Health Promotion in Early Adolescence: Sleep, Activity, and Emotion Regulation
| Status: | Completed |
|---|---|
| Conditions: | Anxiety, Anxiety, Depression, Insomnia Sleep Studies |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 10 - 13 |
| Updated: | 4/21/2016 |
| Start Date: | April 2009 |
| End Date: | March 2013 |
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.
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.
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 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).
Inclusion Criteria:
- Eligibility in the study will be based on multiple criteria, including the family's
low SES status (i.e., income less than 50% over the poverty line and no more than 2
years of college education for parents)
- Risk status on child problems with sleep, physical activity, and/or affect
regulation. Criteria for the latter will be established using a 14-item screening
procedure administered to parents.
Exclusion Criteria:
- Children or parents with severe mental health concerns that prohibit them from
completing the assessment protocol or potentially benefiting from the intervention
will not be eligible for participation (e.g., parents or children with severe mental
retardation, autism, schizophrenia, or other psychotic disorders).
- If a child has a previous diagnosis of obstructive sleep apnea, they will still
benefit from participating in the study and will not be excluded.
- Adolescents who are currently incarcerated or who are in a court mandated facility
will be excluded from enrolling in the study.
- If an adolescent becomes incarcerated or is placed in a court mandated facility after
enrollment in the study, he/she will be withdrawn from the study if the duration of
incarceration or court mandated placement is longer than the amount of time remaining
for study participation.
- However, adolescents who are transiently incarcerated (for example an adolescent who
is detained for a week at juvenile detention facility) may resume research activities
when he/she is no longer incarcerated or in a court mandated facility if the time
remaining for study participation has not lapsed.
- No study procedures or activities will be conducted with any participant while he/she
is incarcerated or in a court mandated facility.
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