Developing a sleep health intervention for shift workers

项目概要/摘要 与NHLBI的战略目标一致，即“开发和优化新的.治疗策略， 治疗和治疗心脏，肺，血液和睡眠疾病，”这一建议旨在发展，完善，并初步 测试旨在改善睡眠健康的全面，个性化，媒体增强的远程医疗干预 在轮班工人中。大约20%的美国劳动力从事某种形式的轮班工作。轮班工作是 常见于基本职业（如护理、运输、食品服务）。轮班工作与 心血管疾病、中风、多种癌症、代谢紊乱、抑郁症、驾驶风险升高 事故、医疗差错和全因死亡率。一个可改变的因素，有助于增加风险， 疾病，事故，错误和死亡之间的倒班工人是睡眠健康状况差，定义为多维 睡眠和唤醒模式，促进最佳的健康和福祉。倒班工人的睡眠健康状况不佳 在睡眠期间表现（例如，失眠症状，睡眠持续时间短）和清醒（例如，疲劳，困倦， 执行功能，抑郁症）。这项拟议中的研究旨在通过以下方式改善轮班工人的睡眠健康： 开发、完善和测试一种新的干预措施，称为轮班工人睡眠健康干预措施（SWISH）， 该计划将把现有的有效干预措施整合到一个全面的计划中， 许多轮班工人都经历过一系列睡眠健康问题。本研究的目的是：1） 反复完善并最终确定SWISH的结构和材料; 2）检查 SWISH与延迟治疗对照的随机预试验研究; 3）初步测试 SWISH对睡眠健康参数的影响; 4）初步测试SWISH对觉醒时间功能的影响。的 拟议的研究计划将是建立一种干预措施的第一步， 改善和减少轮班工人睡眠健康不良的重大社会负担。本研究 具有潜在的深远的公共卫生影响，因为轮班工人的睡眠健康影响超出了 个体（例如，病人在护士的照顾下）。候选人计划的培训活动也是至关重要的 完成这个项目。如职业发展计划所述，一个多学科专家小组将 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，昼夜节律生物学和昼夜节律干预轮班工作，实施科学， 开发丰富的、吸引人的媒体产品，以支持治疗师主导的干预措施。培训计划包括 强有力的指导，研讨会和教学法，正式的课程和机构，实践培训，手稿和 准备赠款和出席科学会议。拟议的研究项目利用 候选人在睡眠健康评估和干预方面的严格研究和临床培训， 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。 研究人员专注于增加服务不足人群的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.