians to deliver in-office TDM use counseling. At 4 PROS sites, we will conduct (1a) cognitive interviews informed by the Consolidated Framework for Implementation Research with n=10 youth-caregiver dyads and n=10 pediatricians (N=30), and (1b) usability testing with n=5 youth-caregiver dyads and n=5 pediatricians (N=15). After finalizing the sFMP and pediatrician-delivered TDM counseling, we will conduct a pilot stepped wedge cluster randomized trial in 4 PROS sites with N=80 adolescent-caregiver dyads and N=12-16 pediatricians to (Aim 2) evaluate sFMP feasibility, acceptability, fidelity, and initial youth sleep and mental health outcomes, and to (Aim 3) explore theoretically derived intervention targets. MPI Moreno’s established Youth Advisory Board and the PROS study specific advisor, Steering Committee (clinicians, caregivers), and Coordinators (clinicians) will provide feedback throughout this work to ensure study procedures, intervention content and delivery methods, and dissemination plans are feasible and acceptable to end-users (pediatricians) and recipients (youth, caregivers). Our MPI model includes expertise in pediatric sleep, TDM use, and adolescent health, while our Co-Is bring expertise in primary care-based clinical trials and human-centered design. Results will inform a future hybrid effectiveness-implementation trial scaling the sFMP across the PROS network to effectively and sustainably improve adolescent sleep and mental health, consistent with the goals of RFA-MH-25-130 and the NIMH.
