0819 Cultural Adaptation and Preliminary Efficacy Testing of a Sleep Intervention (SIESTA) for Urban Latino Children

Abstract Introduction Latino children living in urban areas face disproportionate exposure to contextual and cultural stressors that can challenge optimal sleep. School Intervention to Enhance Latino Students’ Time Asleep (SIESTA) is a tailored intervention to improve sleep hygiene and duration in Latino middle school students in the U.S. and Puerto Rico. Methods Using Barrera and colleagues’ five stages of cultural adaptation, we identified intervention elements to retain, set refinement goals, and gathered information (literature review, focus groups/interviews, school feedback). Stage 2 involved expert review and integrating information from Stage 1. Stage 3 included an open trial to assess the content and acceptability of the adaptation. Stage 4 involved integration of feedback from the open trial. In Stage 5 (pilot RCT), Latino children (ages 11-13, n=34) and their caregivers were recruited from urban middle schools in Greater Providence and San Juan. Children were randomized to the SIESTA or control condition. SIESTA participants received a virtual group intervention (four sessions about sleep hygiene, duration, environment) and two caregiver-child sessions (sleep environment assessment, goal setting, feedback from daily sleep monitoring). Control participants received basic sleep and health education (equivalent contact time). All participants completed baseline, end-of-treatment (EOT), and 4-month follow-up assessments. Results We identified themes about sleep values and beliefs, urban stressors disrupting sleep (e.g., noise, crowding), and barriers to engagement. Each component was tailored based on experiences relevant to many urban Latino families. SIESTA participants reported high acceptability. Sleep duration measured via actigraphy increased by 13.3% (M=45min; d=0.16) in SIESTA participants vs. 7.2% (M=25min; d=0.14) in controls from baseline to EOT, p=.04. Differences were greater at 4-months (15% increase in SIESTA, 1% in controls). Caregiver- and child-reported sleep disturbances significantly decreased from baseline to EOT and to follow-up for SIESTA vs. controls (p’s<.04). Caregiver- and child-reported sleep hygiene improved significantly for SIESTA vs. controls from baseline to EOT and to follow-up (p’s<.05). Conclusion A rigorous, multi-method approach allowed for tailoring of an innovative intervention to address the sleep needs of urban Latino children. SIESTA shows potential to improve sleep duration and hygiene in this population. A large-scale RCT will evaluate effectiveness and implementation. Support (if any) 1R34HL135073