ABC's of SLEEPING

 

Why is the program needed?

Many school-aged children do not get the recommended amount of sleep. This is particularly concerning as we know that insufficient sleep is associated with poorer physical, mental, and emotional well-being.^{1, 2} Most children do not receive intervention for these sleep problems due to barriers that make it hard for parents to access intervention. An accessible way to deliver sleep health care is by utilizing smartphone applications “apps” (mHealth) as 85% of Canadians have access.³ Currently, there are no evidence-based sleep interventions apps available to parents of school-aged children. To address this, our research team has developed an app titled the ABCs of SLEEPING, which is based on the mnemonic developed by Dr. Corkum and trainees to represent the key components of healthy sleep practices:

Age-appropriate Bedtimes and waketimes with Consistency, Schedules, Location, Electronics, Exercise & diet, Positivity, Independence when falling asleep, Needs met during the day, all equals Great sleep.

 

What is the ABC's of SLEEPING program?

The content of the app is based on the ABCs of SLEEPING mnemonic. It was designed to provide parents with evidenced-based assessment (“check-in” feature) and sleep recommendations (“sleep tips” feature) about healthy sleep practices. When using the intervention, parents first complete a “check-in” to assess their child’s sleep practices. Once completed, a “sleep report” is produced detailing what areas of healthy sleep practices are going well and which areas need work. To deliver this information, colour coding is used. Sleep areas that don’t need work are colour coded as green, those areas that need some work are colour coded as yellow, and those areas that are high priority are colour coded red. This colour coding system lets parents know what sleep tips will be the most helpful to work on first. In addition to the “check-in”, “sleep report”, and “sleep tips” features, this intervention also has a “to do list” feature that allows the parents to decide what areas they would like to focus on first. This provides an organizing system for parents to use and helps them keep track of the progress that they have made.

 

What is the research that supports this program?

So far, we have conducted a systematic review, usability study, and feasibility studies. The systematic review⁴ established the evidence-base for the strategies included in this program (e.g., use of electronics, sleep location, etc.) The usability study⁵ established the intervention as highly user-friendly, but requiring some modification to increase usability (e.g., streamlining the sleep tips, improving navigation). Following modifications, a feasibility study⁶ was conducted and found that parents rated the revised app to be highly acceptable; however, implementation (use) of the app was less than desirable (e.g., not daily). Building from participant feedback, the app was further modified to improve implementation (e.g., a “to-do list” feature was added).

Currently, we are conducting a pilot randomized control trial (RCT) to evaluate the preliminary effectiveness of this program and to make important estimations to prepare for a full-scale RCT (e.g., examining recruitment potential, dropout rate, retainment, and sample size estimations). Concurrently, an implementation study is being conducted to understand how the app will operate in the “real world” by examining the demand for the app (i.e., who would use the app), integration (i.e., when and how users would search for the app), and practicality (i.e., barriers and facilitators to using/recommending the intervention).