Advertisement

Infant Sleep and Parent Health Literacy

Published:March 12, 2016DOI:https://doi.org/10.1016/j.acap.2016.03.004

      Abstract

      Objective

      Child sleep problems are prevalent and have been linked to poor behavior, worse school performance, and obesity. Low health literacy (HL) is associated with suboptimal parenting practices and worse health outcomes, but the relationship between parent HL and child sleep-related issues is not known. We examined the association between parent HL and child sleep-related issues.

      Methods

      This was a cross-sectional analysis of data from caregivers enrolled in a cluster randomized trial of a primary care-based child obesity prevention program in 4 pediatric clinics. Parent HL was assessed using the Short Test of Functional Health Literacy in Adults. At the 9-month well-child visit, sleep-related factors were assessed: presence of TV in room where child sleeps, regular naptimes and bedtimes (≥5 days/wk), low daytime and nighttime sleep duration (>1 SD below mean on the basis of national data). Multiple logistic regression analyses were performed.

      Results

      We enrolled 557 caregivers of 9-month-old children (49.7% Hispanic, 26.9% black, 56.2% <$20,000 annual income); 49.6% reported having a TV in the room where their child sleeps; 26.6% did not have regular naptimes norbedtimes. Median sleep duration was 2.3 (interquartile range, 1.5–3.0) hours (daytime), and 9.0 (interquartile range, 8.0–10.0) hours (night) (30.2% low daytime; 20.3% low nighttime sleep duration). Children of parents with low HL were more likely to have a bedroom TV (66.7% vs 47.7%, P = .01; adjusted odds ratio, 2.2; 95% confidence interval, 1.1–4.3) and low night-time sleep (37.0% vs 18.5%; P = .002; adjusted odds ratio, 2.4; 95% confidence interval, 1.2–4.8).

      Conclusions

      Low parent HL is associated with TV in the bedroom and low night sleep duration. Additional study is needed to further explore these associations and intervention strategies to address child sleep problems.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Mindell J.A.
        • Owens J.A.
        • Carskadon M.A.
        Developmental features of sleep.
        Child Adolesc Psychiatr Clin N Am. 1999; 8: 695-725
        • Davis K.F.
        • Parker K.P.
        • Montgomery G.L.
        Sleep in infants and young children: part two: common sleep problems.
        J Pediatr Health Care. 2004; 18: 130-137
        • Thompson D.A.
        • Christakis D.A.
        The association between television viewing and irregular sleep schedules among children less than 3 years of age.
        Pediatrics. 2005; 116: 851-856
        • Mindell J.A.
        • Owens J.A.
        A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems.
        Lippincott Williams & Wilkins, Philadelphia, PA2010
        • Ferber R.
        Circadian rhythm sleep disorders in childhood. Principles and Practice of Sleep Medicine in the Child.
        W.B. Saunders, Philadelphia, PA1995: 91-105
        • Mindell J.A.
        • Meltzer L.J.
        • Carskadon M.A.
        • et al.
        Developmental aspects of sleep hygiene: findings from the 2004 National Sleep Foundation Sleep in America Poll.
        Sleep Med. 2009; 10: 771-779
        • Hagan J.F.
        • Shaw J.S.
        • Duncan P.M.
        Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents.
        American Academy of Pediatrics, Elk Grove Village, Ill2008
        • Fredrickson D.
        • Washington R.
        • Pham N.
        • et al.
        Reading grade levels and health behaviors of parents at child clinics.
        Kans Med. 1995; 96: 127
        • DeWalt D.A.
        • Hink A.
        Health literacy and child health outcomes: a systematic review of the literature.
        Pediatrics. 2009; 124: S265-S274
        • Berkman N.D.
        • Sheridan S.L.
        • Donahue K.E.
        • et al.
        Health literacy interventions and outcomes: an updated systematic review.
        Evid Rep Technol Assess (Full Rep). 2011; (Number 199): 1-941
        • Bernhardt J.M.
        • Felter E.M.
        Online pediatric information seeking among mothers of young children: results from a qualitative study using focus groups.
        J Med Internet Res. 2004; 6: e7
        • Brown A.
        Media use by children younger than 2 years.
        Pediatrics. 2011; 128: 1040-1045
        • Sanders L.M.
        • Perrin E.M.
        • Yin H.S.
        • et al.
        “Greenlight study”: a controlled trial of low-literacy, early childhood obesity prevention.
        Pediatrics. 2014; 133: e1724-e1737
        • Harris P.A.
        • Taylor R.
        • Thielke R.
        • et al.
        Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support.
        J Biomed Inform. 2009; 42: 377-381
        • Taveras E.M.
        • Rifas-Shiman S.L.
        • Oken E.
        • et al.
        Short sleep duration in infancy and risk of childhood overweight.
        Arch Pediatr Adolesc Med. 2008; 162: 305-311
        • Hale L.
        • Berger L.M.
        • LeBourgeois M.K.
        • et al.
        Social and demographic predictors of preschoolers' bedtime routines.
        J Dev Behav Pediatr. 2009; 30: 394-402
      1. Princeton University. Fragile Families and Child Wellbeing Study. Available at: http://www.fragilefamilies.princeton.edu/documentation.asp. Accessed September 11, 2015.

