The Young Adults Working Nights program: developing and evaluating a web- and app-based fatigue intervention for young employees.

The intervention is a website where participants can log in, answer questions about their sleep and work behaviours, and receive personal advice regarding their sleep habits, and how they might improve their sleep. The intervention also includes a smartphone application for tracking sleep behaviour. The overall intervention duration is 4 weeks, with a follow-up survey administered 12-weeks after the intervention is completed. Duration the intervention, participants will log into the website weekly to complete a new module about sleep. The smartphone application will be completed before and after every sleep period. The intervention and smartphone content were developed from focus group findings using a sample of 57 adolescents (32 female, 25 male; mean + SD = 21.12 years + 2.77 years). Focus group questions were developed in line with the key tenets of Social Cognitive Theory, the Theory of Planned Behaviour, and the Elaboration Likelihood Model. Focus group data were analysed using a general inductive approach. When beginning the intervention, participants log into the YAWN website and receive access to the Baseline survey: You and Your Sleep. The baseline survey assesses demographic information and includes questions about work, study, living and sleeping arrangements, general health status, technology use, sleep quality and hygiene, daytime sleepiness, chronotype (morningness vs. eveningness), sleep behaviours and beliefs, facilitators and impediments to sleep, behavioural sleep strategies, physical activity, and sedentary behaviour. Based on their responses, participants in the intervention condition then receive tailored, personalised feedback. Following this, participants are instructed to use some of the things they have learnt and to use the YAWN app to help them keep track of their sleep habits. The baseline survey will take ~20 minutes to complete. One week post-baseline, participants are prompted to return to the YAWN website. Intervention participants then gain access to Module 1: Creating the Perfect Sleep Environment. Module 1 assesses participant's bedroom environment, such as comfort, light, temperature and volume. Intervention participants then receive tailored, personalised feedback, are instructed to use some of the things they have learnt and to use the YAWN app to help them keep track of their sleep habits. Module 1 will take ~15 minutes to complete. Two weeks post-baseline, participants are prompted to return to the YAWN website. Intervention participants then gain access to Module 2: Designing Your Pre-bed Routine. Module 2 assesses participant’s pre-bed behaviours like exercise, napping, eating, and computer/screen time. Intervention participants then receive tailored, personalised feedback, are instructed to use some of the things they have learnt and to use the YAWN app to help them keep track of their sleep habits. Module 2 will take ~15 minutes to complete. Three weeks post-baseline, participants are prompted to return to the YAWN website. Intervention participants will then gain access to Module 3: Falling Asleep and Staying Asleep. Module 3 assesses participant’s variations in sleep and wake times, ability to fall and stay asleep, and things that prevent them falling asleep and staying asleep. Intervention participants then receive tailored, personalised feedback, are instructed to use some of the things they have learnt and to use the YAWN app to help them keep track of their sleep habits. Module 3 will take ~15 minutes to complete. For each of the three modules, participants receive tailored feedback immediately after completion of the module. The feedback will use their answers regarding sleep/wake habits and behaviour and provide advice about changes they could make to improve their sleep. Four weeks post-baseline, participants are prompted to return to the YAWN website. Participants then gain access to the immediate follow-up survey. This re-assesses many of the items from the baseline survey (to observe changes in work, study, living or sleeping arrangements, general health status, technology use, sleep quality and hygiene, daytime sleepiness, chronotype (morningness vs. eveningness), sleep behaviours and beliefs, facilitators and impediments to sleep, behavioural sleep strategies, physical activity, and sedentary behaviour. Both conditions will received questions about the utility of the YAWN website and information. Participants will also complete an assessment of the utility of the YAWN app. Participants will receive a thank you message for participating in the research so far, encouraged to keep working on improving their sleep habits, and informed that the research team will be in touch in eight weeks to check in one last time. The immediate follow-up survey will take ~25 minutes to complete. Twelve weeks post-baseline, participants are prompted to return to the YAWN website. All participants then gain access to the delayed follow-up survey. This re-assesses many of the items from the baseline and immediate follow up survey. Participants will receive questions about whether they have used the YAWN website or app since completing the study. After completion of the delayed follow-up survey, participants will receive a link to follow in order to enter the draw to win an iPad mini (10 to give-away). The delayed follow-up survey will take ~25 minutes to complete. Participants are asked to use a smartphone application to log their sleep and wake behaviour. The application is to be completed at the beginning and end of every sleep period (i.e. at bed time and wake time). The smartphone application asks participants to set a goal bed and wake time. The participant can then set reminders when their goal bed time is approaching, and alarms to wake them at their desired wake time. Before bed time participants record their bed time, pre-sleep fatigue level (on a scale of 1 = full alert to 7= completely exhausted), and set their wake alarm. After waking participants record their wake time, post-sleep fatigue level (on a scale of 1 = full alert to 7= completely exhausted), sleep quality (1= very poor - 5 = very good), and sleep sufficiency rating (1=definitely too little - 5 = definitely enough). Completion of the app should take ~5 minutes per day. Intervention adherence will be tracked by log-ins to the website, as well as the completion of the website modules, and the daily tracking of sleep/wake behaviours via the app. We have included multiple-choice response and free text response questions for participants about the utility of the website and app, and reasons for use or non-use.