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

基本信息

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
项目类别：
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

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

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项目摘要

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。心脏事件是消防员中死亡的主要原因，并在上班时发生令人震惊的高率。短而干扰的睡眠是心血管疾病（CVD）的主要，可修改的风险因素，多达40％疾病。失眠（CBTI）的认知行为疗法是有效有效的在医疗保健环境中。但是，CBTI信息的睡眠健康教练和睡眠的有效性在工作场所以及特别是消防员中的健康促进基本上是未知的。理论驱动需要研究来解决这一研究差距，并确定促进者和障碍在此高风险人群中实施干预。目标。该提案的主要目的是检查是否可扩展，CBTI信息的干预措施，消防员睡眠健康教练（FFSHC），在现实世界中实施时，可以改善睡眠障碍需求工作环境。方法。这项研究建议进行阶梯楔形群集随机对照试验，以便检查提供给400职业的基于证据的睡眠健康教练干预的有效性跨20个消防部门的消防员（AIM 1）。主要结果是（a）务实的Promis睡眠干扰调查表和（b）来自行为的多维睡眠健康指数。次级和第三级结果包括：与睡眠相关，睡眠连续性，血压，心脏胆固醇，体重指数和血压的速率和长期诊所评估。前进实施科学，该项目将采用综合促进行动进行研究实施在卫生服务（IPARIHS）框架中指导混合方法形成性评估（AIM 2A）干预适应和实施策略。基于理论的过程评估（AIM 2B）是嵌入在临床试验中以探索促进代理级实施的因素组合并为未来的公共安全环境实施研究提供信息。意义和创新。这项研究将加速睡眠健康干预措施的翻译通过应用IPARIHS框架，工作场所的健康和提前实施科学。睡眠健康教练的使用是创新的，模型计划如何扩展范围以解决全球睡眠不足的问题。这项研究的长期目标是提供批判性知识促进对睡眠健康干预措施的广泛实施，传播和持续利用促进连续，足够的睡眠，并最终减轻CVD风险。实现学习目标将改善消防员的健康和健康，该人口对于确保公共安全和支持至关重要社区弹性。