Department of Psychology, University of Winchester, Winchester, United Kingdom.
JMIR Form Res. 2024 Oct 23;8:e51322. doi: 10.2196/51322.
Adolescents are advised to sleep 8-10 hours per night; however, most do not sleep for this recommended amount. Poor adolescent sleep is associated with detrimental health outcomes, including reduced physical activity, risk-taking behaviors, and increased depression and anxiety levels, making this an important public health concern. Existing interventions targeting adolescent sleep are often unsuccessful or their effectiveness unclear, as they are frequently noninteractive, time-consuming, and lack a strong theoretical foundation; highlighting an urgent need for innovative interventions deemed acceptable by adolescents.
The main objective of this study was to determine the acceptability, feasibility, and preliminary impact of a web-based person-based sleep intervention (SleepWise) on adolescent sleep quality. Participant incentivization was also explored to understand its impact on engagement, acceptability, and sleep quality.
A feasibility trial was conducted to test the feasibility, acceptability, and preliminary impact of SleepWise on adolescent sleep quality, developed based on the person-based approach to intervention development. In total, 90 participants (aged 13-17 years) from further education institutions and secondary schools were recruited for two 2-arm randomized controlled trials. One trial (trial 1) was incentivized to understand the impact of incentivization. Acceptability and sleep quality were assessed via questionnaires, and a mixed methods process evaluation was undertaken to assess participant engagement and experience with SleepWise. Engagement was automatically tracked by SleepWise, which collected data on the date and time, pages viewed, and the number of goals and sleep logs completed per participant. Semistructured interviews were carried out to gain participant feedback.
Participants in both trials reported high levels of acceptability (trial 1: mean 21.00, SD 2.74; trial 2: mean 20.82, SD 2.48) and demonstrated similar levels of engagement with SleepWise. Participants in trial 1 viewed slightly more pages of the intervention, and those in trial 2 achieved their set goals more frequently. Improvements in sleep quality were found in both trials 1 and 2, with medium (trial 1) and large (trial 2) effect sizes. A larger effect size for improvement in sleep quality was found in the nonincentivized trial (d=0.87), suggesting that incentivization may not impact engagement or sleep quality. Both trials achieved acceptable recruitment (trial 1, N=48; trial 2, N=42), and retention at 5 weeks (trial 1: N=30; trial 2: N=30). Qualitative findings showed that adolescents lead busy lifestyles, which may hinder engagement; however, participants deemed SleepWise acceptable in length and content, and made attempts at behavior change.
SleepWise is an acceptable and potentially efficacious web-based sleep intervention aimed at adolescents. Findings from this study showed that incentivization did not greatly impact engagement, acceptability, or sleep quality. Subject to a full trial, SleepWise has the potential to address the urgent need for innovative, personalized, and acceptable sleep interventions for adolescents.
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建议青少年每晚睡 8-10 小时；然而，大多数人没有睡足这个推荐的时间。青少年睡眠质量差与健康状况不佳有关，包括体力活动减少、冒险行为增加，以及抑郁和焦虑水平升高，这使得这成为一个重要的公共卫生问题。现有的针对青少年睡眠的干预措施往往效果不佳或效果不明确，因为它们通常是非互动的、耗时的，而且缺乏坚实的理论基础；这突出表明需要创新的干预措施，这些措施被青少年接受。
本研究的主要目的是确定基于个人的网络睡眠干预（SleepWise）对青少年睡眠质量的可接受性、可行性和初步影响。还探讨了参与者激励对参与度、可接受性和睡眠质量的影响。
进行了一项可行性试验，以测试基于个人的干预方法开发的 SleepWise 对青少年睡眠质量的可行性、可接受性和初步影响。共有 90 名（年龄在 13-17 岁之间）来自继续教育机构和中学的参与者参加了两项 2 臂随机对照试验。一项试验（试验 1）是为了了解激励的影响而进行的。通过问卷评估可接受性和睡眠质量，并进行混合方法过程评估，以评估参与者对 SleepWise 的参与度和体验。通过 SleepWise 自动跟踪参与度，收集每个参与者的日期和时间、查看的页面、完成的目标和睡眠记录的数量等数据。进行半结构化访谈以获取参与者的反馈。
两项试验的参与者报告的可接受性水平都很高（试验 1：平均 21.00，SD 2.74；试验 2：平均 20.82，SD 2.48），并且对 SleepWise 的参与度相似。试验 1 的参与者查看了更多的干预页面，而试验 2 的参与者更频繁地实现了他们设定的目标。两项试验均发现睡眠质量有所改善，试验 1 的中值（试验 1）和大值（试验 2）效应量。非激励试验中睡眠质量改善的效果较大（d=0.87），这表明激励可能不会影响参与度或睡眠质量。两项试验的招募均达到了可接受的水平（试验 1，N=48；试验 2，N=42），并且在 5 周时的保留率也达到了可接受的水平（试验 1：N=30；试验 2：N=30）。定性研究结果表明，青少年的生活节奏忙碌，这可能会影响他们的参与度；然而，参与者认为 SleepWise 的长度和内容都可以接受，并尝试改变行为。
SleepWise 是一种针对青少年的可接受且可能有效的基于网络的睡眠干预措施。这项研究的结果表明，激励对参与度、可接受性或睡眠质量没有显著影响。在进行全面试验的前提下，SleepWise 有可能满足创新、个性化和青少年接受的睡眠干预措施的迫切需求。
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