Can Healthy Media Intervention Improve a Child’s Sleep?

association sleep patternsThe results of a study published in the September 2012 issue of Pediatrics indicate that parents may be able to positively affect a preschooler’s sleep patterns by making healthier and more educational choices in a child’s media diet.

The journal article, The Impact of a Healthy Media Use Intervention on Sleep in Preschool Childrenexamines whether healthy media interventions in the lives of preschool children can improve sleep patterns. Researchers at the Seattle Children’s Research Institute explain how they conducted a randomized controlled study to discover if the sleep of preschoolers might be improved when families were helped to replace inappropriate and sometimes violent media content with a healthier and more educational media diet. This article is freely available or read the abstract.

The study, which included 617 children and their families from the Seattle area, used two-phase sampling (defined below). In the first phase researchers selected the clinics in the Seattle metropolitan area, making selections that reflected Seattle’s demographic make-up and including providers that served Medicaid patients. In the next phase, researchers invited preschool patients (and their parents) from those clinics to take part in the study. Patients and who met the guidelines for inclusion and agreed to participate were then randomized into a control group (this group received usual pediatric care) and an interventional group (researchers suggested media changes to these participants).

At the beginning, a survey asked everyone about sleep habits, and the researchers classified into categories. Additional information about each child’s media exposure was collected at 6, 12, and 18 months. Of the 617 families who completed the initial sleep survey questionnaire, 565 completed at least one follow-up survey.

In the interventional group, researchers suggested ways that parents could change a child’s media diet by adding better and more age appropriate media. While the study considered all of a child’s screen time, the primary focuses were media watched on television and  on videos — the two that comprise the greatest portion of a preschooler’s exposure. Interestingly, the study’s suggested interventions did not include suggestions that parents decrease the amount of screen time — only changes in programming quality.

Some of interventional group strategies included:

  • Suggesting to parents that they can decide to replace inappropriate programming with better media content.
  • Encouraging parents to co-view programs with their children, observe, and talk about what they see.
  • Sending monthly mailings with program guides and recommendations to the parents.

At the beginning of the study the most common sleep issue for all participating preschool children was taking more than 20 minutes to fall asleep. At the conclusion of the study the children who had received media interventions had “significantly lower odds” of experiencing sleep problems than the children in the control group. This is important because many of the previous studies exploring the relation between media and sleep patterns had not been designed to determine whether a child’s delayed sleep encourages more media use or whether too much inappropriate media causes a child to delay sleep.

 In two-phase, or double, sampling, certain items of information are collected for an initial, or first-phase phase, sample, then further items are collected at the second phase from a subsample of the initial sample.  – Graham Kalton, University of Michigan, Introduction to Survey Sampling.

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