0987 Hózhó: Mixed Method Sleep Intervention for Navajo Caregivers and their Children with Developmental Disabilities

Abstract

Introduction: This pilot project addressed the feasibility and acceptability of a sleep health education intervention for caregivers of children with developmental disabilities (DD) on the Navajo Nation. It was hypothesized that caregiver education and a tailored intervention that addressed their sleep problems and those of their children would improve caregiver and child sleep quality, as well as caregiver health-related quality of life (HR-QOL). Methods: Caregivers (N=15), who had children with DD participated in three 1-hour home-based sessions over a three-month period in this mixed method observational study. Educational modules were tailored to specific sleep issues of the caregiver, and their child(ren), as well as unique environmental and cultural features of Navajo families. Quantitative measures included a sleep habits questionnaire, pre- and post-measures of learning, and the SF-12 HR-QOL. Interviews and texting provided qualitative data regarding facilitators and detractors to healthy sleep. Quantitative data were analyzed with frequencies and repeated measures analyses with p .05. Qualitative comments were transcribed verbatim, coded and categorized into themes. Study approval was obtained from the Navajo Nation IRB. Results: Caregiver sleep duration increased by 2 hours (5.8±1.8 to 7.8±1.9, p=.005) with a decrease in sleep onset from 45 to 15 minutes (p=.01). Caregivers also reported improved physical (45.0±8.2 to 52.8±8.7 p=.001) and mental HR-QOL (41.8±8.9 to 49.3±10.9, p=.002), as well as enhanced knowledge of sleep disorders (13.4±4.0 to 20.7±5.6) and healthy sleep habits (15.7±4.1 to 25.4±3.4 each p=.005). Qualitatively, many participants reported better sleep quality in their children with earlier bedtimes, less night waking, and more consistent nap Conclusion: Findings suggest this Navajo Nation-tailored sleep education program is a salient, culturally responsive approach to educating caregivers regarding sleep disorders and promoting caregiver sleep health and HR-QOL, as well as sleep health of their children. Notably, 3 adults and 2 children were referred to Indian Health Services for further sleep disorders evaluation. Caregivers credited improved personal and child sleep to the support they received during home visits and text messaging.