169 Qualitative Identification of Multilevel Influences on Sleep in Latinx Pre-Adolescents

Introduction The prevalence of obesity among U.S. Latinx children is nearly 10% higher than in their white counterparts. Long-term success of diet and activity level-focused interventions has been limited. Poor sleep is associated with increased obesity risk in youth. Application of social ecological models of behavior change to identify influences of sleep in Latinx youth may reveal unique intervention targets to improve their sleep, which may reduce obesity risk. This qualitative study aimed to identify the multilevel factors that Latinx pre-adolescents believe affect their sleep duration, quality and timing. Methods Eleven focus groups were conducted with forty-six 10-to-12-year-old Latinx pre-adolescents (50% female). Focus groups continued until saturation was reached, and no new information was emerging. Iterative deductive thematic content analysis was conducted by two independent coders (IRR=.815). Results Three themes affecting children’s sleep resulted: 1) Individual-level (emotional/ physical feelings or behaviors); 2) Social (direct interactions with others); and 3) Environmental (characteristics, objects or perceptions of physical environment) influences. Individual-level influences were primarily psychological (e.g., stress, “Whenever I have a test the next day, I am stressed and I wake up I’m like so tired”) and behavioral (e.g., activity levels, “just sitting just the whole day… when it comes to nighttime, you’re not even tired”), and affected sleep quality and timing. Interactions with siblings (e.g., “She [sister] always gets mad at me and like in the night she like wakes me up” and friends (e.g., “arguments like with a really good friend… the whole night I think about it”) were social factors affecting sleep quality. Environmental influences came from within the sleep area and neighborhood, including temperature (e.g., “I like my pillows cold”) and noise (e.g., “My neighbor’s dog… they always take them out at night time to like play with them and then I could hear the dog barking and them screaming”). Conclusion While social influences exist, individual feelings and sleep environment seem to be more prevalent impacts on sleep of Latinx children. Findings support the notion that developing multi-level strategies may be effective in enhancing sleep duration, quality and timing for Latinx pre-adolescents. Support (if any) NIH-NHLBI 5K01HL140283