Feasibility of Passive ECG Bio-sensing and EMA Emotion Reporting Technologies and Acceptability of Just-in-Time Content in a Well-being Intervention, Considerations for Scalability and Improved Uptake

Researchers increasingly use passive sensing data and frequent self-report to implement personalized mobile health (mHealth) interventions. Yet, we know that certain populations may find these technical protocols burdensome and intervention uptake as well as treatment efficacy may be affected as a result. In the present study, we predicted feasibility (participant adherence to protocol) and acceptability (participant engagement with intervention content) as a function of baseline sociodemographic, mental health, and well-being characteristics of 99 women randomized in the personalized preventive intervention Wellness-for-Two (W-4-2), a randomized trial evaluating stress-related alterations during pregnancy and their effect on infant neurodevelopmental trajectories. The W-4-2 study used ecological momentary assessment (EMA) and wearable electrocardiograph (ECG) sensors to detect physiological stress and personalize the intervention. Participant adherence to protocols was 67% for EMAs and 52% for ECG bio-sensors. Higher baseline negative affect significantly predicted lower adherence to both protocols. Women assigned to the intervention group engaged on average with 42% of content they received. Women with higher annual household income were more likely to engage with more of the intervention content. Researchers should carefully consider tailoring of the intensity of technical intervention protocols to reduce fatigue, especially among participants with higher baseline negative affect, which may improve intervention uptake and efficacy findings at scale.

0989 Examining The Role Of Toddler Sleep Quality On Wake EEG And Language Ability

Introduction

Sleep and the development of language are prominent concerns of many parents and until recently, many have examined these concerns tangentially. Children with developmental delays/disabilities have shown to have impaired sleep and poor sleep quality, and impairments or changes in sleep quality may play a prominent role in the acquisition of language and neuronal oscillatory patterns. This study examines the role of child sleep quality paired with a normed measure of language and wake electroencephalography (EEG). Examining the role of child sleep quality with language ability and wake EEG may provide nascent incremental utility to understanding the influences of sleep on healthy development.

Methods

Data from 109 toddlers (age range 24 to 30.5 m, M = 26.83 ± 1.58 m, 52% male) from the Brief Infant Sleep Questionnaire (BISQ), Mullen Scales of Early Learning (MSEL), and continuous EEG were collected and analyzed. EEG was recorded (32 electrode cap BioSemi) while toddlers sat in a booster seat and watched a silent video. Data were analyzed in RStudio and Matlab to examine toddler’s sleep quality (infant sleep and parent behaviors) and relations with the MSEL and EEG (controlling for child age and gender).

Results

Means and standard deviations appeared within expected limits based on the range of each variable. Toddlers with slow-developing language were associated with relatively poor sleep quality, explaining 9.75% of the variance. We find preliminary evidence to suggest a potential sleep disruption around the time when a child is undergoing a rapid expansion in their vocabulary (expressive language). Toddler’s sleep quality and language acquisition were also correlated with wake EEG (alpha and beta).

Conclusion

Sleep is regarded as an essential component supporting the myriad changes observed in early development. Sleep quality fundamentally influences healthy development across domains. Here, we showed child sleep quality is highly associated with toddler’s language ability, and wake EEG, providing new insights into the developing brain.

Support

National Institutes of Health R01DC016273, R01MH107652-03S1, and Johnson & Johnson Consumer Inc., Skillman, NJ, USA.

Developmental pathways from prenatal tobacco and stress exposure to behavioral disinhibition

Prenatal tobacco exposure (PTE) and prenatal stress exposure (PSE) both have been linked to externalizing behavior, although their effects generally have been considered in isolation. Here, we aimed to characterize the joint or interactive roles of PTE and PSE in early developmental pathways to behavioral disinhibition, a profile of cognitive and behavioral under-control that presages severe externalizing behavior. As part of a prospective, longitudinal study, 296 children were assessed at a mean age of 5 years. Exposures were assessed via repeated interviews across the prenatal period and bioassays of cotinine were obtained. Behavioral disinhibition was assessed using temperament measures in infancy, performance-based executive control tasks and measures of disruptive and inattentive behavior. PSE was associated with a higher probability of difficult temperament in infancy. Each exposure independently predicted poorer executive control at age 5 years. Difficult temperament and executive control difficulties in turn predicted elevated levels of disruptive behavior, although links from PTE and PSE to parent-reported attention problems were less robust. Children who experienced these prenatal exposures in conjunction with higher postnatal stress exposure showed the lowest executive control and highest levels of disruptive behavior. Findings highlight the compounding adverse impact of PTE and PSE on children's behavioral trajectories. Given their high concordance, prenatal health campaigns should target these exposures in tandem.