Short Report: Barriers and facilitators to parents' implementation of a transdiagnostic eHealth sleep intervention for children with neurodevelopmental disorders

Background Insomnia is highly prevalent in children diagnosed with neurodevelopmental disorders (NDDs) and has negative effects on physical and mental health and wellbeing. Lack of evidence-based intervention programs and barriers to treatment (e.g., time/cost) reduce treatment access. To address these problems, the possibility was explored of modifying the Better Nights, Better Days intervention for typically developing (TD) children (BNBD-TD) to make it appropriate for children with NDD. Aims The current study's aim was to examine qualitative data from exit interviews conducted during a usability study. Parents of children with NDD used BNBD-TD and reported on barriers and facilitators experienced while implementing the intervention. Methods/procedures Participants were 15 Canadian parents of children aged 4 to 10 years who were formally diagnosed with an NDD. Parents implemented the BNBD-TD intervention with their children and participated in a semi-structured exit interview to provide perspectives on their user experience. Results Based on an inductive thematic analysis, key facilitators included increased self-efficacy, positive outcomes for the family (e.g., improved sleep problems, parent validation), improved sleep related beliefs/attitudes, and increased motivation. Key barriers included time challenges, struggles when trying to improve sleep problems, and psychosocial factors with negative effects on implementation (e.g., burnout, stress, and/or exhaustion). Conclusions/implications Barriers and facilitators identified resulted in recommendations to include more program supports, including helping parents to plan for implementation success.