Pragmatic trial of two novel pathways for implementation of the Better Nights, Better Days (BNBD) online program to promote and protect the sleep, mental health, psychosocial wellbeing, and family resiliency of children and families during and after COVID-19 pandemic

Consistent with worldwide findings, our recent survey of Canadian families shows that sleep has worsened in nearly 40% of school-aged children and 60% of parents since the start of the COVID-19 pandemic. We previously demonstrated that the fully automated online program, Better Nights, Better Days (BNBD), helps parents improve their children's sleep, emotional and behavioural functioning, and quality of life, as well as their own fatigue. Over 5 interactive online sessions, BNBD encourages a 24-hour perspective of healthy daytime behaviours (e.g., exercise, reduced screen time), along with predictable and developmentally appropriate routines, to promote healthy sleep. In turn, sleep promotes resiliency and improved daytime functioning (e.g., emotional regulation, learning, attention). In our recent survey, 95% of parents thought other families who had not used BNBD would benefit from accessing the program during COVID-19. In the current proposed study, we will test how to scale-out BNBD across Canada. We will also determine if BNBD improves the sleep, mental health, psychosocial wellbeing, and family resiliency in children and their parents during and between COVID-19 pandemic waves. We will examine two referral pathways to the BNBD program. The first is a novel direct-to-consumer self-referral pathway that uses a marketing approach. The second uses a traditional healthcare provider referral to the program. We will compare the effect, access, and uptake of BNBD for different CIHR-identified priority populations and across both referral pathways. Our established BNBD program with our multi-disciplinary research, community, institutional, and industry partners, make this research study extremely feasible. Our findings will direct the launch of BNBD as a self-contained virtual program to improve sleep and wellbeing in children and families in the context of COVID-19. Findings could also be used to increase scale and spread of other virtual mental health programs.