The Feasibility of Screening for Sleep Problems in Early Childhood Education Programs.

OBJECTIVES: Assess the feasibility and staff experience of screening for behavioral sleep problems (BSP) and sleep disordered breathing (SDB) in early childhood education (ECE) settings; examine BSP/SDB prevalence and caregivers' knowledge/attitudes, perception of child sleep problems, and sleep health engagement in this sample. METHOD: Eight staff representatives from four ECE sites involved with sleep problem screening procedures within a larger RCT on ECE sleep health, discussed their experiences in a focus group; transcript content reviewed. A random subset of caregiver-child dyads (n = 59) from the four ECE sites completed sleep problem measures (BSP: Children's Sleep Habits Questionnaire, Short form [SF-CSHQ], Tayside Children's Sleep Questionnaire [TCSQ-sleep disturbance and difficulty] and SDB: Pediatric Sleep Questionnaire [PSQ], in addition to RCT measures (Parent Knowledge/Attitude/Self-efficacy/Beliefs survey and sleep health goals). Caregiver sleep health engagement was measured by the sleep health goals set. RESULTS: ECE staff reported sleep problem screening as self-explanatory and doable but sometimes administratively burdensome. BSPs were identified in 44% (SF-CSHQ) to 63% (TCSQ-sleep disturbance) of children; SDBs in 13%. Only 11% of caregivers endorsed their child having a sleep "difficulty" (TCSQ). Sleep health goals were set by 85% of caregivers; 63% employed educational materials' language. CONCLUSION: Sleep problem screening in ECE is feasible, and problems are elicited. While caregivers readily engage in setting healthy sleep goals, few endorse sleep as difficult. ECE education could improve caregiver understanding/recognition of sleep problems.

Understanding the Impact of Contemporary Racism on the Mental Health of Middle Class Black Americans.

Evidence from previous research indicates that while socioeconomic status (SES) narrows Black-White health inequities, these inequities do not completely disappear, and in some cases, worsen. Why do Black-White health inequities persist, even when controlling for SES? It is critical to examine how perceptions of unfair treatment, especially those that are nuanced and subtle, affect the mental health of Black Americans with greater levels of SES. This study, using a new sample composed exclusively of college-educated Black Americans, investigated whether experiences related to racism were associated with poorer mental health. Qualtrics provided the sample from their nationwide panelists that met the research criteria. Inclusion criteria included the following: (1) self-identified as Black or African American; (2) at least 24 years old; (3) completed a 4-year college degree or higher. The findings from this study indicated that the effects of unfair treatment are significantly associated with poorer mental health. These findings highlight the insidious nature of contemporary racism as the everyday experiences of unfair treatment have a tremendous effect on depressive symptoms among this sample of college-educated Black Americans. Efforts to simply improve SES among historically marginalized groups will not bring about health equity. Findings from this study indicate that there are mental health costs associated with upward social mobility. It is likely that these costs, particularly the experience of everyday unfair treatment, likely diminish the social, economic and health returns on the human capital.

"Getting the Staff to Understand It:" Leadership Perspectives on Peer Specialists Before and After the Implementation of a Peer-Delivered Healthy Lifestyle Intervention.

Over the past two decades, there has been increased recognition of the effectiveness of peer delivered services, with prior research highlighting the benefits for both recipients of peer services and peer providers. Despite this, peer specialists report challenges to their work such as experiencing stigma associated with their role and difficulty integrating into a non-peer dominated workforce. The study sought to explore the perceptions of agency leadership from three supportive housing agencies regarding peer specialists and peer-delivered services within their organization before and after a peer-led intervention to promote healthy lifestyles for people with SMI. Semi-structured qualitative interviews were conducted with agency leadership and analyzed using a content analysis approach. Findings from this study contribute to the literature on the peer specialist workforce by identifying factors (e.g., agency's prior experience employing peer specialists) and potential strategies (e.g., exposure to peer services) impact the level of workplace integration of peer specialists.

Intersectionality and Mental Health Among Emerging Adult Black American Men: a Scoping Review.

PURPOSE OF REVIEW: We conducted a scoping review to evaluate the degree to which literature published within the past 5 years concerning mental health among Black emerging adult men in the USA engaged with intersectionality. METHODS: Using scoping review methods, we applied the following a-priori eligibility criteria: (i) sample included Black/African American men who were aged 18-29 years, (ii) pertained to general mental wellness, depression, or anxiety, (iii) published within between 2017 and 2022, (iv) empirical and/or theoretical literature including reviews, pre-prints, and reports from organizations or professional groups, (v) conducted in the USA. In total, 1384 studies were identified from the databases, after which 224 duplicates were removed, resulting in 1160 unique citations that were screened in the title/abstract phase. Overall, 376 sources were assessed for full-text eligibility, and 20 studies were included for extraction. Information pertaining to sample characteristics, intersectionality, and main mental health results were extracted from the included studies. RECENT FINDINGS: Findings from this review indicate that there is a paucity of research that has investigated the mental health of Black American, emerging adult men. Of the studies that have been conducted in recent years, there are few that have used an intersectional framework to examine how different social identities intersect to affect mental health. This review underscores that the mental health of emerging adult Black men is of considerable concern given the developmental stage, social and historical context as well as intersecting identities that men in this stage embody.

