Browsing by Author "Mindell, Jodi A."

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Real-World Implementation of Infant Behavioral Sleep Interventions: Results of a Parental Survey
    (Elsevier, 2018-08) Honaker, Sarah M.; Schwichtenberg, A. J.; Kreps, Tamar A.; Mindell, Jodi A.; Pediatrics, School of Medicine
    Objective To describe parental practices implementing behavioral sleep intervention (BSI) outside a clinical setting. Study design Parents (n = 652), recruited through a Facebook group designed as a peer support group for parents using BSI, completed an online survey about their experience using BSI with their infant or toddler. Results On average, parents implemented BSI when their infant was 5.6 (±2.77) months. Parents most often used modified (49.5%) or unmodified extinction (34.9%), with fewer using a parental presence approach (15.6%). Regardless of BSI type, more parents endorsed “a great deal of stress” during the first night (42.2%) than 1 week later (5.2%). The duration of infant crying was typically greatest the first night (reported by 45%; M = 43 minutes) and was significantly reduced after 1 week (M = 8.54 minutes). Successful implementation of BSI on the first attempt was reported by 83%, with a median and mode of 7 days until completion (79% by 2 weeks). Regardless of BSI type, after intervention parents reported their infant had less difficulty falling asleep, fewer night awakenings, and were more likely to sleep in their room and/or in their own crib/bed. Conclusions The majority of parents report successfully implementing BSI, with significantly reduced infant crying by the end of 1 week and success within 2 weeks. Few differences were found between behavioral approaches.
  • Thumbnail Image
    Item
    Screening for Problematic Sleep in a Diverse Sample of Infants
    (Oxford University Press, 2021) Honaker, Sarah M.; McQuillan, Maureen E.; Mindell, Jodi A.; Downs, Stephen M.; Slaven, James E.; Schwichtenberg, A.J.; Pediatrics, School of Medicine
    Objective: To examine screening strategies for identifying problematic sleep in a diverse sample of infants. Methods: Parents of infants (5-19 months; N = 3,271) presenting for a primary care visit responded to five screening items and the Infant Sleep Questionnaire (ISQ), a validated measure of problematic infant sleep. If parents responded affirmatively to any screening item, primary care providers received a prompt to evaluate. For each of the screening questions, we examined differences in item endorsement and criterion related validity with the ISQ. Using conceptual composites of night waking and sleep difficulty, prevalence, criterion-related validity, and concurrent demographic correlates were analyzed. Results: Infants were primarily of Black race (50.1%) or Hispanic ethnicity (31.7%), with the majority (63.3%) living in economically distressed communities. Rates of problematic sleep ranged from 7.4%, for a single item assessing parental perception of an infant having a sleep problem, to 74.0%, for a single item assessing night wakings requiring adult intervention. Items assessing sleep difficulty had high (95.0-97.8%) agreement with the ISQ in identifying infants without problematic sleep, but low agreement (24.9-34.0%) in identifying those with problematic sleep. The opposite was true for items assessing night waking, which identified 91.0-94.6% of those with sleep problems but only 31.8-46.9% of those without. Conclusions: Screening strategies for identifying problematic infant sleep yielded highly variable prevalence rates and associated factors, depending on whether the strategy emphasized parent-perceived sleep difficulty or night wakings. The strategy that is most appropriate will depend on the system's goals.