Background: Mental and physical fatigue while at work is common among emergency medical services (EMS) shift workers. Extended shifts (for example 24 hours) and excessive amounts of overtime work increase the likelihood of negative safety outcomes and pose a challenge for EMS fatigue-risk management. Text message-based interventions are a potentially high-impact, low-cost platform for sleep and fatigue assessment and distributing information to workers at risk of negative safety outcomes related to sleep behaviors and fatigue.
Methods/design: We will conduct a pilot randomized trial with a convenience sample of adult EMS workers recruited from across the United States using a single study website. Participants will be allocated to one of two possible arms for a 90-day study period. The intervention arm will involve text message assessments of sleepiness, fatigue, and difficulty with concentration at the beginning, during, and end of scheduled shifts. Intervention subjects reporting high levels of sleepiness or fatigue will receive one of four randomly selected intervention messages promoting behavior change during shiftwork. Control subjects will receive assessment only text messages. We aim to determine the performance characteristics of a text messaging tool for the delivery of a sleep and fatigue intervention. We seek to determine if a text messaging program with tailored intervention messages is effective at reducing perceived sleepiness and/or fatigue among emergency medicine clinician shift workers. Additional aims include testing whether a theory-based behavioral intervention, delivered by text message, changes 'alertness behaviors'.
Discussion: The SleepTrackTXT pilot trial could provide evidence of compliance and effectiveness that would support rapid widespread expansion in one of two forms: 1) a stand-alone program in the form of a tailored/individualized sleep monitoring and fatigue reduction support service for EMS workers; or 2) an add-on to a multi-component fatigue risk management program led and maintained by employers or by safety and risk management services.
Trial Registration: Clinicaltrials.gov NCT02063737, Registered on 10 January 2014.
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http://dx.doi.org/10.1186/1745-6215-15-244 | DOI Listing |
J Med Internet Res
December 2024
Yakima, WA, United States.
JMIR Form Res
January 2025
UNICEF Jamaica, Kingston, Jamaica.
Background: Intimate partner violence (IPV) and violence against children are global issues with severe consequences. Intersections shared by the 2 forms of violence have led to calls for joint programming efforts to prevent both IPV and violence against children. Parenting programs have been identified as a key entry point for addressing multiple forms of family violence.
View Article and Find Full Text PDFJ Manag Care Spec Pharm
January 2025
University of Colorado, Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora.
Background: Improved medication adherence, represented as an increase in the proportion of days covered (PDC), to chronic medications is associated with better patient outcomes, yet effective strategies to improve adherence are often resource intensive. To quantify the impact of a pharmacist-supported electronic outreach initiative on medication adherence measures and to qualitatively evaluate patient engagement with and response to electronic messaging.
Methods: This retrospective cohort evaluation used mixed methods to assess the impact of a population health quality improvement program to address medication adherence for Medicare Advantage enrollees.
JAMA Netw Open
January 2025
Office of Global and Population Health, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts.
Importance: Caries is the most common chronic childhood disease, with substantial health disparities.
Objective: To test whether parent-targeted oral health text (OHT) messages outperform child wellness text (CWT) messages on pediatric caries increment and oral health behaviors among underserved children attending pediatric well-child visits.
Design, Setting, And Participants: The parallel randomized clinical trial, Interactive Parent-Targeted Text Messaging in Pediatric Clinics to Reduce Caries Among Urban Children (iSmile), included participants who were recruited during pediatric medical clinic visits at 4 sites in Boston, Massachusetts, that serve low-income and racially and ethnically diverse (herein, underserved) populations.
Front Public Health
January 2025
Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
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