2 - (SYM 123) Partnering with Arizona Fire Agencies to Promote Sleep Health Intervention in the Workplace

Insufficient sleep is a major public health crisis in the United States and worldwide disproportionately affecting shift workers and other at-risk groups. Firefighters are one such group at heightened risk for disturbed sleep. Almost half of career firefighters report short sleep and poor sleep quality, and 35-40% of firefighters screen positive for a sleep disorder. While sleep education has been used to mitigate fatigue in the public safety sector, education generally has short-lived effects on behavior change because it does not incorporate contextual determinants that dictate capacity to use the educational information. Evidence-based sleep health interventions, like Cognitive Behavioral Therapy for Insomnia (CBTi), are highly effective in eliciting behavioral change. Unfortunately, access to evidence-based intervention remains low for individuals outside of the Veterans Health Administration. Firefighters, in particular, may encounter barriers to behavioral healthcare, such as: 24 hour shifts that limit scheduling availability, social norms that deter help-seeking, and workplace cultures that reward sleep loss.

To inform the adaptation, delivery, and successful implementation of a CBTi-informed intervention, employees and supervisors at approximately 22 fire service agencies in the State of Arizona received a theory-based survey. The integrated Promoting Action on Research Implementation in Health Services (iPARIHS) framework guided measurement choice along with feedback from a Community Advisory Board representing diverse stakeholder perspectives within the fire service. The survey assessed sleep intervention preferences, workplace culture, contextual readiness and facilitation factors to inform implementation strategies. Data collection is ongoing with expected completion (n = 200 employees and supervisors) by May 2024.

This presentation will describe survey results and explain the methodology of conducting pre-implementation formative evaluation within organizational contexts. The next phase of the study tests the effectiveness of CBTi and identifies multi-level factors associated with successful implementation. This project aims to promote sustainable, sleep health worksite wellness programming in a group of individuals at high risk for sleep disturbance who might otherwise be unlikely to seek behavioral health care.