Developing a sleep health intervention for shift workers

项目摘要/摘要 与NHLBI的战略目标保持一致，即开发和优化新型…预防的治疗策略， 治疗和治愈心、肺、血液和睡眠疾病“，这项建议旨在发展、完善和初步 测试旨在改善睡眠健康的全面、个性化、媒体增强的远程健康干预 在倒班工人中。大约20%的美国劳动力从事某种形式的倒班工作。倒班工作是 在基本职业(如护理、运输、食品服务)中很常见。轮班工作与 心血管疾病、中风、多发性癌症、代谢紊乱、抑郁、驾驶的风险增加 事故、医疗差错和全因死亡。一个可修改的因素，导致风险增加 疾病、事故、失误和死亡是倒班工人睡眠健康状况差的多维定义 睡眠和醒来的模式，促进最佳健康和福祉。倒班工人的睡眠健康状况不佳 在睡眠(例如，失眠症状、睡眠时间短)和清醒(例如，疲劳、困倦、 执行功能、抑郁)。这项拟议的研究旨在通过以下方式改善轮班工人的睡眠健康 开发、提炼和测试一种新的干预措施，称为轮班工人睡眠健康干预(SWISH)， 它将把现有的有效干预措施整合到一个全面的计划中，以解决 许多轮班工人都会遇到一系列睡眠健康问题。本研究的目的是：1) 反复细化和最终确定SWISH的结构和材料；2)检查以下项目的可行性和可接受性 随机先导试验与延迟治疗对照的疗效比较；3)初步检验 对睡眠健康参数的影响；4)初步检测了睡眠刺激对觉醒时间功能的影响。这个 拟议的研究计划将是朝着建立干预措施迈出的第一步，这有助于 改善和减少倒班工人睡眠健康不良造成的重大社会负担。这项研究 具有潜在的深远的公共健康影响，因为轮班工人的睡眠健康的影响超出了 个人(例如，在护士护理下的病人)。候选人计划的培训活动也对 完成这一项目。如《职业发展计划》所述，多学科专家小组将 为候选人提供关键领域的高级培训和指导，包括临床试验设计、实施、 和报告、昼夜节律生物学和倒班工作的昼夜干预、实施科学和 开发丰富的、引人入胜的媒体产品，以支持治疗师主导的干预。培训计划包括 强大的指导，研讨会和教学，正规的课程和机构，动手培训，手稿和 赠款准备和出席科学会议。拟议的研究项目利用 应聘者在睡眠健康评估和干预方面进行了严格的前期研究和临床培训 提供必要的额外培训，为候选人成为独立的临床医生奠定基础 研究人员重点关注在服务不足的人群中提高睡眠健康干预措施的可及性。

PROJECT SUMMARY/ABSTRACT Consistent with the NHLBI Strategic Objective to “develop and optimize novel…therapeutic strategies to prevent, treat, and cure heart, lung, blood and sleep diseases,” this proposal aims to develop, refine, and preliminarily test a comprehensive, personalized, media-augmented telehealth intervention designed to improve sleep health among shift workers. Approximately 20% of the US workforce engages in some form of shift work. Shift work is common in essential occupations (e.g. nursing, transportation, food service). Shift work is associated with elevated risk for cardiovascular disease, stroke, multiple cancers, metabolic disorders, depression, driving accidents, medical errors, and all-cause mortality. One modifiable factor that contributes to increased risk for disease, accidents, errors, and death among shift workers is poor sleep health, defined as the multidimensional pattern of sleep and wake which promotes optimal health and wellbeing. Poor sleep health in shift workers manifests during both sleep (e.g., insomnia symptoms, short sleep duration) and wake (e.g., fatigue, sleepiness, executive function, depression). The proposed study seeks to improve sleep health among shift workers by developing, refining, and testing a novel intervention, termed Shift Worker Intervention for Sleep Health (SWISH), which will integrate existing effective interventions into a comprehensive program that addresses the constellation of sleep health problems experienced by many shift workers. The aims of this research are to: 1) iteratively refine and finalize the structure and materials of SWISH; 2) examine feasibility and acceptability of SWISH compared to delayed treatment control in a randomized pilot study; 3) preliminarily test the effect of SWISH on sleep health parameters; and 4) preliminarily test the effect of SWISH on wake time functioning. The proposed research plan will be the first step towards building an intervention that can contribute to the improvement and reduce the significant societal burden of poor sleep health among shift workers. This research has potential far-reaching public health implications, as the sleep health of shift workers has impacts beyond the individual (e.g., patients under a nurse's care). The candidate's planned training activities are also vital to the completion of this project. As outlined in the Career Development Plan, a multidisciplinary team of experts will provide the candidate with advanced training and mentoring in key areas including clinical trial design, conduct, and reporting, circadian rhythms biology and circadian interventions for shift work, implementation science, and development of rich, engaging media products to support therapist-led interventions. The training plan includes strong mentorship, seminars and didactics, formal coursework and institutes, hands-on training, manuscript and grant preparation, and attendance at scientific meetings. The proposed research project leverages the candidate's rigorous prior research and clinical training in sleep health assessment and interventions while providing necessary additional training to set the stage for the candidate to become an independent clinical investigator focused on increasing accessibility for sleep health interventions in underserved populations.