Abstract
Abstract Introduction Bedtime routines are the hallmark for sleep guidance in young children. Yet, Black children have an 80% increased likelihood of not having a bedtime routine, compared to white children. To promote healthy bedtime routines, a comprehensive assessment tool that capture children’s bedtime routine behaviors and relevant bedtime environment and context is needed to guide the targeting areas for intervention. However, existing sleep routine questionnaires do not capture sleep contexts that are relevant to Black families. Thus, the objective of our study was to develop a comprehensive sleep routine questionnaire that captures child’s bedtime routine behaviors, and household adult-child interaction and bedtime environment that support health bedtime behaviors. As the first step of the measurement development, we focused on study cultural relevance, salience and appropriateness of the three bedtime measures: 1. the Parent-Child Sleep Interaction Scale, 2. Bedtime Routines Questionnaire, and 3. Child Routines Inventory scales, prior to formal administration. Methods A human-centered design process, Ecological Theory (considering individual, home, black community contexts), and qualitative formative research methods were applied to guide sleep routine questionnaire adaptation. A convenience sample of five Black caregivers with preschool-aged children were interviewed and provided feedback for the bedtime routine surveys. Interview questions were guided by human-centered design, centering the lived experience of the caregivers, as well as multiple-domains of sleep contexts and behaviors to understand child sleep routine practices, household structure, child sleep environment, social-family connection, social support and child sleep decision-making. Results Thematic areas of caregiver feedback fell into the following three areas: 1. deficit-based and focused on punitive discipline, 2. Do not capture child weekend sleepovers at Grandparent’s house, 3. Two-home households were not reflected, 4. Racial options for mixed children were not reflected and 5. age-appropriate activities were not reflected in the measures. Conclusion Current pediatric bedtime routine sleep measures are not culturally tailored for Black families of preschool aged children. Future steps include holding caregiver focus groups to glean relevant survey items/domains for the development of a new comprehensive culturally tailored measure for Black preschool-aged children that can be used to guide the intervention and intervention theory of testing. Support (if any) NIH K01HL169419-01