Evaluating the effect of sleep kits and training in foster care clinic visits

Abstract Objective This three-arm pragmatic control trial tested the effectiveness of a single-dose evidence-based psychological intervention (EBPI) with and without a sleep kit (treatment arms) to usual care (control arm) among young people (ages 2–20 years) new to a foster care placement. Methods Caregivers and youth were screened for sleep concerns before their foster care clinic visit; if a concern was identified, enrolled young people and caregivers (N = 177) completed sleep assessments before the start of their clinic visit. On days when a psychologist was unavailable to address sleep concerns, participants were enrolled in the control arm. When a psychologist was present, clinic days were randomly assigned to condition (EBPI, EBPI + sleep kit). Participants and clinicians were masked to treatment arm during the clinician portion of their visit. Participants were unmasked at the end of their visit. At follow-up visits, surveys assessing sleep were re-administered. Chart reviews captured documented sleep concerns at clinic visits outside the foster care clinic in the 6 months following intervention. Results Compared to controls, those receiving EBPI reported less medicinal sleep aid use (e.g., melatonin) following intervention. Sleep concerns persisted in approximately half of enrolled youth and did not vary by study assignment; sleep outcomes were also similar. Conclusions A single-dose EBPI to address sleep concerns may be effective for reducing use of medicinal sleep aids but is not effective for addressing sleep concerns more generally for young people in foster care.