A shared-management web-based intervention for sleep deficiency in school-age children with juvenile idiopathic arthritis and their parents: feasibility and acceptability study

Abstract

Study objectives: We aimed to describe the feasibility, acceptability, and preliminary efficacy of a pilot randomized controlled trial of a sleep health intervention (SLEEPSMART) for children with juvenile idiopathic arthritis and their parents.

Methods: Fifty children, 8-13 years of age, with juvenile idiopathic arthritis and sleep deficiency and their parents participated in the study. Participants were randomized to either the SLEEPSMART intervention or the control group (usual care). The SLEEPSMART intervention lasted 7 weeks and included weekly educational modules, quizzes, assignments, goal setting, and an online sleep coach. Children wore actigraphy and completed sleep diaries and surveys at baseline, immediately postintervention, and 1 month postintervention. Feasibility was measured by the percentage of eligible, enrolled, and retained child-parent dyads; engagement was measured when dyads completed the modules; and usefulness and acceptability were measured with the Treatment Evaluation Inventory and qualitative exit interviews.

Results: Of the 50 child-parent dyads enrolled, 88% completed the baseline assessment. Seventy-five percent of children and 89% of parents reported high acceptance; 89% of parents and 80% of children recommend SLEEPSMART. Compared to children in the control group, those who received the SLEEPSMART intervention had significant improvements in actigraphy total sleep time and sleep efficiency and Patient-Reported Outcomes Measurement Information System sleep disturbance scores immediately postintervention and at 1-month follow-up and in their dysfunctional beliefs and attitudes about sleep and sleep efficacy scores 1 month postintervention. Parents in the SLEEPSMART group had significant improvements in the Patient-Reported Outcomes Measurement Information System sleep-related impairment and dysfunctional beliefs and attitudes about sleep scores immediately postintervention and at 1-month follow-up and in their self-efficacy scores 1 month postintervention in comparison to parents in the control group.

Conclusions: SLEEPSMART was feasible, acceptable, and improved objective and self-report sleep and self-efficacy outcomes in children with juvenile idiopathic arthritis and their parents.

Clinical trial registration: Registry: ClinicalTrials.gov; Name: Sleep Shared-Management Intervention for Children with Juvenile Idiopathic Arthritis; URL: https://clinicaltrials.gov/study/NCT04066205; Identifier: NCT04066205.

Citation: Zhai S, Palermo TM, Shenoi S, et al. A shared-management web-based intervention for sleep deficiency in school-age children with juvenile idiopathic arthritis and their parents: feasibility and acceptability study. J Clin Sleep Med. 2025;21(6):1007-1021.

Keywords: JIA; RCT intervention; actigraphy; beliefs and attitudes about sleep; child–parent dyads; school-age children; self-efficacy; shared management; technology; transdiagnostic sleep and circadian intervention.