Hózhó: Promoting sleep health among Navajo caregivers

Abstract

Objectives This study explored the feasibility and acceptability of a sleep health education intervention for caregivers of children with developmental disabilities (DD).

Design This mixed-methods pilot study utilized repeated measures and caregiver interviews.

Setting The intervention occurred in the homes of caregivers who live on the Navajo Nation.

Participants Fifteen caregivers of children with DD aged from birth to 3 years old participated.

Intervention The intervention consisted of three 1-hour home-based sessions. Educational modules were tailored to specific sleep issues of the caregiver and their child(ren), as well as the unique environmental and cultural features of Navajo families.

Measurements Quantitative measures included a sleep habits questionnaire, pre- and postmeasures of learning, and the SF-12 HRQoL. Quantitative data were analyzed with frequencies and repeated measures analyses with p .05. Qualitative comments regarding facilitators and detractors to healthy sleep were transcribed verbatim and categorized into themes.

Results Caregiver sleep duration increased by 2 hours (5.8±1.8 to 7.8±1.9, p = .005). 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), and 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). Many participants reported better sleep quality in their children with earlier bedtimes and less night waking.

Conclusions Findings suggest that this tailored sleep education program is a culturally responsive approach to promoting caregiver sleep health and HR-QoL, as well as the sleep health of their children. Caregivers credited improved sleep to the support they received during visits and text messaging.