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Bridging the gap: leveraging implementation science to advance pediatric behavioral sleep interventions
Jessica C Levenson1,2, Ariel A Williamson3,4
1Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Insights
Pediatric behavioral sleep interventions (BSIs) need better research translation. Implementation science can improve access and scalability for diverse children and families.
Area of Science:
- Pediatric sleep medicine
- Implementation science
- Behavioral health
Background:
- Behavioral sleep interventions (BSIs) show promise for youth sleep disturbances.
- Current BSI research has gaps, particularly for older children, adolescents, and diverse socioeconomic/ethnic groups.
- Translating research into accessible, scalable interventions remains a significant challenge.
Approach:
- Review common pediatric sleep disturbances and evidence-based BSIs.
- Identify research gaps and barriers to implementation in real-world settings.
- Propose a model using implementation science strategies to bridge the research-practice gap.
Key Points:
- Limited research includes older children, adolescents, and minoritized populations.
- Scalable and disseminable tools are crucial for early intervention and positive child outcomes.
- Implementation science frameworks are essential for designing, adapting, and testing BSIs.
Conclusions:
- Effective pediatric BSIs must be adaptable, scalable, and easily disseminated.
- Implementation science enhances access, engagement, and widespread use of BSIs.
- Integrating implementation science advances pediatric BSI research and application across settings and populations.
Study Objectives:
This review synthesizes the pediatric behavioral sleep intervention (BSI) evidence base, summarizes challenges in translating BSIs from research to practice, and provides recommendations for integrating implementation science methods to advance pediatric BSI research.
Methods:
We briefly review the common behavioral sleep disturbances among youth, discuss the pediatric BSIs with well-established evidence, and identify gaps in pediatric BSI research. We then identify contributors to the dearth of research evaluating pediatric BSIs in accessible settings and present a model for applying implementation science strategies to address identified gaps across the continuum of translational research.
Results:
Relatively few BSI trials include older children and adolescents. Similarly, there is limited research evaluating BSIs among racially and ethnically minoritized children and families and/or those of lower socioeconomic status backgrounds. Access to scalable and easily disseminable tools to treat pediatric sleep disturbances early in their development is crucial for promoting positive child outcomes. To address these gaps, researchers should apply implementation science theories, models, and frameworks to design new interventions for implementation, adapt existing interventions with end users and settings in mind, conduct hybrid effectiveness-implementation trials, and test implementation strategies.
Conclusions:
Given the prevalence and consequences of poor sleep across developmental periods, pediatric BSIs must be effective as well as adaptable, scalable, and easily disseminable. Implementation science theories, models, and frameworks can enhance access to, engagement in, and the implementation and dissemination of scalable BSIs across diverse pediatric care settings and heterogeneous populations.
Citation:
Levenson JC, Williamson AA. Bridging the gap: leveraging implementation science to advance pediatric behavioral sleep interventions. J Clin Sleep Med. 2023;19(7):1321-1336.
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