Sleep Differences by Race in Preschool Children: The Roles of Parenting Behaviors and Socioeconomic Status

Background Childhood obesity is a complex and multifaceted problem involving interactions among child, family and community environment. Aim The purpose of this study was to examine the contributing factors to early childhood obesity within a multilevel context, including child and family, childcare setting and community. Methods A cross‐sectional, quantitative research design was employed. A total of 129 preschoolers and their parents in northwest Florida participated in this study. Child height and weight were measured, and body mass index (BMI) was calculated. Parents and directors of preschools completed survey questionnaires to assess child/family, childcare setting and community factors, respectively. Hierarchical multiple regression was used to evaluate the association of each level of factors with child BMI z‐score. Results Twenty‐one per cent of children were overweight or obese (≥85th BMI percentile). In hierarchical multiple regression, household income, parent beliefs, attitudes and practices for child feeding, family obesogenic environment, child routines (screen time on weekends, sleep hours, bedtime) and physical activity environment were significantly related to child BMI z‐score. Conclusions The findings of this study provide a broader understanding of factors that influence child BMI z‐score. Shaping a non‐obesogenic environment by establishing healthy routines for children in the home, childcare setting and community is essential in childhood obesity prevention. Implications for nursing practice and health policy Paediatric nurses should routinely assess accurate parental perception of child weight, feeding style and child routines in well‐child care visits. Healthcare professionals and health policymakers should enact policies that build a healthy environment for preschoolers in their childcare setting and community.

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“…A study by Patrick et al. () reported that black children have a later bedtime than white children. Similarly, Mindell et al.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing obesity among preschoolers: multilevel approach

Park

Bahorski

et al. 2019

International Nursing Review

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“…24 However, unlike other intervention efforts, in this study parents did not receive specific information about age-appropriate sleep duration. Also of note, only intervention children had a nighttime sleep duration of 10 hours at follow-up, which aligns with the recommended sleep guidelines 7 for the age of the majority of children in this study sample (children ages [6][7][8][9][10][11][12].…”

Section: Discussionmentioning

confidence: 98%

Sleep Well!: A Pilot Study of an Education Campaign to Improve Sleep of Socioeconomically Disadvantaged Children

Mindell

Sedmak²,

Boyle

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Socioeconomically disadvantaged children are at risk for poor sleep hygiene and increased sleep problems. This pilot study examined the efficacy of Sleep Well!, a parent-based sleep education endeavor, which supplemented an outreach program that provides beds to socioeconomically disadvantaged children. Methods: In addition to receiving a bed, 152 children (mean age = 5.95 years, 57.2% boys) were randomly assigned to sleep education (3 messages: bedtime before 21:00; no caffeine; keep electronics out of the bedroom) or control (dental hygiene education) conditions. All education was provided at both the time of scheduling and delivery of a bed to each child. Parent-reported sleep data were collected at baseline and at 4-week follow-up. Results: Provision of a bed was associated with reduced bedroom electronics and increased parent-reported nighttime sleep duration for all children. However, relative to control children, intervention children showed even greater reductions in electronics (baseline mean = 1.91 items, follow-up mean = 0.85 items) and improvements in sleep duration (baseline mean = 9.75 hours, follow-up mean = 10.19 hours). There was no intervention effect for caffeine consumption or bedtime from baseline to follow-up. Conclusions: Providing beds to socioeconomically disadvantaged children resulted in increased sleep duration and decreased use of electronics at bedtime, while the combination of a bed and brief parent sleep education conferred additional sleep benefits. Further study of brief child sleep interventions is warranted, particularly among socioeconomically disadvantaged children who are at risk for sleep problems.

