A multi-method evaluation of bed provision and sleep education for young children and their families living in poverty.

STUDY OBJECTIVES: To evaluate the impact of bed provision and sleep education through the Beds for Kids (BfK) program on early childhood sleep and behavior, and maternal mood and sleep.

METHODS: Twenty-seven mother-child dyads (childage = 2-5 yrs, 85.2% Black) living in poverty and without an individual child bed were randomly assigned (multi-method randomized waitlist control trial design) to BfK intervention ~1-week post-baseline (initial intervention) or ~2 weeks post-baseline (waitlist control), with follow-up at one-month. BfK intervention (home bed delivery and written sleep health education) was provided to all families. Children wore actigraphs and mothers completed daily diaries to assess child and maternal sleep, child behavior, and maternal mood for the initial one-week comparison period. Maternal-reported child sleep and behavior (internalizing and externalizing problems) were collected at one-month post BfK-participation for all families; n=11 completed a qualitative interview at one-month assessment.

RESULTS: At one-week post-BfK, mothers' sleep duration increased by 1 hour compared to waitlist controls. No changes were found in child sleep, child behavior, or maternal mood. However, at one-month post-BfK intervention, improvements were found in mother-reported child night awakenings, sleep quality and sleep problems, and behavior. Mothers qualitatively reported significant BfK benefits for child sleep and family wellbeing, although noted challenges to transitioning young children to sleeping independently.

CONCLUSIONS: Bed provision and sleep education for families living in poverty has a more immediate impact on maternal sleep and reported wellbeing. Child sleep and behavioral improvements are seen by one month, with children experiencing an initial adjustment period to sleeping independently.

CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: Impact of Beds for Kids Program on Child Sleep; Identifier: NCT03392844; URL: https://www.clinicaltrials.gov/ct2/show/NCT03392844.