Co-designing Nova Sleepcare: identifying priority areas for implementation

Background: Sleep problems are common in youth with neurodevelopmental disorders and directly contribute to behaviors of concern. While behavioral sleep education improves both issues, a disconnect exists between research and clinical reality: evidence-based sleep interventions are mainly delivered through specialized clinics and multi-week programs, which are often inaccessible to families needing immediate support. To bridge this gap we co-designed with end-users, a physician-delivered, point-of-care active sleep education intervention called Nova Sleepcare that can be directly implemented in clinical and household setting. Objective: To identify end-user priorities for learning about, implementing, and supporting Nova Sleepcare in clinical and household settings through consensus methods. Methods: Fifteen end-users (four youth, six caregivers, and five pediatric physicians) participated in structured nominal group technique sessions. Each group addressed questions about: (1) youth and caregiver's preferred methods for learning about Nova Sleepcare from physicians; (2) implementation barriers and support needs at home reported by caregivers and youth; and (3) physician training requirements and clinical implementation support. Priorities were ranked using consensus voting. Results: Top-ranked priorities varied by end-users. Caregivers prioritized pre-appointment information materials and stepwise instructions. Youth emphasized visual learning tools and app-based progress tracking. Physicians prioritized a streamlined script, needs assessment to guide training, and dissemination through conferences and in-person meetings. Cross-cutting themes included flexible delivery formats and ongoing implementation support beyond initial training. Conclusion: This consensus-building process with end-users identified distinct but complementary implementation priorities for Nova Sleepcare. These findings inform a multi-level implementation strategy addressing both clinical delivery and household adoption needs.