Assessing Clinical Effectiveness and Implementation of Worksite Sleep Health Coaching in Firefighters

评估消防员工作现场睡眠健康指导的临床效果和实施情况

• 批准号: 10585123
• 负责人: Patricia Haynes
• 金额: $ 87.55万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585123
• 关键词: Acceleration; Achievement; Address; Adoption; Affect; Arizona; Awareness; Behavioral; Behaviorism; Blood Pressure; Body mass index; Cardiac; Cardiometabolic Disease; Cardiovascular Diseases; Cause of Death; Cessation of life; Cholesterol; Clinic; Clinical; Clinical Trials; Clinical effectiveness; Cognitive; Cognitive Therapy; Communities; Data; Dimensions; Disease Outcome; Dissemination and Implementation; Education; Effectiveness; Enrollment; Evaluation; Event; Evidence based intervention; Fatigue; Fire - disasters; Foundations; Future; Goals; Health; Health Hazards; Health Promotion; Health Services; Health behavior; Health behavior change; Healthcare; Heart Rate; Hour; Hybrids; Impairment; Individual; Intervention; Knowledge; Lead; Medicine; Mental Depression; Metabolic syndrome; Methods; Modeling; Occupations; Outcome; Persons; Pharmaceutical Preparations; Phase; Population; Populations at Risk; Positioning Attribute; Promoting Action on Research Implementation in Health Services framework; Provider; Psychotherapy; Public Health; Questionnaires; Randomized; Randomized, Controlled Trials; Readiness; Reporting; Research; Research Priority; Rewards; Risk; Safety; Schedule; Shift-Work Sleep Disorder; Sleep; Sleep Apnea Syndromes; Sleep Deprivation; Sleep Disorders; Sleep disturbances; Sleeplessness; Solid; Symptoms; System; Testing; Translating; Translations; United States; United States Department of Veterans Affairs; United States National Institutes of Health; Vulnerable Populations; Wellness Program; Work; Workplace; actigraphy; base; behavioral health; burnout; cardiovascular disorder risk; cardiovascular risk factor; care seeking; career; clinical implementation; cluster randomized design; comparative; effectiveness evaluation; effectiveness testing; effectiveness/implementation trial; evidence base; experience; fire fighter; first responder; formative assessment; future implementation; health care settings; help-seeking behavior; high risk population; hybrid type 1 design; implementation determinants; implementation intervention; implementation research; implementation science; implementation strategy; improved; improvement on sleep; indexing; innovation; modifiable risk; mortality; poor sleep; post implementation; preference; primary outcome; process evaluation; professional atmosphere; programs; randomized trial; reduce symptoms; research to practice; resilience; secondary outcome; sleep health; sleep quality; social norm; theories; treatment as usual

Background. Cardiac events are the leading cause of death among firefighters and occur while on-duty at an alarmingly high rate. Short, disrupted sleep is a major, modifiable risk factor for cardiovascular disease (CVD), and up to 40% of firefighters experience sufficiently severe sleep disruption to screen positive for sleep disorders. Cognitive behavioral therapy for insomnia (CBTi) is well-established as efficacious and effective within health care settings. However, the effectiveness of CBTi-informed sleep health coaching and sleep health promotion in workplace settings, and among firefighters specifically, is largely unknown. Theory-driven research is required to address this research-to-practice gap and also identify facilitators to and barriers of intervention implementation in this high-risk population. Goal. The primary objective of this proposal is to examine whether a scalable, CBTi-informed intervention, firefighter sleep health coaching (ffSHC), improves sleep disturbances when implemented in a real-world, high- demand work environment. Methods. This study proposes to conduct a stepped wedge cluster randomized controlled trial in order to examine the effectiveness of an evidence-based sleep health coaching intervention delivered to 400 career firefighters across 20 fire departments (Aim 1). The primary outcomes are (a) the pragmatic PROMIS Sleep Disturbances questionnaire and (b) the multidimensional sleep health index derived from actigraphy. Secondary and tertiary outcomes include: sleep related impairment, sleep continuity, blood pressure, heart rate, and long-term clinic-assessments of cholesterol, body mass index, and blood pressure. To advance implementation science, this project will employ the Integrated Promotion Action on Research Implementation in Health Services (iPARIHS) framework to guide a mixed methods formative evaluation (Aim 2a) of intervention adaptations and implementation strategies. A theory-based process evaluation (Aim 2b) is embedded within the clinical trial to explore combinations of factors that promote agency-level implementation and to inform future implementation research in public safety settings. Significance and Innovation. This research will accelerate the translation of sleep health intervention to workplace wellness and advance implementation science through the application of the iPARIHS framework. The use of sleep health coaches is innovative and models how programs may expand reach to address the global problem of insufficient sleep. The long-term goal of this research is to provide critical knowledge that facilitates the widespread implementation, dissemination, and sustained utilization of sleep health intervention to promote continuous, sufficient sleep and ultimately mitigate CVD risk. Achievement of study goals will improve the health and wellness of firefighters, a population whose health is vital to assuring public safety and supporting community resiliency.

背景。心脏疾病是消防队员死亡的主要原因，发生在消防中心值班时