0905 DEVELOPMENT OF THE PROMIS® SLEEP HEALTH MEASURES FOR CHILDREN AND ADOLESCENTS

Abstract

There is no standard pediatric self-report measure of sleep health. Furthermore, existing measures have not been informed by stakeholders or developed using rigorous measurement science. The Patient Reported Outcomes Measurement Information System (PROMIS®) has produced over 100 person-centered measures that evaluate physical, mental, and social health in adults and children. Two PROMIS sleep-related measures (Sleep Disturbance and Sleep-Related Impairment) have been developed and psychometrically evaluated for adults. The purpose of this study was to develop and evaluate pediatric sleep health measures using PROMIS methodology. Concepts for self-report questions (items) were identified with input from sleep experts, clinicians, parents, youth, and systematic literature review. Items were iteratively revised based on cognitive interviews with 35 children and 21 parents, and then administered to 1104 children aged 8–17 and 1477 parents of children aged 5–17. Items were subjected to classic psychometric analysis and item response theory-based calibration. The initial item pool contained 112 items. Items were removed (52), revised (19), or added (1) based on cognitive interviews. Sixty-one items were field tested, with an additional 25 items removed based on psychometric properties. Two item banks measuring distinct sleep health dimensions were identified. Sleep Disturbance (SD, 12 items) captures difficulties with sleep initiation, sleep maintenance, and sleep quality. Sleep-Related Impairment (SRI, 13 items) assesses the impact of poor sleep on daytime functioning. SD and SRI item banks discriminate among children with a wide range of sleep health experiences. Items were selected for 8- and 4-item short forms to ensure adequate measurement precision across the full range of severity. An index of Sleep Practices (11 items) was also developed, with items focusing on sleep routines, technology use around sleep, and sleep timing. The PROMIS pediatric SD and SRI item banks are brief and psychometrically robust measures of patient-reported sleep experiences. These measures are meaningful and well-understood by children and parents, and provide efficient and precise measures of sleep in children across development, and in both general and clinical populations. The final measures are undergoing clinical validation in youth with sleep disorders, autism, asthma, and atopic dermatitis. PCORI SC-14-1403-12211.