Optimizing the Better Nights, Better Days for Children with Neurodevelopmental Disorders program for large scale implementation
Bibliographic record
Abstract
Objective Pediatric insomnia is one of the most commonly reported disorders, especially in children with neurodevelopmental disorders. Better Nights, Better Days for Children with Neurodevelopmental Disorders ( BNBD-NDD ) is a transdiagnostic, self-guided, eHealth behavioral sleep intervention developed for parents of children with NDDs ages 4–12 years with insomnia. After usability testing, a randomized controlled trial (RCT) was conducted to evaluate the effectiveness of the BNBD-NDD program. By interviewing RCT participants after their outcome measures were collected, we sought to determine the barriers and facilitators that affect the reach, effectiveness, adoption, implementation, and maintenance of the BNBD-NDD intervention, as well as to assess whether barriers and facilitators differ across levels of engagement with the program and NDD groups. Method Twenty parents who had been randomized to the treatment condition of the RCT participated in this study. These parents participated in virtual semi-structured qualitative interviews about their experiences with the BNBD-NDD program. Rapid analysis was used, in which one researcher facilitated the interview, and another simultaneously coded the interview using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Results Overall, more facilitators than barriers were identified for Reach, Effectiveness, Implementation, and Maintenance, whereas for Adoption more barriers emerged. Participants who were engaged reported more facilitators about the BNBD-NDD program design and behavior change, while unengaged participants mentioned needing more support to help facilitate their use of the program. Lastly, parents of children with ASD reported more facilitators and more barriers than did parents of children with ADHD. Conclusion With this feedback from participants, we can optimize BNBD-NDD for large-scale implementation, by modifying the program to better support parents, helping them implement the strategies effectively at home, and increasing the accessibility of this evidence-based treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".