Andrea Steele

Introduction: Reviews have indicated that community-based interventions targeting infant sleep can be effective. However, the literature is less clear as to the theoretical underpinnings and active components of infant sleep interventions, whether these are related to parental measures, such as acceptability, adherence, satisfaction and mood, and whether certain characteristics of interventions are associated with greater effectiveness on sleep measures.

Aim: This review broadly aimed to characterise behavioural infant sleep interventions delivered in a community setting in terms of theoretical underpinnings and behaviour change techniques. Where applicable, this review also aimed to explore associations between meaningful groupings of theory type (e.g., operant conditioning and extinction; attachment theory) and behaviour change techniques and secondary outcomes including parent and infant sleep, parent satisfaction and intervention adherence.

Method: Online databases were searched from inception to October 2022 to identify Randomised Controlled and cluster Randomised Controlled Trials of behavioural interventions delivered in community settings that targeted the prevention or treatment of sleep problems in infants (0-3 years). Using the PRISMA guidelines, records were independently screened by two reviewers and eligible interventions were coded for the presence and type of theoretical underpinnings used. Active components were also coded using a taxonomy for behaviour change techniques. The role of secondary outcomes, such as intervention feasibility and parent satisfaction, were also explored.

Conclusions: This systematic review elucidates the specific components used by behavioural infant sleep interventions and the theories that are drawn upon to inform intervention development. This study concludes with a discussion of how obtained results may aid in the development of community based infant sleep support, such as the consideration around which behaviour change components to utilise when addressing particular outcomes. Implications for selection of theoretical underpinnings in intervention development on parent outcomes are also explored.

Introduction: Reviews have indicated that community-based interventions targeting infant sleep can be effective. However, the literature is less clear as to the theoretical underpinnings and active components of infant sleep interventions, whether these are related to parental measures, such as acceptability, adherence, satisfaction and mood, and whether certain characteristics of interventions are associated with greater effectiveness on sleep measures.

Aim: This review broadly aimed to characterise behavioural infant sleep interventions delivered in a community setting in terms of theoretical underpinnings and behaviour change techniques. Where applicable, this review also aimed to explore associations between meaningful groupings of theory type (e.g., operant conditioning and extinction; attachment theory) and behaviour change techniques and secondary outcomes including parent and infant sleep, parent satisfaction and intervention adherence.

Method: Online databases were searched from inception to October 2022 to identify Randomised Controlled and cluster Randomised Controlled Trials of behavioural interventions delivered in community settings that targeted the prevention or treatment of sleep problems in infants (0-3 years). Using the PRISMA guidelines, records were independently screened by two reviewers and eligible interventions were coded for the presence and type of theoretical underpinnings used. Active components were also coded using a taxonomy for behaviour change techniques. The role of secondary outcomes, such as intervention feasibility and parent satisfaction, were also explored.

Conclusions: This systematic review elucidates the specific components used by behavioural infant sleep interventions and the theories that are drawn upon to inform intervention development. This study concludes with a discussion of how obtained results may aid in the development of communitybased infant sleep support, such as the consideration around which behaviour change components to utilise when addressing particular outcomes. Implications for selection of theoretical underpinnings in intervention development on parent outcomes are also explored.