The National Sleep Foundation's Sleep Satisfaction Tool.

OBJECTIVES: The National Sleep Foundation (NSF) sought to test, refine, and add statistical rigor to its previously described provisional Sleep Satisfaction Tool (SST). The tool assesses the general population's sleep satisfaction. DESIGN: In 2017, NSF created a provisional tool through systematic literature review and an expert consensus panel process. This tool was expanded, refined, and tested through an open-ended survey, 2 rounds of cognitive testing, and a national survey of a random sample of Internet users (aged 18-90). Factor analysis and final consensus panel voting produced the robust SST. RESULTS: The exploratory, open-ended surveying for identifying additional factors important to the public led to question formulation around mind relaxation. Cognitive testing yielded significant refinement to question and response option formatting. Factor analysis of questions from field testing indicated loading on one construct identified as "sleep satisfaction." The final 9-item SST demonstrated strong reliability and internal validity with overall SST scores of 56/100 (higher scores indicating greater sleep satisfaction). Individual SST item mean scores ranged from 39 to 66, and overall SST scores varied substantially across demographic groups. CONCLUSIONS: NSF used a series of development and validation tests on its provisional SST, producing a novel and reliable research tool that measures the general population's sleep satisfaction. The SST is a short, reliable, nonclinical assessment that expands the set of tools available to researchers that implements the individual, social, and environmental factors related to sleep satisfaction. Further research will explore refined scoring methods along with factor weighting and use within different populations.

Evaluating Industry Self-Regulation of Food Marketing to Children.

INTRODUCTION: Concern has grown about the role of televised food advertising as a contributor to childhood obesity. In response, the food industry adopted a program of self-regulation, with participating companies pledging to limit child-targeted advertising to healthier products. The implicit promise of the industry initiative is a significant improvement in the overall nutritional quality of foods marketed to children, thereby negating the need for governmental regulation to accomplish that objective. This study assesses the efficacy of industry self-regulation by comparing advertising content on children's TV programs before and after self-regulation was implemented. METHODS: A systematic content analysis of food advertisements (n=625 in 2007, n=354 in 2013) appearing in children's TV programs on the most popular cable and broadcast channels was conducted. RESULTS: All analyses were conducted in 2014. Findings indicated that no significant improvement in the overall nutritional quality of foods marketed to children has been achieved since industry self-regulation was adopted. In 2013, 80.5% of all foods advertised to children on TV were for products in the poorest nutritional category, and thus pose high risk for contributing to obesity. CONCLUSIONS: The lack of significant improvement in the nutritional quality of food marketed to children is likely a result of the weak nutritional standards for defining healthy foods employed by industry, and because a substantial proportion of child-oriented food marketers do not participate in self-regulation. The lack of success achieved by self-regulation indicates that other policy actions are needed to effectively reduce children's exposure to obesogenic food advertising.