      2. Woodard EH IV, Gridina N. Media in the home. The Fifth Annual Survey of Parents and Children. 2000. Available at: http://cdn.annenbergpublicpolicycenter.org/wp-content/uploads/survey72.pdf. Accessed September 11, 2015.

      3. National Sleep Foundation. 2004 Children and Sleep. Available at: http://sleepfoundation.org/sleep-polls-data/sleep-in-america-poll/2004-children-and-sleep. Accessed September 11, 2015.

        • Baker D.W.
        • Williams M.V.
        • Parker R.M.
        • et al.
        Development of a brief test to measure functional health literacy.
        Patient Educ Couns. 1999; 38: 33-42
        • Guerra C.E.
        • Dominguez F.
        • Shea J.A.
        Literacy and knowledge, attitudes, and behavior about colorectal cancer screening.
        J Health Commun. 2005; 10: 651-663
        • Hironaka L.K.
        • Paasche-Orlow M.K.
        • Young R.L.
        • et al.
        Caregiver health literacy and adherence to a daily multi-vitamin with iron regimen in infants.
        Patient Educ Couns. 2009; 75: 376-380
        • Radloff L.S.
        The CES-D scale A self-report depression scale for research in the general population.
        Appl Psychol Meas. 1977; 1: 385-401
        • Yin H.S.
        • Sanders L.M.
        • Rothman R.L.
        • et al.
        Parent health literacy and “obesogenic” feeding and physical activity-related infant care behaviors.
        J Pediatr. 2014; 164: 577-583.e1
        • Perrin E.M.
        • Rothman R.L.
        • Sanders L.M.
        • et al.
        Racial and ethnic differences associated with feeding- and activity-related behaviors in infants.
        Pediatrics. 2014; 133: e857-e867
        • Stanger J.
        • Jamieson K.
        Television in the Home 1998: The Third Annual National Survey of Parents and Children.
        Annenberg Public Policy Center, Philadelphia1998
        • Dennison B.A.
        • Erb T.A.
        • Jenkins P.L.
        Television viewing and television in bedroom associated with overweight risk among low-income preschool children.
        Pediatrics. 2002; 109: 1028-1035
      4. Roberts DF. Kids & [email protected] the New Millennium: A Kaiser Family Foundation Report. A Comprehensive National Analysis of Children's Media Use. Executive Summary. 1999.Available at: https://kaiserfamilyfoundation.files.wordpress.com/2013/01/kids-media-the-new-millennium-report.pdf. Accessed September 11, 2015.

        • Iglowstein I.
        • Jenni O.G.
        • Molinari L.
        • et al.
        Sleep duration from infancy to adolescence: reference values and generational trends.
        Pediatrics. 2003; 111: 302-307
        • Sadeh A.
        • Mindell J.A.
        • Luedtke K.
        • et al.
        Sleep and sleep ecology in the first 3 years: a Web-based study.
        J Sleep Res. 2009; 18: 60-73
        • Williams J.A.
        • Zimmerman F.J.
        • Bell J.F.
        Norms and trends of sleep time among US children and adolescents.
        JAMA Pediatr. 2013; 167: 55-60
        • Buckhalt J.A.
        • El-Sheikh M.
        • Keller P.S.
        • et al.
        Concurrent and longitudinal relations between children's sleep and cognitive functioning: the moderating role of parent education.
        Child Dev. 2009; 80: 875-892
        • Owens J.A.
        The practice of pediatric sleep medicine: results of a community survey.
        Pediatrics. 2001; 108: e51
        • Meltzer L.J.
        • Johnson C.
        • Crosette J.
        • et al.
        Prevalence of diagnosed sleep disorders in pediatric primary care practices.
        Pediatrics. 2010; 125: e1410-e1418
        • Kumar D.
        • Sanders L.
        • Perrin E.M.
        • et al.
        Parental understanding of infant health information: health literacy, numeracy, and the Parental Health Literacy Activities Test (PHLAT).
        Acad Pediatr. 2010; 10: 309-316