Faculty Bibliography

OBJECTIVE:To assess relationships between material hardships, shortened sleep duration, and suboptimal sleep practices across infancy and toddlerhood in low-income Hispanic families. METHODS:We analyzed longitudinal data of 451 low-income Hispanic mother-child pairs from a child obesity prevention trial. During infancy and toddlerhood, we used adjusted linear regression to assess associations between material hardship (financial difficulty, food insecurity, housing disrepair, multiple hardships), sleep duration (24-hour, night), and the number of suboptimal sleep practices (e.g., later bedtime, co-sleeping). We used adjusted linear regression to assess the longitudinal association between the number of suboptimal sleep practices in infancy and toddlerhood, and tested whether specific or multiple hardships moderated this association. RESULTS:In infants, financial difficulty and multiple hardships were associated with decreased night sleep (B=-0.59 hours, 95% CI: -1.04, -0.14; and B=-0.54 hours, 95% CI: -1.00, -0.08). Housing disrepair was associated with decreased 24-hour sleep (B=-0.64 hours, 95% CI: -1.29, -0.01). In toddlers, each additional suboptimal sleep practice was associated with a decrease in night sleep (B=-0.19 hours, 95% CI: -0.29, -0.09). Each additional suboptimal sleep practice in infancy was associated with a 0.30 increase in the number of suboptimal sleep practices in toddlerhood (p<0.001), with greater increases for those with food insecurity or multiple hardships. CONCLUSION/CONCLUSIONS:Specific and multiple hardships shortened sleep duration during infancy, and moderated the increase of suboptimal sleep behaviors between infancy and toddlerhood. Future studies should consider these early critically sensitive periods for interventions to mitigate material hardships and establish healthy sleep practices.

PURPOSE AND OBJECTIVES/UNASSIGNED:The objective of our study was to strengthen wellness policy in Title 1 schools by implementing a mentored behavior-change model that extends the continuum of care from academic to community settings and mobilizes existing public resources in accordance with US Preventive Services Task Force screening guidelines for childhood obesity management. INTERVENTION APPROACH/UNASSIGNED:Team Kid POWER! (KiPOW!) health mentors (students and trainees in medical and health-related fields) in 2 geographically and demographically distinct school districts, the District of Columbia and Orange County, California, delivered standardized health curricular modules to fifth grade classrooms, modeled healthy eating behaviors during school lunchtime, and engaged in active play at recess. EVALUATION METHODS/METHODS:Initial interventions in the the District of Columbia and Orange County delivered 10 sessions in which all participants received the intervention. Two subsequent interventions in Orange County, for 5 weeks (Lite) and 10 weeks (Full), included controls. Pre-post measurements of body mass index (BMI) and blood pressure were documented in all participants. A mixed linear regression model, which included a random effect for each school, estimated differences between Full and Lite interventions compared with controls, adjusting for site, sex, and baseline status of the dependent variable. RESULTS:KiPOW! Full, but not KiPOW! Lite, was associated with a modest reduction in BMI percentile compared with control (KiPOW! Full, P = .04; KiPOW! Lite, P = .41), especially in Orange County (P < .001). Systolic blood pressure improved in Full (P < .046) more than in Lite interventions (P = .11), and diastolic blood pressure improved in both Full (P = .02) and Lite (P = .03) interventions. Annual renewal of the school and volunteer commitment needed to maintain KiPOW! was found to be sustainable. IMPLICATIONS FOR PUBLIC HEALTH/UNASSIGNED:KiPOW! is a generalizable academic-community partnership promoting face-to-face contact between students and trusted health mentors to reinforce school wellness policies and foster youth confidence in decision-making about nutrition- and activity-related behaviors to achieve reduced BMI percentile and lowered blood pressure.