PROJECT SUMMARY/ABSTRACT Consistent with the NHLBI Strategic Objective to “develop and optimize novel…therapeutic strategies to prevent, treat, and cure heart, lung, blood and sleep diseases,” this proposal aims to develop, refine, and preliminarily test a comprehensive, personalized, media-augmented telehealth intervention designed to improve sleep health among shift workers. Approximately 20% of the US workforce engages in some form of shift work. Shift work is common in essential occupations (e.g. nursing, transportation, food service). Shift work is associated with elevated risk for cardiovascular disease, stroke, multiple cancers, metabolic disorders, depression, driving accidents, medical errors, and all-cause mortality. One modifiable factor that contributes to increased risk for disease, accidents, errors, and death among shift workers is poor sleep health, defined as the multidimensional pattern of sleep and wake which promotes optimal health and wellbeing. Poor sleep health in shift workers manifests during both sleep (e.g., insomnia symptoms, short sleep duration) and wake (e.g., fatigue, sleepiness, executive function, depression). The proposed study seeks to improve sleep health among shift workers by developing, refining, and testing a novel intervention, termed Shift Worker Intervention for Sleep Health (SWISH), which will integrate existing effective interventions into a comprehensive program that addresses the constellation of sleep health problems experienced by many shift workers. The aims of this research are to: 1) iteratively refine and finalize the structure and materials of SWISH; 2) examine feasibility and acceptability of SWISH compared to delayed treatment control in a randomized pilot study; 3) preliminarily test the effect of SWISH on sleep health parameters; and 4) preliminarily test the effect of SWISH on wake time functioning. The proposed research plan will be the first step towards building an intervention that can contribute to the improvement and reduce the significant societal burden of poor sleep health among shift workers. This research has potential far-reaching public health implications, as the sleep health of shift workers has impacts beyond the individual (e.g., patients under a nurse's care). The candidate's planned training activities are also vital to the completion of this project. As outlined in the Career Development Plan, a multidisciplinary team of experts will provide the candidate with advanced training and mentoring in key areas including clinical trial design, conduct, and reporting, circadian rhythms biology and circadian interventions for shift work, implementation science, and development of rich, engaging media products to support therapist-led interventions. The training plan includes strong mentorship, seminars and didactics, formal coursework and institutes, hands-on training, manuscript and grant preparation, and attendance at scientific meetings. The proposed research project leverages the candidate's rigorous prior research and clinical training in sleep health assessment and interventions while providing necessary additional training to set the stage for the candidate to become an independent clinical investigator focused on increasing accessibility for sleep health interventions in underserved populations.

PROJECT NARRATIVE Poor sleep health is an underappreciated risk factor for disease, death, errors, and accidents among shift workers, who make up 20% of the US workforce. The purpose of the proposed K23 is to prepare the applicant for an independent clinical sleep research career by developing, refining, and pilot-testing a comprehensive, personalized, media-augmented telehealth intervention designed to improve sleep health among shift workers. This proposal will address the critical lack of evidence-based, accessible interventions by targeting shift workers' unique sleep health problems which manifest during both sleep (e.g., insomnia symptoms, short sleep duration) and wake (e.g., fatigue, sleepiness, poor executive function, depressive symptoms).