Assessing Clinical Effectiveness and Implementation of Worksite Sleep Health Coaching in Firefighters
Overview
- Phase
- Phase 4
- Intervention
- Not specified
- Conditions
- Cognitive Behavioral Therapy
- Sponsor
- University of Arizona
- Enrollment
- 400
- Locations
- 1
- Primary Endpoint
- PROMIS Sleep Disturbance questionnaire
- Status
- Enrolling By Invitation
- Last Updated
- last year
Overview
Brief Summary
Insufficient sleep is a significant public health issue, particularly affecting shift workers like firefighters, nearly half of whom report short or poor-quality sleep, with 35-40% screening positive for sleep disorders. Cognitive Behavioral Therapy for Insomnia (CBTi) is a recommended and effective treatment, but access to such interventions remains low. This study will recruit 20 fire agencies in Arizona (400 firefighters) to test if a CBTi-informed intervention, including sleep health coaching and agency-wide promotion, improves sleep more effectively than usual care. The trial will also explore factors that influence successful implementation across agencies.
Detailed Description
Insufficient sleep is a major public health crisis in the United States and worldwide, disproportionately affecting shift workers and other at-risk groups. Firefighters are one such group at heightened risk for disturbed sleep. Almost half of career firefighters report short sleep and poor sleep quality, and 35-40% of firefighters screen positive for a sleep disorder. Evidence-based sleep health interventions are available and highly effective in eliciting behavioral change. The American College of Physicians recommends Cognitive Behavioral Therapy for Insomnia (CBTi) as the first-line treatment for Insomnia Disorder, and substantial evidence supports the efficacy of this therapy with comorbid conditions, including shiftwork and obstructive sleep apnea. Unfortunately, access to CBT-informed sleep health interventions remains low. Workplace wellness programs could be one way to help more firefighters receive sleep intervention. This study will recruit 20 fire agencies in Arizona (n = 400 career firefighters) to examine whether a CBTi-informed intervention is more effective than usual care in reducing sleep disturbances or improving multidimensional sleep health. The intervention will last one year and will include telephone-administered sleep health coaching to firefighters, sleep health promotion to the agency and agency leaders, and external/internal facilitation strategies for implementation. The trial will also examine which combinations of factors are associated with successful agency implementation of the intervention. All participating agencies will receive the intervention; however, some agencies will wait longer to receive the intervention than others.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Required to be employed as career (paid), uniformed fire service workers that must work in a participating fire agency.
- •Must have moderate or more severe levels of sleep disturbances \[item-level calibrated T-score of 55 or higher on the 8-item Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance (SD) questionnaire\].
- •Must have private access to a computer or phone for sleep health coaching.
Exclusion Criteria
- •Children younger than 18 years of age.
Outcomes
Primary Outcomes
PROMIS Sleep Disturbance questionnaire
Time Frame: 6 assessments, 6 months apart
PROMIS measures are scored on the T-score metric. 50 is the mean score of a relevant reference population, and 10 is the standard deviation of that population. High scores mean more of the concept being measured.
Multidimensional sleep health (MSH) composite
Time Frame: 6 assessments, 6 months apart
The composite uses weighted summaries of the z-scores of four actigraphic sleep health dimensions: regularity, timing, sleep efficacy, sleep duration and two subjective sleep health dimensions: satisfaction and alertness, derived from items on the PROMIS-SD and PROMIS Sleep Related Impairment (PROMIS-SRI) scale respectively. High scores mean less of the concept being measured (i.e., worse sleep health).
Secondary Outcomes
- PROMIS Sleep Related Impairment questionnaire(6 assessments, 6 months apart)
- Wake time after sleep onset (WASO), min - actigraphy(6 assessments, 6 months apart)
- Number of awakenings (NAW) - actigraphy(6 assessments, 6 months apart)