Feasibility and Benefits of a School-Based Family Sleep Promotion Intervention for Preschool Children

Shortened child sleep duration has been identified as a ‘risk factor’ for poor child health outcomes like obesity. Identification of predictive factors for insufficient sleep may be helpful in developing interventions to change sleep health risk behaviors and for the purpose of preventing obesity in preschool populations. Preschool is the developmental stage of adopting health habits, thus it is an optimal time to promote healthy behaviors. The school is an excellent setting for the promotion of health habits. Family is a health socialization unit and health habits aggregate within the family. Family is the major component of young children’s social and environmental contexts, and therefore parents have strong influence on children health behaviors. In addition, the effectiveness of parents’ socialization of their children will have an effect on their establishment, training, and enforcement of children’s health behavior. Health promotion interventions for the preschool children will need to have the collaboration of their parents. Hence, the overall objective for this study is to develop and evaluate a school-based family sleep intervention for preschool children. Sleep is expressed as two variables, total sleep time and sleep quality obtained by 24-hour wrist actigraphy, sleep diary, and Children's Sleep Habits Questionnaire. Children and parents’ sleep hygiene, parental self-efficacy and parenting behavior will be measured to assess their roles as predictors for children’s sleep. Anthropometric measures of children include waist circumstance and body mass index will be taken for the assessment of total and central fat. W/Ht will be calculated and used as an anthropometric measurement. A cluster-randomized controlled trial will be used to evaluate the effect of sleep intervention. A school-based family sleep intervention for preschool children will be developed and evaluated for feasibility and acceptability to parents. The study will design a family centered intervention to be trialed based on information obtained in previous study and components of existing interventions may be modified and adopted in light of information obtained via systematic review of literature. Intervention will be developed to promote sleep health among preschool children that include parallel groups for parents and children. Raising healthy sleeper will be the curriculum developed to help parents of 3- to 5-years-olds gain the knowledge, skills, and confidence to help their children develop healthy sleep habits. Eight weeks of small-group lessons, focus on child development, parenting skills, age-appropriate sleeping practice will be developed in accordance with social cognitive theory. The preschool will be the unit of randomization and also the unit of intervention. Similar size and social economic levels will be ensured to help ensure that the intervention and comparison group will be balanced with respect to these variables. The final sample will include 10 schools in the intervention group and 10 schools in the control group. The intervention effects will include the preschool children’s changes in sleep duration, sleep behavior, and anthropometric measurement before and after the intervention. The final phase of the study will be a follow-up design to evaluate parents’ perception of the sleep intervention and determine the long term outcome of the sleep promotion intervention. Outcome measures include the sleep duration, sleep behavior, and anthropometric measurements. One year and two year intervention assessment will be conducted. The results will be helpful for health professional to develop their knowledge and skills for the promotion of children’s sleep health.