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弥合差距:利用实施科学推进儿科行为睡眠干预。

Bridging the gap: leveraging implementation science to advance pediatric behavioral sleep interventions.

机构信息

Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

出版信息

J Clin Sleep Med. 2023 Jul 1;19(7):1321-1336. doi: 10.5664/jcsm.10476.

Abstract

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. . 2023;19(7):1321-1336.

摘要

研究目的

本综述综合了儿科行为睡眠干预(BSI)的证据基础,总结了将 BSI 从研究转化为实践的挑战,并为整合实施科学方法以推进儿科 BSI 研究提供了建议。

方法

我们简要回顾了青少年常见的行为性睡眠障碍,讨论了具有既定证据的儿科 BSI,并确定了儿科 BSI 研究中的空白。然后,我们确定了导致缺乏评估可及环境中儿科 BSI 的研究的因素,并提出了一个应用实施科学策略的模型,以解决整个转化研究连续体中确定的差距。

结果

相对较少的 BSI 试验包括年龄较大的儿童和青少年。同样,也有限制研究评估少数族裔和族裔少数儿童和家庭以及/或社会经济地位较低的家庭中的 BSI。尽早开发用于治疗儿科睡眠障碍的可扩展且易于传播的工具对于促进积极的儿童结果至关重要。为了解决这些差距,研究人员应应用实施科学理论、模型和框架来设计新的干预措施以进行实施,根据最终用户和环境来改编现有的干预措施,开展混合有效性-实施试验,并测试实施策略。

结论

鉴于不良睡眠在整个发育时期的普遍性和后果,儿科 BSI 必须有效,并且具有适应性、可扩展性和易于传播性。实施科学理论、模型和框架可以增强对不同儿科护理环境和异质人群中可扩展 BSI 的获取、参与以及实施和传播。

引文

Levenson JC, Williamson AA. 弥合差距:利用实施科学推进儿科行为睡眠干预。睡眠医学评论。2023;19(7):1321-1336.

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