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Adams EL, Edgar A, Mosher P, Armstrong B, Burkart S, Weaver RG, Beets MW, Siceloff ER, Prinz RJ. Barriers to Optimal Child Sleep among Families with Low Income: A Mixed-Methods Study to Inform Intervention Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:862. [PMID: 36613199 PMCID: PMC9820071 DOI: 10.3390/ijerph20010862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
This study gathered formative data on barriers to optimal child sleep to inform the development of a sleep intervention for parents of preschool-aged children in low-income households. Parents (n = 15, age: 34 ± 8 years, household income: $30,000 ± 17,845/year) reporting difficulties with their child's sleep participated in this study. Mixed methods included an online survey and semi-structured phone interview. Items assessed barriers/facilitators to optimal child sleep and intervention preferences. Interview transcripts were coded using inductive analyses and constant-comparison methods to generate themes. Derived themes were then mapped onto the Theoretical Domains Framework to contextualize barriers and inform future intervention strategies. Themes that emerged included: stimulating bedtime activities, child behavior challenges, variability in children's structure, parent work responsibilities, sleep-hindering environment, and parent's emotional capacity. Parent's intervention preferences included virtual delivery (preferred by 60% of parents) to reduce barriers and provide flexibility. Mixed preferences were observed for the group (47%) vs. individual (53%) intervention sessions. Parents felt motivated to try new intervention strategies given current frustrations, the potential for tangible results, and knowing others were in a similar situation. Future work will map perceived barriers to behavior change strategies using the Behavior Change Wheel framework to develop a parenting sleep intervention.
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Affiliation(s)
- Elizabeth L. Adams
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - Amanda Edgar
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - Peyton Mosher
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
| | - Bridget Armstrong
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - Sarah Burkart
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - R. Glenn Weaver
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - Michael W. Beets
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - E. Rebekah Siceloff
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
| | - Ronald J. Prinz
- Research Center for Child Well-Being, University of South Carolina, 1400 Pickens Street, Suite 400, Columbia, SC 29201, USA
- Department of Psychology, Barnwell College, University of South Carolina, 1512 Pendleton Street, Columbia, SC 29208, USA
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Brody C, Reno R, Chhoun P, Ith S, Tep S, Tuot S, Yi S. Developing a WhatsApp hotline for female entertainment workers in Cambodia: a qualitative study. Mhealth 2022; 8:5. [PMID: 35178436 PMCID: PMC8800199 DOI: 10.21037/mhealth-21-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/30/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Female entertainment workers (FEWs) in Cambodia experience high levels of stress due to economic hardship, exposure to violence, and harassment by law enforcement due to their employment. This study aims to gather qualitative data on stressors, coping strategies, and preferences for chatline functions to inform the development of a WhatsApp hotline (chatline) for FEWs in Cambodia. METHODS This qualitative study includes data from 5 focus groups and 10 in-depth interviews (IDIs), at which point data collectors felt we approached saturation. Participants were asked to respond to open-ended questions, a comic strip showing how the hotline might work and an audio recording of a hypothetical hotline conversation. Primary structural coding was used to identify the preferred functions and type of support participants want to receive from hotline staff. As more secondary themes arose during codebook development, an inductive thematic analytical approach was selected to categorize these data. RESULTS Participants identified several stressors associated with female entertainment work, including concerns about physical and mental health, fear related to experiences with the police or threat of arrest, and exposure to violence. Passive/avoidance and active coping strategies were also identified. Participants preferred a 24 h chatline that provides emotional support from a kind and comforting female staff person. The types of support participants were looking for were advice about personal problems, encouragement to achieve their goals and address depression, and immediate help for violence. Most participants felt that the hotline could bring them a sense of relief and safety and improve their mood. Some stated that the hotline alone would not alleviate the stressors they were exposed to, particularly related to violence and called for more transformational change. CONCLUSIONS This study offers textured evidence to inform the WhatsApp hotline development and staff training tailored to meet the needs of this specific population. Linking this hotline with crisis response, legal support, and longer-term in-depth counseling and using information gathered from this project to inform more extensive structural and policy-level changes should also be part a foundational part of this project.
