Graduation Year

2019

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Psychological and Social Foundations

Major Professor

Kathy Bradley-Klug, Ph.D.

Committee Member

Robert Dedrick, Ph.D.

Committee Member

Emily Shaffer-Hudkins, Ph.D.

Committee Member

Kathleen Armstrong, Ph.D.

Committee Member

Jennifer Takagishi, Ph.D.

Keywords

Behavioral Insomnia, Pediatric Psychology, Pediatric Sleep Intervention, Sleep Hygiene

Abstract

One of the most significant and underrecognized public health concerns in young children is related to the consequences of inadequate sleep. Inadequate sleep may result in problems related to behavioral regulation, executive functioning, and academic performance. ‘Sleep hygiene’, a term that describes consistent daytime and nighttime practices that promote healthy sleep, has been found to significantly increase sleep duration and improve sleep quality in the pediatric population. Researchers have found that many parents have a poor understanding of sleep hygiene. The purpose of this study was to determine if an educational intervention increased parental knowledge and practices of sleep hygiene and encouraged parents to communicate with pediatric healthcare providers regarding sleep. This study evaluated the acceptability of a written sleep intervention among parents and pediatric providers. Employing a two-group, true experimental design with random assignment. Participants included parents of children between the ages of 2 years and 5 years who were recruited from a community developmental screening. A total of 45 parents participated in the study. During Phase One of the study, parents were randomly assigned to a condition. Twenty-one parents were assigned to the experimental group (Healthy Sleep Handout) and 24 were assigned to the control group (Healthy Eating Handout). Following the handout, parents were asked to complete the Sleep Hygiene Knowledge Test, a 12-item true/false test. On average, the experimental and control group obtained total scores of 78% and 71%, respectively. There was no significant difference between group means. Phase Two was completed approximately one week after the first phase. Of the 45 parents who consented and participated in the study, 41 completed both phases of the study yielding a 91% follow-up rate between phases. During Phase Two, parents were asked to complete the Pediatric Sleep Hygiene Questionnaire. Participants in the experimental group scored statistically significantly higher on the sleep hygiene scale than the control group. Cohen’s effect size value suggested a moderate effect. With regard to future parental intent to communicate with pediatric healthcare providers regarding sleep, the experimental group endorsed a slightly higher intent to communicate with pediatric providers; however, there was not a statistically significant difference between group means. The effect size for this analysis suggested a small effect. Of note, 65% of the experimental group and 43% of the control group endorsed that they ‘very probably’ or ‘definitely’ plan to talk with their child’s healthcare provider in the future regarding sleep concerns. Parents and pediatric providers involved in the study participated in feedback interviews. Taken together, both parents and providers reported the intervention as practical and beneficial to practice. Implications of the findings are discussed in relation to developing strategies for improved dissemination of sleep health knowledge and increasing parental sleep hygiene practices in families of young children including implications for healthcare settings, schools, and communities. Recommendations for future qualitative research include examining the factors associated with parental readiness to make changes regarding their child’s sleep behaviors, as well as perceived challenges and barriers.

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