A Qualitative Analysis of Predictors of Success in the Behavioral Sleep in Preschoolers (SHIP) Intervention

Abstract

Given the importance of healthy sleep behaviors in early childhood, and a need for effective and accessible interventions, the current study utilized qualitative research methodology to identify early predictors of intervention success in a previously conducted study of a sleep health intervention for preschool-aged children with behavioral sleep problems, specifically the Sleep Health in Preschoolers (SHIP) intervention. We aimed to identify early markers that someone may need a more intensive or different intervention approach to be successful. Regression analysis was used to determine SHIP clinical trial cases who had the highest and lowest response to the intervention. Thematic analysis was conducted on data consisting of text notes collected during the weekly delivery of the 12-week, active phase of the SHIP intervention between case managers and a primary study participant of a child with behavioral sleep problems. Content analysis was used to guide the identification of thematic predictors of intervention success. Themes of high self-efficacy, positive parent attitudes, and engaged behavior with the intervention presented themselves more often in cases with a high response to the intervention relative to cases in the low response group. Themes of low self-efficacy, multiple concurrent known barriers to behavioral sleep health interventions, and disadvantageous parental behavior presented themselves more often in cases with a low response to the intervention relative to cases in the high response group. The study is an example of how qualitative analysis can be valuable tool in improving the real-world effectiveness of complex behavioral interventions and identifying signals we might use to better triage families with children with behavioral sleep problems toward appropriate interventions.