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CTSA UL1TR001878

Normative Feedback and Framing Incentives to Encourage Sleep Extension in Children

Principal Investigator: Jonathan Mitchell, PhD, MSc

A large proportion of children sleep insufficiently, and inadequate total sleep time (TST) in childhood has been implicated with adverse development. Late bedtimes and early wake times lead to sleep insufficiency, which is an example of acting irrationally. Behavioral economics can counter irrational decisions, but it has not yet been applied to efforts to extend time in bed (TIB) in children.

We propose to test if normative feedback in combination with framing incentives can help children to increase their TIB and TST, using a four arm randomized comparison trial experimental design. The intervention will be delivered to 60 children, aged 10-12y, using the Way to Health platform and will last for 50-days. The TIB goals offered will be 9.5, 10.0 or 10.5 hours per night. Fitbits will estimate TIB and TST in “real-time.”

Participants will be randomized to a comparison arm (i.e., sleep hygiene text messages), a normative feedback arm (i.e., messages plus being placed into teams of five with weekly feedback on rank with respect to TIB goal achievement), a loss-framed arm (i.e., messages plus a virtual account starting with $50, and $1 deductions each time TIB goal is not met), or a normative feedback combined with the loss-framed incentive arm.

We hypothesize that normative feedback alone and loss-framed incentives alone will increase the proportion of intervention days the children meet their TIB goal, with the proportion being even greater when both behavioral economic approaches are combined. The study will demonstrate feasibility and generate pilot data for future funding.