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“…[3][4][5] Community-based studies have shown that Black preschoolers are more likely than their White peers to exhibit symptoms of behavioral sleep disturbances, such as increased bedtime resistance, longer sleep onset latency, and shorter total sleep duration. [5][6][7][8] Aspects of sleep routines and the sleep environment also differ by race, with Black children showing later bedtimes and decreased likelihood of following a regular bedtime routine, 5,6,8,9 as well as higher rates of parent-child bed-sharing. 10,11 Later bedtimes and less regular bedtime routines have been associated with increased child sleep disturbances, 2,12,13 and research on the effect of bed-sharing on child sleep is mixed.…”

Section: Introductionmentioning

confidence: 99%

“…The slightly later bedtimes and longer nap duration for Black children in this sample converge with previous research drawn from community-based samples. 3,[5][6][7][8] It may be that these results did not significantly differ from patterns of White children due to the nature of the clinically referred sample. It was striking that 16.1% of all children in our sample had reportedly consumed caffeine.…”

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confidence: 99%

“…Especially as socioeconomic factors have been found to interact in complex ways with both caregiver racial/ ethnic background and sleep-related caregiver behaviors to predict child sleep patterns and problems, 7,14 an examination of these factors using multiple measures is needed in research that examines sleep problems in clinical samples, as well as potential disparities in pediatric sleep services. Future research studies on this topic should include multiple points of assessment prior to the initial sleep consultation, such as at the point of sleep problem identification and/or at referral to a specialty sleep clinic, as well as following the initial consultation, to assess diagnostic confirmation of OSA, treatment adherence for insomnia and OSA, and related follow-up care.…”

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confidence: 99%

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Differences in Sleep Patterns and Problems by Race in a Clinical Sample of Black and White Preschoolers

Williamson

Rubens

Patrick

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: Community-based research indicates that Black preschoolers tend to have more bedtime difficulties and are at higher risk for obstructive sleep apnea (OSA) compared to White preschoolers. This study examined differences in sleep patterns and problems by race among a clinical sample of Black and White preschoolers at an outpatient sleep clinic. Methods: Data were collected from electronic medical records for 125 children ages 2-5 years (mean = 3.37 years, 64.0% White, 36.0% Black; 59.2% male) presenting at a pediatric sleep clinic in an academic medical center. Neighborhood income data were based on ZIP codes entered into the United States Census Bureau's American Fact Finder. Results: Black patients (51.1%) were significantly more likely than White patients (20.0%) to bed-share with a caregiver (χ 2 = 12.99, P ≤ .001). There were no other significant differences in presenting sleep patterns (bed/wake times, sleep onset latency, naps, night awakenings, or sleep opportunity). Logistic regressions showed that White patients were more likely to present with difficulty falling/staying asleep and receive an insomnia diagnosis, and Black patients were more likely to present with OSA-related concerns and receive a diagnosis of suspected OSA, even when controlling for relevant sociodemographic covariates. Conclusions: In contrast to community-based research, Black and White children showed similar sleep patterns. However, there were differences by race in referral questions and diagnoses. Findings suggest the need to consider caregiver perceptions and other sociocultural factors that may contribute to differential rates of presentation for sleep services, as well as potential health disparities in this regard. I NTRO DUCTI O NAlthough sleep problems affect 20% to 30% of infants, preschoolers, and kindergarteners, 1,2 recent research indicates that young children from non-White racial/ethnic backgrounds are at increased risk of experiencing sleep difficulties compared to non-Hispanic/Latino White youth (hereafter the term "White" will be used to reference non-Hispanic/Latino White racial/ ethnic background). Specifically, studies comparing Black and White children have found that racial/ethnic background is a significant predictor of variation in preschoolers' sleep regularity, duration, and quality.3-5 Community-based studies have shown that Black preschoolers are more likely than their White peers to exhibit symptoms of behavioral sleep disturbances, such as increased bedtime resistance, longer sleep onset latency, and shorter total sleep duration.5-8 Aspects of sleep routines and the sleep environment also differ by race, with Black children showing later bedtimes and decreased likelihood of following a regular bedtime routine, 5,6,8,9 as well as higher rates of parent-child bed-sharing. 10,11 Later bedtimes and less regular bedtime routines have been associated with increased child sleep disturbances, 2,12,13 and research on the effect of bed-sharing on child sleep is mixed.11 Some families may choos...

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Sleep Differences by Race in Preschool Children: The Roles of Parenting Behaviors and Socioeconomic Status

Cited by 40 publications

References 38 publications

Factors influencing obesity among preschoolers: multilevel approach

Factors influencing obesity among preschoolers: multilevel approach

Sleep Well!: A Pilot Study of an Education Campaign to Improve Sleep of Socioeconomically Disadvantaged Children

Differences in Sleep Patterns and Problems by Race in a Clinical Sample of Black and White Preschoolers

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