Although early interventions can improve health equity in young children living in poverty, this promise often is not realized because of barriers to family engagement. The proposed study will target co-morbid behavior and sleep problems in early childhood, comparing child outcomes and family response to sleep and behavior interventions and investigating the novel strategy of letting families select their intervention.We will enroll 500 low-income toddlers with co-morbid sleep and behavior problems, randomized to 4 parent coaching interventions: sleep, behavior, family choice (sleep or behavior), and an active control. At baseline and at 1, 5, and 9 months post- intervention, we will assess child sleep and behavior and family functioning. We will measure family preference, engagement, and perceived value of each intervention. The goals of the study are: (1) to examine effects of evidence- based sleep and behavior interventions in young low-income children with co-morbid sleep and behavior problems on child sleep and behavior and family functioning; (2) to determine whether parents prefer, engage with, and value a sleep or behavior intervention more; and (3) to examine if giving families a choice of intervention results in higher engagement, higher perceived value and better family and child outcomes than assignment to intervention. By informing best practices for engaging low-income families to treat co-morbid sleep and behavior problems, results will be critical to reducing health disparities for children living in poverty.
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Change in Child Behavior Checklist (CBCL) from screening to one month
Timeframe: Change from screening to one month post-intervention
Change in Child Behavior Checklist (CBCL) from screening to five months
Timeframe: Change from screening to five months post-intervention
Change in Child Behavior Checklist (CBCL) from screening to nine months
Timeframe: Change from screening to nine months post-intervention
Change in Emotion Regulation Checklist (ERC) from baseline to one month
Timeframe: Change from baseline to one month post-intervention
Change in Emotion Regulation Checklist (ERC) from baseline to five months
Timeframe: Change from baseline to five months post-intervention
Change in Emotion Regulation Checklist (ERC) from baseline to nine months
Timeframe: Change from baseline to nine months post-intervention
Change in Children's Sleep Wake Scale (CSWS) from screening to one month
Timeframe: Change from screening to one month post-intervention
Change in Children's Sleep Wake Scale (CSWS) from screening to five months
Timeframe: Change from screening to five months post-intervention
Change in Children's Sleep Wake Scale (CSWS) from screening to nine months
Timeframe: Change from screening to nine months post-intervention
Change in nighttime sleep minutes from baseline to one month as measured by actigraphy
Timeframe: Change from baseline to one month post-intervention
Change in nighttime sleep minutes from baseline to five months as measured by actigraphy
Timeframe: Change from baseline to five months post-intervention
Change in sleep onset from baseline to one month as measured by actigraphy
Timeframe: Change from baseline to one month post-intervention
Change in sleep onset from baseline to five months as measured by actigraphy
Timeframe: Change from baseline to five months post-intervention
Change in sleep consistency from baseline to one month as measured by actigraphy
Timeframe: Change from baseline to one month post-intervention
Change in sleep consistency from baseline to five months as measured by actigraphy
Timeframe: Change from baseline to five months post-intervention