Evaluating Worksite Sleep Health Coaching in Firefighters: The Sleep Assistance for Firefighters Study

Официальное название

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

Обзор

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.

Подробное описание

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.

Вмешательства

• Поведенческое firefighter Sleep Health Coaching Intervention (ffSHC)
  This multi-component intervention is based on principles of cognitive behavioral therapy for insomnia. It includes telephone-based sleep health coaching to individuals, targeted training and sleep health education to fire service leaders, agency-level sleep health promotion, and facilitation strategies to internal facilitators.
• Поведенческое Control (Minimally Enhanced Usual Care)
  The control arm is minimally enhanced usual care. Usual care interventions for sleep disturbance include any health or wellness interventions administered by the agency on the topic of sleep, including occupational health intervention, employee assistance programs, education, signage, and webinars. The type and dose of care will be assessed at each timepoint. Minimal enhancement is a referral to the agency's Employee Assistance Program and will address the ethical problem in the control conditio

Первичные конечные точки

• PROMIS Sleep Disturbance questionnaire [Срок оценки: 6 assessments, 6 months apart]
• Multidimensional sleep health (MSH) composite [Срок оценки: 6 assessments, 6 months apart]

Вторичные конечные точки (3)

• PROMIS Sleep Related Impairment questionnaire [Срок оценки: 6 assessments, 6 months apart]
• Wake time after sleep onset (WASO), min - actigraphy [Срок оценки: 6 assessments, 6 months apart]
• Number of awakenings (NAW) - actigraphy [Срок оценки: 6 assessments, 6 months apart]

Критерии участия

Критерии включения

• 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.

Критерии исключения

• Children younger than 18 years of age.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Перекрёстный дизайн

Маскирование

Простое слепое

Основная цель

Профилактика

Центры проведения

США · 1 центр

• University of Arizona — Tucson

Идентификаторы

NCT: NCT06684444 · STUDY00001612 · R01HL162799

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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