Abstract
Background Sleep problems are common among infants and can have a serious impact on the health and wellbeing of both child and parents. To sustainably promote infant sleep on a population level, it is necessary to develop evidence-based programs that can be implemented on a large scale. The Youth Health Care setting, with its focus on prevention, child health promotion and services widely available for parents, can be a suitable setting to do so. Currently however, sleep health promotion in this setting seems to be suboptimal. To promote healthy infant sleep on a population level, programs need to be accessible and comprehensible for all parents, including parents with limited (health) literacy. Therefore, this study aims to develop, implement and evaluate a program called ‘Sleep on number 1’, that is tailored to Dutch Youth Health Care, to sustainably promote healthy sleep in 0-2-year-old infants. Methods The program was developed based on co-creation with parents and Youth Health Care professionals, evidence-based behaviour change theories and sleep health promotion methods. Program effectiveness is investigated with a quasi-experimental study design comparing the program group with the care as usual control group. Participants consist of parents of 0-2-year-old children. Primary outcome is infant sleep quality at the age of 10 weeks and 6, 9, 14 and 24 months, measured with a sleep diary. The primary data analysis focuses on night awakenings at 9 months. Secondary outcomes focus on parental behaviour regarding infant sleep, related behavioural determinants and parental satisfaction with Youth Health Care sleep advice. Program effectiveness is analysed using a linear mixed-model in case of data clustering, and an independent samples T-test or linear regression in case no substantial clustering effects are found. A mixed methods process evaluation is performed with parents and Youth Health Care professionals, assessing program reach, adoption, implementation, maintenance and working mechanisms. Promoting healthy sleep in 0-2-year-old infants: a study protocol for the development and mixed method evaluation of a sleep health program tailored to Dutch youth healthcare regions MPW van de Sande1*, SMPL Gerards1, MP L’Hoir2,3, A Gabrio4, RP Reijs5,6, I Tissen7, SW van Dam6, FHGY Alberts8 and RM Meertens1 Page 2 of 12 van de Sande et al. BMC Public Health (2024) 24:1913 Background Sleep problems are common amongst infants. Accord ing to international studies, approximately 20–30% of infants and toddlers experience sleep problems such as delayed sleep onset, frequent nighttime awakenings and early awakenings [1–4]. Moreover, many parents report having difficulties with managing their infant’s sleep, even when their child’s sleep appears to be normal [5–7]. Since infant sleep differs significantly from adult sleep, often includes night awakenings and is subject to many changes during infant development, it can be a challenge for parents to adequately m