Health Promotion in Early Adolescence: Sleep, Activity, and Emotion Regulation
Condition: Sleep Disorders; Physical Activity; Depression; Anxiety
MeSH terms: Sleep Wake Disorders
Study type: Interventional

Summary: 
      The primary goal of this project is to examine the short and long-term effects of an
      intervention focusing on three interrelated dimensions of health: improving sleep, increasing
      physical activity, and improving skills in emotion regulation. This intervention targets
      high-risk youth at a key neuromaturational period-early adolescence-when many individuals are
      experiencing new challenges to regulatory systems involved in sleep, activity, and emotion
      regulation. This maturational period is also a crucial time in the normal development of
      habits, skills, and proclivities in each of these domains. Thus, early adolescence presents
      unique opportunities for intervention targeting these three interrelated regulatory systems.
      Participants will include 200 9-13 year-old children who are siblings of children enrolled in
      one of three ongoing studies of vulnerability and resilience, whose families were initially
      identified on the basis of sociodemographic, child, and/or family risk or are recruited thru
      local Family Centers. Children will be selected as having difficulties in at least one of
      these domains (sleep, sedentary behavior, or emotion regulation) and then randomly assigned
      to either a control or intervention group. All families will receive baseline, one- and
      two-year follow-up assessments of child sleep, physical activity, and emotion regulation.
      Families in the intervention group will have the opportunity to receive feedback and
      intervention services on these three child domains and other parenting and family issues
      (e.g., parent involvement, parent self-care, school problems) following the initial
      assessment and the one-year follow up. The intervention will involve the parent and target
      youth receiving feedback about the child's current status in these areas and family
      functioning. If desired, the family will also participate in follow-up meetings with the
      parent and/or target youth to improve the youth's sleep, physical activity, and/or emotion
      regulation skills, as well as aspects of the family environment. The investigators
      hypothesize that the intervention will be associated with improvements in sleep, physical
      activity, and emotion regulation among those in the intervention group, as well as
      improvements in measures of social, behavioral, and affective function. Finally, the
      investigators will explore the possibility that increases in parental involvement mediate
      some of the changes found in child sleep, physical activity, and emotion regulation.
    

Detailed description: 
      The primary objective of this project is to examine the short and long-term effects of an
      intervention focusing on three interrelated dimensions of health: improving sleep, increasing
      physical activity, and improving skills in emotion regulation. This intervention targets
      high-risk youth at a key neuromaturational period-early adolescence-when many individuals are
      experiencing new challenges to regulatory systems involved in sleep, activity, and emotion
      regulation.

      SPECIFIC AIMS:

        1. To examine the effects of the intervention on sleep, physical activity, and emotion
           regulation:

           Hypothesis 1a: The intervention will result in increased total sleep and more
           regularized sleep/wake schedules (as measured by Sensewear sleep/activity monitors and
           sleep logs in the home environment).

           Hypothesis 1b: The intervention will result in increased physical activity and less time
           per week in sedentary activity (as measured by Sensewear activity monitors and
           standardized physical activity questionnaire).

           Hypothesis 1c: The intervention will result in improved emotion regulation (as measured
           by a composite index derived from interaction tasks, as well as home and school measures
           of emotion regulation).

        2. To examine intervention effects on externalizing (problem behavior), internalizing
           symptoms, and peer relationships.

           Hypothesis 2a: The intervention will result in lower levels of externalizing and
           internalizing symptoms and improved relationships with peers as measured by parent,
           youth, and teacher reports.

           Hypothesis 2b: Intervention effects for lower levels of externalizing and internalizing
           symptoms and improved relationships with peers, if found, will be mediated by
           improvements in child sleep, physical activity, and emotion regulation.

           SECONDARY AIMS: In addition to these specific aims the following exploratory analyses
           are planned:

        3. To examine parent-child interaction as a mediator of change in child sleep, physical
           activity, and emotion regulation. Just as we are interested in the possibility that
           changes in child problem behavior and peer relationships are mediated by improvements in
           sleep, physical activity, and emotion regulation, we will examine aspects of
           improvements in sleep, physical activity, and emotion regulation that are mediated by
           improvements in the quality of parent-child interaction (e.g., parental involvement),
           based on both parent reports and observations of parent-child quality.

        4. To explore directional effects between sleep, daytime activity, daytime mood, emotion
           regulation, and affective and behavioral symptoms. For example, we will examine: a) if
           sleep difficulties will predict daytime measures of negative mood, irritability, and
           decreased physical activity the following day; or b) if daytime measures of stress and
           negative affect will predict sleep difficulties the subsequent night; c) if physical
           activity during the day will be associated with better sleep that night.

        5. To examine the impact of this intervention on measures of physical health (e.g., Body
           Mass Index and waist circumference) and academic function (e.g., days of school
           missed/tardiness and school performance).
    

Intervention name(s): Family Check Up
Intervention type(s): Behavioral
Intervention description(s): Families in the intervention condition will be contacted by the parent consultant following the T1 and T2 assessments and be invited to participate in the Family Check-Up (FCU). The FCU intervention involves at least three sessions in which we expect both mother and child to participate in. First is the in-home family assessment. The second session involves rapport-building via an initial interview with the caregiver(s), referred to as the Get-to-Know-You visit, or for families already enrolled in an ongoing study, a Check-Back-In visit. The third is a Feedback Session during which the results of the assessment and initial interview are discussed with the caregiver, with attention focused on the caregiver's and child's readiness to change and the delineation of specific change options.
Other intervention name(s): Sleeping Tigers; Project MOVE
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention