Evaluation of the potential for translation to practice of a sleep disorders management program.
Czeisler CA; Rajaratnam SMW; Lockley SW; Barger LK; Landrigan CP
Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R01-OH-009403, 2011 Apr; :1-59
Background: Sleep disorders are common, costly, and treatable, but often remain undiagnosed and untreated. Police officers, due to their extremely demanding work schedules, are at an increased risk of having sleep disorders. Although the public expects police officers to perform flawlessly, their cognitive abilities, reaction times and alertness can be severely disrupted by their extreme work hours and sleep disorders. Additionally, both acute and chronic sleep deprivation adversely affect personal health, increase the risk of gastrointestinal and heart disease, impair glucose metabolism, and substantially increase the risk of injury due to motor vehicle crashes. The aim of our original study (Sleep disorders Management, Health and Safety in Police; R01-OH008496; FWACD-04-002) was to evaluate the efficacy of a sleep disorders detection and treatment program to improve the safety, health, and performance of police officers. In this extension of that project, we expanded the evaluation of the Operation Healthy Sleep program beyond an investigation of efficacy, and evaluated the potential for translation to practice. Approach: We employed a combination of methods to evaluate the translation of the Operation Healthy Sleep (OHS) program, including use of RE-AIM framework for health behaviour interventions. We conducted both quantitative and qualitative analyses of participation throughout the various stages of the OHS program. We compared demographic data of police officers who participated in various stages of the intervention program with demographic data of officers who elected not to participate. Additionally, we compared the demographic data of officers who participated in OHS with national police demographics. Qualitative information was obtained through focus group interviews with OHS study participants, nonparticipants, and officers in management positions. We recruited 21 officers from the OHS police cohort to participate in focus group interviews (44.3 + 9.0 years old; mean + SD), including 8 officers ranked Sergeant and higher and 13 Troopers. Forty-two percent of participants did not attend the OHS information/education session carried out by our research staff on visits to police stations. All focus group interviews were video and audio recorded and subsequently transcribed. Qualitative analyses were conducted using NVivo 8 (QSR International Ltd). Software. To evaluate the cost, feasibility, and sustainability of the Operation Healthy Sleep program (specific aim 2), we assessed the costs associated with the program and the expected benefits in the following way: (i) Costs: We calculated the costs associated with implementing the screening program in the police department; (2) Benefits: We compared the rate of MVCs and citations in police officers who screened high risk for OSA and those who screened low risk for OSA. To evaluate the external validity of the Operation Healthy Sleep program (specific aim 3), we compared across three cohorts (primary cohort, secondary cohort and web-based cohort) the proportion of individuals who screened at high risk for OSA, demographic data, health and performance outcomes. Specifically, for demographic data we examined age, gender, race and ethnicity. For health, we examined BMI and self reported health status. Finally, for performance outcomes, we examined the number of officer-initiated vehicle assistances reported by each officer.
Sleep-deprivation; Sleep-disorders; Police-officers; Law-enforcement-workers; Health-hazards; Risk-factors; Gastrointestinal-system; Gastrointestinal-system-disorders; Cardiopulmonary-system-disorders; Cardiopulmonary-system; Cardiovascular-system-disease; Cardiovascular-system-disorders; Cardiovascular-system; Cardiovascular-function; Cardiovascular-disease; Metabolism; Injuries; Motor-vehicles; Accidents; Demographic-characteristics; Qualitative-analysis; Humans; Men; Women; Age-groups
Charles A. Czeisler, Ph.D., M.D., F.R.C.P., 221 Longwood Avenue, Boston MA 02115-5817
Final Grant Report
NTIS Accession No.
National Institute for Occupational Safety and Health
Brigham and Women's Hospital, Inc.- Boston