Early Childhood Sleep Intervention in Urban Primary Care: Caregiver and Clinician Perspectives

Williamson, Ariel A.; Milaniak, Izabela; Watson, Bethany; Cicalese, Olivia; Fiks, Alexander G.; Power, Thomas J.; Barg, Frances K.; Beidas, Rinad S.; Mindell, Jodi A.; Rendle, Katharine A.

doi:10.1093/jpepsy/jsaa024

Cited by 35 publications

(24 citation statements)

References 38 publications

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“…69 Studies using qualitative methods have provided insights into the ways in which different socio-ecological factors may interact to create barriers to healthy sleep for youth and their families of primarily lower-SES and nonwhite backgrounds. 70,71…”

Section: Disparities In Pediatric Sleepmentioning

confidence: 99%

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Disparities in Sleep Health and Potential Intervention Models

Billings

Cohen

Baldwin

et al. 2021

Chest

157

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Disparities in sleep health are important but under-recognized contributors to health disparities. Understanding the factors contributing to sleep heath disparities and developing effective interventions are critical to improving all aspects of heath. Sleep heath disparities are impacted by socio-economic status, racism, discrimination, neighborhood segregation, geography, social patterns and access to healthcare as well as by cultural beliefs necessitating a cultural appropriateness component in any intervention devised for reducing sleep health disparities. Pediatric sleep disparities require innovative and urgent intervention to establish a foundation of lifelong healthy sleep. Tapping the vast potential of technology in improving sleep health access may be an underutilized tool to reduce sleep heath disparities. Identifying, implementing, replicating and disseminating successful interventions to address sleep disparities have the potential to reduce overall disparities in health and quality of life.

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Section: Disparities In Pediatric Sleepmentioning

confidence: 99%

“…71 Overall, identifying youth, family, and other stakeholder perceptions about sleep health and treatments is critical for developing and implementing acceptable and efficacious methods to address pediatric sleep disparities. 70,71…”

Section: Approaches To Addressing Pediatric Sleep Disparitiesmentioning

confidence: 99%

Disparities in Sleep Health and Potential Intervention Models

Billings

Cohen

Baldwin

et al. 2021

Chest

157

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“…By understanding barriers, the authors were able to pilot a well-received intervention for these patients. A qualitative study ( Williamson et al., 2020 ) of caregivers and clinicians focused on identifying ways to adapt and implement evidence-based interventions for primarily Black-identified toddlers and preschoolers presenting with sleep issues in an urban environment relegated for people experiencing low socioeconomic status. The findings highlight the common and unique concerns of caregivers and clinicians living and working in these environments; thus, emphasizing the value of attaining both perspectives when designing and preparing to implement interventions in settings relegated to have fewer resources.…”

Section: Factors Impacting Implementation Of Interventions To Addressmentioning

confidence: 99%

Introduction to the Special Issue: Addressing Health Disparities in Pediatric Psychology

Valrie

Thurston

Santos

2020

Journal of Pediatric Psychology

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This introduction to the special issue on Addressing Health Disparities in Pediatric Psychology provides context for why this special issue is needed, reviews key findings of the accepted articles, and discusses future directions for advancing the field. This special issue, one of three on this topic area that has been put forth in the history of this journal, comes at a critical point in our world. This is a time when the COVID-19 pandemic is systematically infecting Black, Indigenous, and People of Color and when there has been increased attention to systemic racism and intersecting violence inherent in multiple systems, including the justice, health, and educational systems. Using Kilbourne et al. (2016) framework, this special issue focuses on Phase 2 and Phase 3 research. Rather than only identifying health disparities (Phase 1), this issue focuses on understanding mechanisms and translating such understanding into interventions and policy changes. The accepted articles span a wide gamut from obesity to autism to rural populations. Furthermore, the articles provide methods for advancing the field beyond simply noting that systematic differences exist toward strategies to address these inequities. We conclude this introduction by discussing next steps for future research, with hopes that it inspires the next generation to study issues of disparities and inequity in deeper, more meaningful, and impactful ways.

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“…In a study comparing attitudes toward adopting EBPs for autism, providers reported that they thought many EBPs were not a good fit for children treated in community settings (Stahmer & Aarons, 2009). A study evaluating community clinicians' use of a behavioral intervention for toddlers and preschoolers with sleep difficulties found that clinicians were less likely to use the intervention with families that they perceived as experiencing stressors often ascribed to families from lower socioeconomic status, such as inflexible or variable work schedules, close living quarters, and neighborhood safety concerns (Williamson et al, 2020). Similarly, EI providers described families as being either "conducive" or "unconducive" to family-centered practices, with unconducive families most often being those who were poor or minorities.…”

mentioning

confidence: 99%

Who gets coached? A qualitative inquiry into community clinicians’ decisions to use caregiver coaching

Tomczuk

Stewart

Beidas

et al. 2021

Autism

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Clinicians’ beliefs about an intervention’s fit with an individual family influence whether they use it with that family. The factors that influence clinicians’ decisions to implement evidence-based practices for young autistic children have yet to be evaluated systematically. These factors may partially account for the significant disparities in quality of and access to early intervention. We examined disparities in clinicians’ reported use of caregiver coaching, an evidence-based practice, with families from minoritized or structurally marginalized groups, and the perceived reasons for those disparities, to assess the factors that influence clinicians’ use of caregiver coaching. We conducted semi-structured interviews with 36 early intervention clinicians from publicly funded early intervention agencies in two distinct geographic regions in the United States. Clinicians identified social and structural factors, including perceived family characteristics and stigma, that influenced their beliefs about the fit of coaching with families from minoritized or structurally marginalized groups. These findings point to the presence of beliefs that likely exacerbate disparities in access to evidence-based practices and reduce the quality of care for minoritized families of young autistic children. These findings highlight the need to develop and deploy equity-focused implementation strategies to improve both access to and quality of evidence-based practices for young autistic children from minoritized groups. Lay abstract Providers’ beliefs about an intervention’s fit with a family can affect whether or not they use that intervention with a family. The factors that affect providers’ decisions to use evidence-based practices for young autistic children have not been studied. These factors may play a role in the major differences we see in the quality of and access to early intervention services in the community. We looked at differences in providers’ use of caregiver coaching, an evidence-based practice, with families from minority or vulnerable backgrounds, and the possible reasons for those differences. We did this to figure out what factors affect providers’ use of caregiver coaching. We interviewed 36 early intervention providers from early intervention agencies in two different parts of the United States. Providers pointed out things like what they thought about a family’s circumstances that affected their beliefs about how well coaching fits with minority and vulnerable families. Our findings bring attention to these beliefs that likely make accessing evidence-based practices for minority and vulnerable families harder and lessen the quality of care for these families of young autistic children. These findings highlight the need to come up with and use strategies to improve both access to and the quality of evidence-based practices for young autistic children from minority and vulnerable groups.

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Early Childhood Sleep Intervention in Urban Primary Care: Caregiver and Clinician Perspectives

Cited by 35 publications

References 38 publications

Disparities in Sleep Health and Potential Intervention Models

Disparities in Sleep Health and Potential Intervention Models

Introduction to the Special Issue: Addressing Health Disparities in Pediatric Psychology

Who gets coached? A qualitative inquiry into community clinicians’ decisions to use caregiver coaching

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