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Faculty Profile

Karen A. Bonuck, Ph.D.

Dr. Karen A. Bonuck
 

Professional Interests

 

Research Overview:

I conduct research on pediatric sleep and parent-child interventions. My research on early childhood sleep problems includes cohort analyses of >11,000 children, in which behavior difficulties at 7 years (Pediatrics, March 2012) and special education at 8 years (Pediatrics, Sept. 2012), were linked to having had sleep problems prior to 5 years. I have extensive experience with clinical trials of anticipatory guidance- sleep, breastfeeding, bottle-weaning, oral health, and child maltreatment. 

 Currently, I am the Principal Investigator (pending NoA) or "Increasing Sleep Health Literacy in Head Start: A Social-Ecological Approach."  This NIH-funded R01 This study aims to empower families in early childhood programs with the knowledge and self-management skills needed to obtain healthy sleep via interpersonal, organizational, community, and policy level interventions. A stepped wedge cluster randomized trial in Head Start will test effects upon child, parent, and classroom outcomes; a policy evaluation will assess the impact of knowledge translation strategies. 

I have managed all phases of large-scale NIH, R01, and R01-equivalent studies. I have led formative research to create materials for low-income and racial/ethnic minority families. My bottle-weaning trial, e.g., created a parent brochure, educational flipchart, and video, as we propose here. I have a proven ability to recruit/retain participants, and to collect process, fidelity, and outcomes data. My R01 breastfeeding promotion trial(s), e.g., enrolled ≈1,000 pregnant women, with 95% follow-up at 6 months post-partum. I am the author of 70 peer-reviewed manuscripts. 

Peer Review Publications: Recent (since 2012) and Selected (from > 70) 

Bottles as Early Risk for Overweight: Pilot and Epidemiological Research

Bottles have long been implicated in early childhood caries (ECC).  Their design (soft nipples, non-spill) promotes at-will consumption of liquids, beverages and foods containing fermentable carbohydrates (e.g. juice drinks, milk, and starches) that promote ECC. The same facets of the bottle that promote ECC, can also promote intake of excess calories. I led several pilot studies and analyses of NHANES data to explore this link. Our work affirmed such a link, later found by other researchers.

  1. Bonuck K, Kahn R.Prolonged bottle use and its association with iron deficiency anemia and overweight: A preliminary study.Journal of Clinical Pediatrics.2002; Vol. 41 (8): 603-607.
  2. Bonuck, K, Kahn R, Schechter C.Is late bottle weaning associated with overweight and iron Deficiency Anemia?Analysis of NHANES III data.Clinical Pediatrics. 2004; 43: 535-540. 2004 Jul-Aug;43(6):535-40.PMID:15248006
  3. Kahn R, Bonuck K, Trombley M. Randomized Controlled Trial of Bottle Weaning Intervention: A Pilot Study.  Clinical Pediatrics, March 2007;46(2):163-74. PMID: 17325091
  4. Bonuck, K, Huang V, Fletcher J. Inappropriate Bottle Use An Early Risk for Overweight?: Literature Review and Pilot Data for a Bottle-Weaning Trial.  Maternal and Child Nutrition. 2010 Jan;6(1):38-52. 

 B

ottle-Weaning RCT: Effects on Bottle-Use, Dietary Intake, and Weight

Using the above work as the foundation, I designed and obtained funding to conduct an RCT of a bottle-weaning intervention, based in the WIC program (nutrition voucher and counseling program for low-income pregnant and parenting women, and their children up to age 5 years).  The trial enrolled children at 12 months of age, who were drinking 2+ non-water bottles/day. This 1-time, WIC clinic based intervention led to a sharp decline in use of bottles and caloric intake, but did not result in fewer children being < 85% weight-for-length. The intervention group’s increased use of sippy cups may have attenuated an effect upon overweight.  

  1. Bonuck K, Hearst M, Ben Avraham S, Kahn R, Hyden C. Is overweight at 12 months associated with differences in eating behaviour or dietary intake among children selected for inappropriate bottle use? Maternal and Child Nutrition.  2014 Apr;10(2):234-44. doi: 10.1111/mcn.12042. Epub 2013 Apr 5.PMID: 23556429
  2. Bonuck, K, Avraham SB, Lo Y, Kahn R, Hyden C. Bottle weaning intervention and toddler overweight. Journal of Pediatrics.   2014 Feb;164(2):306-12. PMID: 24183206.
  3. Ben-Avraham S, Hyden C, Fletcher, Bonuck K. Bottle and sippy cup use is associated with diet and energy intake in toddlers. Maternal and Child Nutrition. 2014 May 1. doi:10.1111.  PMID:24784143.
  4. Hyden C and Bonuck K. Addition of solids and sweeteners in toddler bottles and sippy cups. ICAN: Infant, Child and Adolescent Nutrition. August 2014; 6 (4): 205-210.

