Feasibility and Preliminary Efficacy of a Brief Behavioral Sleep Intervention for Excessive Weight Gain Prevention in Primary Care

PROJECT SUMMARY/ABSTRACT Pediatric obesity is an epidemic with striking disparities by socioeconomic status (SES) and race/ethnicity. Thus, there is a need to identify novel approaches for obesity prevention, particularly for those at greatest risk. Primarycare may be an ideal settingfor enhancing reach and equitable access to obesity prevention given the high percentage of children who attend annual well child visits and recommendations that lifestyle behaviors be addressed in primary care with all children who do not yet have obesity. However, there is limited support for effectiveness of obesity prevention for school-aged children in primary care. Thus, identification of effective and efficient approaches that are well suited for translation are imperative. One such efficient approach may be enhancing children's sleep. A good night's sleep in childhood is a well-known correlate of healthier weight status. Adult experimental studies demonstrate that increasing sleep leads to positive changes in eating behaviors and weight. However, few interventions to enhance sleep duration have been conducted with school-aged children and we are unaware of any in primary care, which is striking given the large percentage of children with insufficient sleep and accumulating evidence supporting the importance of sleep for weight regulation. Our own randomized controlled trials with school-aged children provide compelling preliminary evidence that a brief behavioral intervention can result in clinically meaningful improvements in children's sleep duration and that enhancing sleep can lead to positive changes in eating and activity behaviors and weight status. However, our studies have been limited to academic settings. Thus, the purpose of the proposed study is to determine feasibility, primary signal modeling condition (from a RE-AIM – reach effectiveness, adoption, implementation, maintenance – framework) acceptability, and preliminary effectiveness of our sleep intervention for obesity prevention in care. The intervention's brevity, flexibility in delivery mode (e.g., via zoom/phone), and consistent for efficacy enhances translation potential. Further, we propose enhancing r eimbursement potential by our intervention delivery after an existing reimbursable model of care for nother chronic health (asthma) in which pediatricians refer for disease management support by a registered nurse (RN). a Fifty short sleeping (< 9 hours/night) children 6-11 years old who primarily identify as African American/Black and from under-resourced communities will be enrolled. Children will be randomly assigned to either: 1) optimize sleep primary care (OSPC; our 4-session behavioral intervention to enhance sleep duration delivered by a RN in primary care) or 2) enhanced usual care (EUC; usual care plus sleep education delivered at the same timepoints as OSPC). At baseline, end of treatment (2 months), and 6 months, the following will be measured: feasibility/acceptability metrics, sleep duration (actigraphy), eating behaviors (24-hour dietary recalls), physical activity (accelerometry), and anthropometrics (measured height and weight).