0798 Feasibility & Acceptability of SAFE: A Brief Trauma-Informed Behavioral Sleep Intervention for Youth in Foster Care

Abstract Introduction Children who have spent time in foster care unsurprisingly experience high rates of sleep problems and disorders, which negatively impacts well-being. Sleep and Adjustment in Foster Environments (SAFE) is a brief, telehealth-delivered behavioral sleep intervention for caregivers of young children in or adopted from foster/kinship care. Building upon existing evidence-based behavioral sleep strategies by using a trauma-informed approach, SAFE promotes children’s self-regulation, felt safety, and connection with foster caregivers to improve sleep. Using data from a randomized controlled pilot study, we explored the feasibility and acceptability of SAFE compared to an active control condition (Sleep Education Support; SES), which provided families with a mailed informational booklet about young children’s healthy sleep. Methods Foster/kinship caregivers and adoptive foster parents of children ages 2-5 years were recruited across Texas. Children with organic sleep disorders (e.g., OSA), major medical conditions/disorders, and/or autism were ineligible. Beliefs about treatment were assessed pre-treatment with the Credibility/Expectancy Questionnaire; perceived intervention utility and acceptability were assessed post-treatment with the Client Satisfaction Questionnaire and via qualitative interviews. Results Over an 18-month period, N=127 families inquired about the study, 78 were screened, and 67 were eligible. Of these, 22/67 (33%) did not move forward due to scheduling difficulties (n=9), no longer being interested (n=8), or loss of contact (n=5). The remaining 45 eligible families were randomized to SAFE (n=22) or SES (n=23). Among SAFE families, 21/22 (95%) completed all three intervention sessions and the post-treatment assessment. Among SES families, 20/23 (87%) completed the post-intervention assessment. Primary factors influencing study withdrawal included the child leaving the home and scheduling difficulties. Results of independent-samples t-tests revealed significantly higher treatment satisfaction in the SAFE group (M=29.57, SD=4.78) compared to the SES group (M=23.95, SD=7.00; t=-2.988, p=.005). Groups did not significantly differ in treatment credibility or expectancy. Conclusion SAFE appears feasible and acceptable to foster/adoptive caregivers. While both groups reported similar baseline beliefs about treatment and shared positive post-treatment feedback, satisfaction was greater for the SAFE group. Results underscore a need for sleep health interventions tailored to this population. Support (if any) This study was funded by the Grant to Enhance and Advance Research (GEAR) from the University of Houston.