Changing School Start Times: Impact on Student, Family, Teacher, and Community Health

Study Overview
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Brief Summary
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Sleep is not an optional luxury, but a fundamental biological need, essential for health and well-being. Insufficient sleep is a significant public health issue, with 69% of adolescents in America obtaining less than the minimum requirement of 8 hours of sleep per night. Early school start times has been identified as the most significant and modifiable factor that restricts sleep duration in adolescents. The American Academy of Pediatrics recommended in 2014 that all middle and high schools start no earlier than 8:30 a.m., yet few school districts have implemented this change. In fall 2017, the Cherry Creek School District, a diverse district of almost 55,000 students outside Denver, changed school start times. Although previous studies have shown increased sleep duration, decreased daytime sleepiness, and improved academics following start time changes for secondary students, there remains an urgent need to understand how this policy impacts health and well-being for all students, including youth in elementary school. Recognizing that students are part of a complex system that includes parents, school staff, and the community, this observational study will be a multi-year, broad-based evaluation that includes key stakeholders, multiple sources of quantitative data (i.e., surveys, academic records, district nursing electronic health records), contextual qualitative data (i.e., open-ended surveys and focus groups), and community-based outcomes (i.e., data on vehicle crashes and juvenile crimes). The primary hypothesis is that later school start times will have a positive impact on middle and high school students sleep and health outcomes, while earlier school start times will have a neutral impact on elementary school students sleep and health outcomes.

Official Title
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Changing School Start Times: Impact on Student, Family, Teacher, and Community Health

Conditions
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Sleep

Intervention / Treatment
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* Other: Change in school start times


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Students in grades 3-12 enrolled in the school district Parents of students in grades K-12 enrolled in the school district School-based teachers and staff in grades K-12 in the school district Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 8 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Students Grades 3-12<br> | Other: Change in school start times<br>* Elementary start times changed from 9:00 a.m. to 8:00 a.m.; middle school start times changed from 8:00 a.m. to 8:50 a.m.; high school start times changed from 7:10 a.m. to 8:20 a.m.<br>|
| Parents of Students Grades K-12<br> | Other: Change in school start times<br>* Elementary start times changed from 9:00 a.m. to 8:00 a.m.; middle school start times changed from 8:00 a.m. to 8:50 a.m.; high school start times changed from 7:10 a.m. to 8:20 a.m.<br>|
| School Based Teachers and Staff Grades K-12<br> | Other: Change in school start times<br>* Elementary start times changed from 9:00 a.m. to 8:00 a.m.; middle school start times changed from 8:00 a.m. to 8:50 a.m.; high school start times changed from 7:10 a.m. to 8:20 a.m.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in sleep duration from before start time change to 1 and 2 years after start time change | Reported sleep from bedtime to wake time | Typical bedtime and wake time, assessed prior to start time change, and 1 and 2 years after start time change |