Understanding the modality, frequency, and context of sleep health communication among black adolescents

Black adolescents experience persistent sleep health disparities, yet little is known about how sleep is discussed within families, healthcare encounters, and community settings. This study examined the modality, frequency, and context of sleep health communication among Black adolescents to identify gaps and opportunities for improving sleep health literacy and equitable sleep promotion.

In-depth interviews were conducted with consented/assented adolescents aged 11 to 17 years who self-identified as Black/African American. Participants were recruited in Columbus, Ohio through Nationwide Children's Hospital (NCH) primary care and specialty clinics, school-based health clinics, the Science Education Outreach program, and the NCH Marketing/Public Relations team. Interviews explored sleep environment, beliefs, habits, sleep communication, and awareness of sleep-related resources. Interviews were conducted via Webex between May 2022 and May 2023 and transcribed for thematic analysis using Microsoft Excel.

The sample included 21 U.S. Black/African American adolescents (mean age 14.0 ± 0.15 years); half identified as female (n=11). Three primary themes emerged as follows: (1) how sleep conversations occur (modality and setting); (2) who initiates sleep conversations (healthcare providers, family members, other adults, peers); and (3) depth and scarcity of sleep dialog (limited or non-existent). Findings highlight limited meaningful sleep-related communication in home and community settings, with most adolescents reporting brief, annual conversations about sleep during pediatric healthcare visits.

Black adolescents experience fragmented sleep health communication, particularly outside clinical encounters. Interventions prioritizing sleep health literacy and framing sleep as a multigenerational family health behavior may strengthen sleep communication and support more equitable sleep health outcomes for Black adolescents.