Understanding Perceptions of Depression and Depression Care across Culture and Context.

Depression is a leading cause of disability, affecting approximately 300 million people globally [...].

Effects of a Sleep Health Education Program for Children and Parents on Child Sleep Duration and Difficulties: A Stepped-Wedge Cluster Randomized Clinical Trial.

Importance: Preschool-aged children often lack sufficient sleep and experience sleep difficulties. A consistent bedtime routine, falling asleep alone, and other sleep practices reduce difficulties and increase sleep duration. Objective: To evaluate the effects of a preschool-based sleep health literacy program on children's sleep duration and difficulties and on parent sleep knowledge, attitudes, self-efficacy, and beliefs 9 and 12 months after the program. Design, Setting, and Participants: This stepped-wedge cluster randomized clinical trial was implemented across the 2018-2019 school year. Head Start preschool personnel delivered interventions and collected outcomes data at baseline and 4 follow-ups. Seven Head Start agencies across New York State were randomized to implement interventions in either fall 2018 or winter and spring 2019. Outcomes were ascertained at 9- and 12-month follow-up. From March 19 through September 28, 2018, Head Start staff recruited (a) English- or Spanish-speaking parents (b) of children 3 years of age on or about September 2018 (c) who planned to remain at the site through the school year. Altogether, 519 parent-child (aged 3 years) dyads completed baseline and (any) follow-up data. Interventions: A 2-week classroom curriculum for children, a 1-hour parent workshop, and 1-on-1 parent discussions at home or school. Main Outcomes and Measures: Outcomes were the pre- vs postintervention differences measured at baseline and 9-month follow-up for parent-reported child school-night sleep duration per sleep logs, mild or moderate sleep difficulties per a validated questionnaire, and the total and domain scores for parent sleep knowledge, attitudes, self-efficacy, and beliefs. A modified intention-to-treat analysis excluding participants with only baseline data was used. Results: The mean (SD) age at enrollment of 519 children was 2.7 (0.1) years, 264 (50.9%) were girls, 196 (37.8%) lived in Spanish-speaking households, and 5 (0.9%) identified as Alaskan Native or American Indian, 17 (3.2%) as Asian American or Pacific Islander, 57 (10.8%) as Black, 199 (37.8%) as White, and 63 (12.0%) as other. Mean sleep durations increased nonsignificantly from baseline by 5.6 minutes (95% CI, -2.3 to 13.6 minutes; P = .17) at 9-month follow-up and by 6.8 minutes (95% CI, 0.2-13.7 minutes; P = .06) at 12-month follow-up. There was a slight improvement in parental knowledge (1.13 unit increase from baseline; 95% CI, 0.13-2.12 units), but no significant outcomes for parent sleep attitudes (0.16 unit increase from baseline; 95% CI, -0.46 to 0.77 units), self-efficacy (-0.13 unit decrease from baseline; 95% CI, -1.02 to 0.76 units) and beliefs (-0.20 unit decrease from baseline; 95% CI, -0.56 to 0.16 units). Intervention effects for child sleep difficulties were not significant (odds ratio, 1.13; 95% CI, 0.62-2.09). Fewer than 1 in 4 parents accurately perceived their child's sleep difficulty at 12 months. Conclusions and Relevance: The findings of this large pragmatic, stepped-wedge cluster randomized clinical trial, albeit largely negative, may have implications for the sustained impact, focus, and potential population-level effects of sleep education programs. Future research should evaluate the effects of more recurrent programming that emphasizes recognition of sleep problems and whether small increments of sleep across months and years in early childhood have meaningful effects. Trial Registration: ClinicalTrials.gov Identifier: NCT03556462.

Environmental Scan of Sleep Health in Early Childhood Programs.

OBJECTIVE: To ascertain how sleep health knowledge is translated to early care and education (ECE) programs, using a multi-component environmental scan. METHODS: A website scan identified organizations' sleep content re: recommended practices, developmental effects, and "actionable" ratings (0-2). ECE staff surveys assessed preparedness, practices, and beliefs about addressing sleep health and sleep problems in ECE programs. Semi-structured interviews with stakeholders from the ECE, pediatric and sleep communities assessed awareness, priorities, and practices at their organizations. RESULTS: Of 15 websites scanned, half lacked sleep content on links to development, optimal duration, or scientific background. ECE staff (n = 31) were comfortable speaking to parents about healthy sleep, and with incorporating sleep education and guidance into ECE. Stakeholders (n = 15) rated healthy sleep as a high relevance, but lower priority issue. Within ECE settings stakeholders reported that knowledge about specific links to health and development was poor and that sleep health was often obscured by "safe sleep" issues. Their recommendations included: linking sleep health to "hot topics" such as obesity or preschool suspensions and expulsions, integrating it with the teaching of routines, and raising public awareness. CONCLUSION: Despite understanding that healthy sleep promotes school readiness, there is insufficiently specific, actionable information in ECE training, programs, or policies. Findings suggest a need for an awareness campaign with clear, actionable messaging, dissemination of turnkey materials, and integration with policy and professional training systems. TRIAL REGISTRATION: - ClinicalTrials.Gov: NCT03556462.