Breastfeeding Promotion: Randomized Controlled Trials

Though breastfeeding’s benefits are well known, few women breastfeed for as long or as exclusively as recommended. This is especially true for racial/ethnic minority and low-income women; my breastfeeding promotion research focuses on this population. My first trial of a lactation consultant intervention was reported in Pediatrics in 2005. I then refined the intervention and follow-up strategies for two NIH-funded trials that integrated lactation consultants into routine prenatal and hospital care. These interventions yielded 3-folded increases in exclusive and high intensity breastfeeding- far surpassing effects reported in USPSTF and Cochrane reviews (Amer. J. Public Health 2014) and the AHRQ Health Care Innovations Exchange.

  1. Bonuck, K, Trombley M, Freeman K, McKee D. Randomized controlled trial of a pre- and post-natal lactation consultant Intervention upon duration and intensity of breastfeeding up to 12 months.  Pediatrics.  December 2005; 116 (6): 1413-1426
  2. Bonuck, K, Lischewski J, Brittner M.  Clinical Translational Research Hits the Road: RCT of Breastfeeding Promotion Interventions in Routine Prenatal Care. Journal of Contemporary Clinical Trials. 2009 Sep;30(5):419-26. PMCID: PMC2752285
  3. Barnett J, Aguilar S, Brittner M, Bonuck K. Recruiting and retaining low-income, multi-ethnic women into randomized controlled trials: Successful strategies and staffing. Contemp Clin Trials. Sep 2012;33(5):925-932. PMID:22732312  
  4. Bonuck K, Stuebe A, Barnett J, Labbok MH, Fletcher J, Bernstein P.  Effect of primary care intervention on breastfeeding duration and intensity. American Journal of Public Health. 2014; Feb 104 Suppl 2014 Feb;104 Suppl 1:S119-27. PMID: 24354834.

 

Pediatric Sleep:  Effects of Problem Sleep and Sleep Education

My work on pediatric sleep includes cohort analyses of >11,000 children, in which behavior difficulties at 7 years (Pediatrics, March 2012) and special education at 8 years (Pediatrics, Sept. 2012), were linked to having had sleep problems prior to 5 years.  My 2014 paper established that short sleep duration and sleep- disordered breathing in early childhood are robust, independent predictors of obesity through 15 years of age (J Pediatrics).  I am excited to implement my anticipated R01 funded by NICHD: “Increasing Sleep Health Literacy in Head Start: A Social-Ecological Approach” (score= 15, percentile= 3rd), which includes a stepped wedge randomized controlled trial (individual & interpersonal); classroom outcomes (organizational); local outreach/education (community) and knowledge translation (policy). 

  1. Bonuck K, Freeman K, Chervin R, Xu, L. Sleep Disordered Breathing in a Population-Based Cohort: Behavioral Effects at 4 and 7 Years.  Pediatrics. 2012; 129 (4): e857-865. PMID: 22392181.
  2. Bonuck K, Rao T, Xu L. Pediatric Sleep Disorders and Special Educational Need at 8 Years: A Population-Based Cohort Study. Pediatrics. 2012; 130 (4): 634-642. PMID: 22945405.
  3. Wilson KE, Miller AL. Bonuck K, Lumeng JC, Chervin RD. Evaluation of a sleep education program for low-income preschool children and their families.  SLEEP; 2014; 37 (6): 1117-1125. PMCID: PMC 4015386.
  4. Bonuck K, Chervin RD, Howe L. Sleep-Disordered Breathing, Sleep Duration and Childhood Overweight: A Longitudinal Cohort Study.  Journal of Pediatrics. 2015; 166 (3): 632-639. PMID: 25499598 

 NCBI link: http://www.ncbi.nlm.nih.gov/sites/myncbi/1BsWvVxiklW5H/bibliography/40553228/public/?sort=date&direction=ascending

 

 

Selected Publications

 

Peer Review Manunscripts: Selected from > 70

Pediatric Sleep Research

  1. Bonuck K, Grant R. Sleep Problems and Early Developmental Delay: Implications for Early Intervention Programs. Intellectual and Developmental Disabilities. 2012; Feb;50(1):41-52. PMID:22316225.
  2. Freeman K, Bonuck K, Snoring, mouth-breathing, and apnea trajectories in a population-based cohort followed from infancy to 81 months: a cluster analysis. Int J Pediatr Otorhinolaryngol. 2012;76(1):122-30. Epub 2011 Nov 16. PMID:22093741.
  3. Bonuck K, Freeman K, Chervin R, Xu, L. Sleep Disordered Breathing in a Population-Based Cohort: Behavioral Effects at 4 and 7 Years.  Pediatrics. 2012; 129 (4): e857-865. PMID: 22392181.
  4. Bonuck K, Rao T, Xu L. Pediatric Sleep Disorders and Special Educational Need at 8 Years: A Population-Based Cohort Study. Pediatrics. 2012; 130 (4): 634-642. PMID: 22945405.
  5. Moore M, Bonuck K. Co-morbid symptoms of sleep disordered breathing and behavioral sleep problems from 18 - 57 months of age: A population-based study. Behavioral Sleep Medicine. 2012; 11:1–9.PMID: 23205586.
  6. Wilson KE, Miller AL. Bonuck K, Lumeng JC, Chervin RD. Evaluation of a sleep education program for low-income preschool children and their families.  SLEEP; 2014; 37 (6): 1117-1125. PMCID: PMC 4015386.
  7. Bonuck K, Chervin RD, Howe L. Sleep-Disordered Breathing, Sleep Duration and Childhood Overweight: A Longitudinal Cohort Study.  Journal of Pediatrics. 2015 Mar;166(3):632-9. doi: 10.1016/j.jpeds.2014.11.001. Epub 2014 Nov 6
  8. Bonuck K, Schwartz B, Schechter C. Sleep Health Literacy in Head Start Families and Staff: Exploratory Study of Knowledge, Motivation, and Competencies to Promote Healthy Sleep. Sleep Health: Journal of the National Sleep Foundation. (in press)