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Affiliation(s)
- Carinne Brody
- Public Health Program, Center for Global Health Research, Touro University California, Vallejo, CA, USA
| | | | - Pheak Chhoun
- KHANA, Center for Population Health Research, Phnom Penh, Cambodia
| | - Sopherean Ith
- KHANA, Center for Population Health Research, Phnom Penh, Cambodia
| | - Sovanvorleak Tep
- KHANA, Center for Population Health Research, Phnom Penh, Cambodia
| | - Sovannary Tuot
- KHANA, Center for Population Health Research, Phnom Penh, Cambodia
| | - Siyan Yi
- Public Health Program, Center for Global Health Research, Touro University California, Vallejo, CA, USA
- KHANA, Center for Population Health Research, Phnom Penh, Cambodia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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Sampath R, Nayak R, Gladston S, Ebenezer K, Mudd SS, Peck J, Brenner MJ, Pandian V. Sleep disturbance and psychological distress among hospitalized children in India: Parental perceptions on pediatric inpatient experiences. J SPEC PEDIATR NURS 2022; 27:e12361. [PMID: 34676682 DOI: 10.1111/jspn.12361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/06/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Investigate parental perceptions of children's sleep disturbance and psychological distress associated with an inpatient stay in a low-resource hospital setting. DESIGN AND METHODS Demographic and validated survey instruments were adapted for administration to parents of children in the medical wards of a tertiary hospital in India. Parents proficient in English, Hindi, Tamil, or Telugu with a child age 4-12 years admitted for at least 48 h were eligible to participate. All respondents completed the Factors Affecting Sleep Disturbance Scale, Sleep Duration Questionnaire, Sleep Disturbance Scale, and Kessler Psychological Distress Scale. Data analysis entailed descriptive statistics, correlations, and multivariate regressions to analyze relationships across responses on demographics, sleep disturbance, and psychological distress. RESULTS Among 105 parents with hospitalized children, most had children 4-6 years old (54%), including 65% boys and 35% girls. Parents reported that their children slept overnight in the hospital for a mean of 8.3 ± 1.6 h. Children 4-6 year old (relative risk ratio [RRR] = 0.63, p = .004), dyspnea (RRR = 8.73, p = .04), previous hospitalization (RRR = 9.17, p = .03), nighttime procedures (RRR = 2.97, p = .03, and missing home (RRR = 6.78, p < .001) were the factors affecting sleep. Factors affecting psychological distress was nighttime medication administration (RRR = 4.92, p = .01). Sleep disturbances correlated with psychological distress (r = 0.56; p < .01). CONCLUSION Sleep disturbance and associated psychological distress in hospitalized children were widely reported by parents queried in this low-resource hospital setting. PRACTICAL IMPLICATIONS Nurses can lead efforts in ameliorating sleep in hospitalized children, including partnering with stakeholders on measures to reduce sleep disruption. Child-centered interventions may improve sleep hygiene and decrease psychological distress among children.
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Affiliation(s)
- Ramya Sampath
- Critical Care Nurse, Pediatric Intensive Care Unit, Inova Fairfax Hospital, Falls church, Virginia, USA
| | - Ruma Nayak
- Department of Pediatric Nursing, College of Nursing, Christian Medical College, Vellore, India
| | - Shanthi Gladston
- Department of Pediatric Nursing, College of Nursing, Christian Medical College, Vellore, India
| | - Kala Ebenezer
- Department of Pediatrics, Christian Medical College and Hospital, Vellore, India
| | - Shawna S Mudd
- Department of Nursing Faculty, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Jessica Peck
- Department of Nursing, Baylor University Louise Herrington School of Nursing, Dallas, Texas, USA
| | - Michael J Brenner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Vinciya Pandian
- Department of Nursing Faculty, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
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Alaribe CU, Nwabara OU, Spruyt K. Daily concordance between ecological stressors and sleep in young minority children during the pre-COVID-19 outbreak period. SLEEP EPIDEMIOLOGY 2021; 1:100007. [PMID: 35673625 PMCID: PMC8442306 DOI: 10.1016/j.sleepe.2021.100007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/30/2021] [Accepted: 09/08/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE As the COVID-19 pandemic brings widespread changes in families, the sociology of sleep becomes noticeable. Yet, the socio-contextual determinants of a biopsychosocial phenomenon as sleep are poorly investigated. We examine changes concomitantly occurring in the child's sleep per familial and community stressors. METHODS During the pre-COVID-19 outbreak period, in 24 minority children (5.4 ± 1.7 years old, 54.2% girls), sleep was objectively measured 24 h for two consecutive weeks, and this was repeated three times over the study period of three months. The caregiver filled out questionnaires surveying sociodemographic, community and family aspects. RESULTS Children went to bed at 22:26 and woke up at 07:04, with each a variability of about 50 min. Money and time were revealed as related key stressors to sleep. Five dimensions best fitted their association. In general, concurrent changes within the individual child indicate that mean sleep variables seem to relate to predominantly features of the stressors (explained variance of 34.7 to 56.7%), while variability of sleep tends to associate to situational aspects of the stressors (explained variance of 30.4 to 61.8%). Associations were best explained in terms of the 24 h dimension, particularly exposing sleep variability. CONCLUSION Individual variabilities in a child's sleep are associated with familial resources, such as caregiver's time to self, money and basic needs. Time spent in bed, a modifiable factor by society and shaper of sleep quantity and quality, plays a key role in stressor-sleep associations. Insights from biopsychosocial perspectives may be valuable for understanding COVID-19 sleep studies, and the development of (post-) COVID-19 sleep recommendations.
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Key Words
- BN, basic needs
- BT, bedtime
- Child
- Family
- M, money
- Minority
- PEV, percentage explained variance
- RESTLESS, restlessness index
- RT, Risetime
- SES, socioeconomic status
- SOFL, sleep offset latency
- SONL, sleep onset latency
- Sleep duration
- Sleep variability
- Stress
- TF, time for family
- TIB, time in bed
- TS, time for self
- TST, total sleep time
- USS, urban stress score
- WASO, wake after sleep onset
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Affiliation(s)
- Calista U Alaribe
- College of Health Sciences, Department of Health Studies, Chicago State University, Chicago, IL, USA
| | - Odochi U Nwabara
- College of Health Sciences, Department of Health Studies, Chicago State University, Chicago, IL, USA
| | - Karen Spruyt
- NeuroDiderot -INSERM, Université de Paris, Paris F-75019, France
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