Examining the acceptability of a sleep management tool for shift workers

Consenting participants who are shift workers in healthcare will receive access to a digital app that delivers personalised recommendations for sleep and wake (e.g., light and nutrition) behaviours based on their shift schedules and other personal commitments. The app provides a sleep wake schedule (e.g., sleep from 9pm to 5am) with a minimum duration of 8 hours within 24 hours. Sleep recommendations may be "sleep from 6pm to 8pm" before a shift starting at 10pm, or "sleep from 10pm to 6am" to be prepared for a day shift starting at 8am. The app also provides other recommendations such as "consume caffeine between 10am and 2pm" or "avoid light from 7pm to 10pm". Such recommendations are based on shift time and personal commitments, entered by the user. Participants are asked to engage with the app for about 5 minutes a day. The app was previously co-designed with shift workers from healthcare and defence to provide lifestyle support based on their operational needs. Part 1: Baseline testing to identify sleep patterns (2 weeks) Before the study begins, managers at hospitals will be provided with information to support shift workers to download and use the app for the first time. Once downloaded, the app will show participants how to use its features, how to add or access shift-work information, and how to log sleep. Participants will be asked to use these features to record their bedtime and waketime everyday (~2-5 minutes daily). Alternatively, participants can sync their wearable devices to the app. During baseline, participants will complete an online survey instrument. This will assess demographic information, sleep and sleep disorders, mental health, and organisational factors. It will take about 20 minutes. The questionnaire can be completed online via a secure link. Part 2: Intervention, using recommendations delivered through the app (4 weeks) After the first 2 weeks, participants will receive access to all features of the app, including sleep and other recommendations. Participants should engage with the app daily to receive recommendations and attempt to follow them to the best of their ability. During the period, participants will record their bedtime and waketime in the app (manually or via wearable devices), and their shift schedules. These can be synced to their calendars. Participants will complete an online survey assessing the same outcomes as Part 1, except demographics. This survey will also have questions about the feasibility and usefulness of the app. Part 3: Follow-up, survey only 4 weeks after Part 2 About 4 weeks after using the app, participants will complete a short version of the survey administered in Part 2. This will again assess some items on sleep and sleep disorders, organisational outcomes and feasibility measures. Throughout the study participants can provide feedback on the app (and through surveys in Part 2 and 3). Participants' adherence to sleep recommendations will be monitored through the app via their responses to the sleep diary (or syncing to their wearable devices). Engagement with the app will also be monitored passively by measuring average minutes of interaction with the app each day. Total duration for these participants is: 6 weeks of interacting with the app, including baseline (2 weeks), intervention (4 weeks), and a short 5 minute survey 4 weeks following the intervention (at ~ week 10). At this time (Part 3), the leadership team of hospitals participating in the intervention will be invited to attend a focus group (multiple offered). The focus group will discuss enablers and barriers to adopting the intervention (app) at their organisation and in healthcare more generally. These focus groups will comprise leaders and managers from hospitals who are familiar with the intervention being conducted in their workplace. They will be recruited from the same workplace as shift workers for the intervention. The focus groups will be conducted online by researchers via Zoom, and will comprise 4-6 people, The focus groups plan to have 12 people (two focus groups of 6). We will recruit for a month with this goal or it will close once there are 12 participants enrolled. Following the one month, the focus groups will continue with at least 4 in each group, or the recruitment window may be extended if needed. Total duration for this group is: one 60-minute focus group.