Bottle-Weaning

  1. Hyden C, Kahn R, Bonuck K. Bottle-weaning intervention tools: “How” and “Why” of a WIC-based educational flipchart, parent brochure and website. Health Promotion Practice. 2013; 14 (1): 75-80. epub 5 April 2012. PMID: 22491388.  For materials, see http://proudtobebottlefree.org/files/FYCS_Flipchart.pdf
  2. Bonuck, K, Avraham SB, Lo Y, Kahn R, Hyden C. Bottle weaning intervention and toddler overweight. Journal of Pediatrics.   2014 Feb;164(2):306-12. PMID: 24183206.
  3. Ben-Avraham S, Hyden C, Fletcher, Bonuck K. Bottle and sippy cup use is associated with diet and energy intake in toddlers. Maternal and Child Nutrition. 2014 May 1. doi:10.1111
  4. Bonuck K, Avraham SB, Hearst M, Kahn R, Hyden C. Matern Child Nutr. 2014 Apr;10(2):234-44. doi: 10.1111/mcn.12042. Epub 2013 Apr 5. PMID: 23556429

 

Breastfeeding Promotion

  1. Bonuck K, Stuebe A, Barnett J, Labbok MH, Fletcher J, Bernstein P.  Effect of primary care intervention on breastfeeding duration and intensity. American Journal of Public Health. 2014; Feb 104 Suppl 2014 Feb;104 Suppl 1:S119-27. PMID: 24354834.
  2. Teich AS, Barnett J, Bonuck K. Women’s perceptions of breastfeeding barriers in the early post-partum period: Qualitative analysis nested in two randomized controlled trials. Breastfeed Med. 2014 Jan-Feb;9(1):9-15. doi: 10.1089/bfm.2013.0063. Epub 2013 Dec 4.PMID:24304033
  3. Mehta-Lee SS, Lischewski Goel JL, Xu L, Brittner MR, Bernstein PS, Bonuck KA. Perception of weight status and its impact on weight gain in an urban population. Matern Child Health J. 2013 Dec;17(10):1931-9. doi: 10.1007/s10995-013-1219-8.
  4. Berry DC, Neal M, Hall EG, Schwartz TA, Verbiest S, Bonuck K, Goodnight W, Brody S, Dorman KF, Menard MK, Stuebe AM. Rationale, design, and methodology for the optimizing outcomes in women with gestational diabetes mellitus and their infants study. BMC Pregnancy Childbirth.  2013; Oct 10: 184.
  5. Herold R, Bonuck K.  Medicaid IBCLC Coverage Following Medicaid and Affordable Care Act Updates: A 50 State Survey.  Journal of Human Lactation (in press).

 

Child Maltreatment: Attachment-Based Interventions

  1. Murphy A, Steele M, Dube SR, Bate J, Bonuck K, Meissner P, Goldman H, Steele H. Adverse Childhood Experiences Questionnaire (ACE’s) and Adult Attachment Interview (AAI): Implications for parent-child relationships. Child Abuse Negl. 2014 Feb;38(2):224-33. doi: 10.1016/ Epub 2013 Oct 24.
  2. Steele M, Steele H, Bate J, Knafo H, Kinsey M, Bonuck K, Meisner P, Murphy A. Looking from the outside in: use of video in attachment-based interventions. Attach Hum Dev. 2014;16(4):402-15. doi: 10.1080/14616734.2014.912491. Erratum in: Attach Hum Dev. 2014;16(6):656
  3. Murphy A, Steele H, Bate J, Nikitiades A, Allman B, Bonuck K, Meissner P, Goldman H, Steele M. Group Attachment Based Intervention: Trauma Informed Care for Families with Adverse Childhood Experiences. Journal of Family and Community Health.2014; 38 (3): 268-279.
 

Material in this section is provided by individual faculty members who are solely responsible for its accuracy and content.

Contact

Albert Einstein College of Medicine
Jack and Pearl Resnick Campus
1300 Morris Park Avenue
Block, Room 418
Bronx, NY 10461

Tel: 718.430.4085
Fax: 718.430.8816
karen.bonuck@einstein.yu.edu

 
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Media Coverage

NPR’s Shots blog interviews Dr. Karen Bonuck about her study that found lack of sleep and sleep-disordered breathing doubled kids’ risk for obesity.

Is ADHD caused by bad sleep? U.S. News & World Report interviews Dr. Karen Bonuck about her research linking nighttime breathing and ADHD.

More media coverage