Adapting Research to a Global Pandemic: A Fully Remote Actigraphy and Ecological Momentary Assessment Study.

BACKGROUND: Mandated social distancing practices and quarantines in response to COVID-19 have resulted in challenges for research on healthcare workers, such as hospital nurses. It remains unknown whether nursing studies utilizing complex methodology like sleep actigraphy and ecological momentary assessment (EMA) can be conducted remotely without compromising data quality. OBJECTIVES: We aimed to (a) disseminate our remote study protocol for sleep actigraphy and EMA data from hospital nurses during COVID-19, (b) assess feasibility and acceptability of this approach for studies on hospital nurses, and (c) examine the reliability and ecological validity of sleep characteristics measured across 14 days. METHODS: Using an online platform, we provided 86 outpatient nurses from a cancer hospital with detailed video/text instructions regarding the study and facilitated virtual study onboarding meetings. Feasibility was assessed by comparing adherence rates to a similar in-person study of nurses from the same hospital; acceptability was evaluated through content analysis of qualitative study feedback. Multilevel modeling was conducted to assess changes in sleep characteristics as a function of study day and daily stressful experiences. RESULTS: Adherence to EMA (91.8%) and actigraphy (97.9%) was high. EMA adherence was higher than the in-person study of inpatient day-shift nurses from the same hospital. Content analyses revealed primarily positive feedback, with 51.2% reporting "easy, clear, simple onboarding" and 16.3% reporting the website was "helpful." Six participants provided only negative feedback. Sleep characteristics did not change as a function of study day except for self-reported quality, which increased slightly during Week 1 and regressed toward baseline after that. A higher incidence of stressor days or higher stressor severity followed nights with shorter-than-usual time in bed or poorer-than-usual sleep quality, supporting the ecological validity for these methods of assessing sleep in nurses. DISCUSSION: Findings suggest that a fully remote study protocol for EMA and actigraphy studies in nursing yields robust feasibility, acceptability, reliability, and validity. Given the busy schedules of nurses, the convenience of this approach may be preferable to traditional in-person data collection. Lessons learned from COVID-19 may apply to improving nursing research postpandemic.

Diversity of Activities, Emotions, and Pleasant Events and Their Associations With Mental and Cognitive Health

The COVID-19 pandemic dramatically changed the structure of our daily lives. One of the most significant changes is a limited opportunity to engage in face-to-face social interactions and enjoy diverse daily activities. This raises a public health concern, because diverse experiences are critical sources of health by increasing social integration, cognitive reserve, and psychological resources. Recently, two lines of research have consistently shown that activity diversity or emodiversity is associated with multiple health outcomes. However, still more integrated efforts are needed to better understand diversity of daily experiences in various aspects and their contributions to health. This symposium brings together different endeavors towards understanding how diversity of daily experiences – activity diversity, emodiversity, and variety in positive experiences – are associated with health and well-being across adulthood. The topic of this symposium is timely to discuss potential prevention approaches to protect population well-being as the pandemic evolves. Paper 1 examines activity diversity (breadth and evenness of daily activity participation) and how it is related to positive and negative emodiversity (rich and balanced emotional experiences) differently by age groups. Paper 2 investigates the longitudinal relationship between activity variety across cognitive, physical, and social domains and cognitive functioning. Paper 3 examines variety in pleasant events and its associations with mental health outcomes. Paper 4 examines whether and how negative emodiversity is associated with mental illness during COVID-19. The discussant, Dr. David Almeida will integrate key findings from these studies, discuss their theoretical and methodological contributions, and consider opportunities for future research.

Making the Most of Adversity: A Fully Remote Ecological Momentary Assessment and Actigraphy Study of Hospital Nurses

The COVID-19 pandemic has created challenges and opportunities for research. This is especially true for research on essential workers, such as hospital nurses. In adaptation to the pandemic, the current study aimed to assess the feasibility and acceptability of a fully remote study to collect data on psychological and behavioral measures such as daily stress and sleep, utilizing ecological momentary assessments (EMA) and sleep actigraphy. Our remote study protocol was conducted through a web platform that provided detailed video and written instructions regarding the study and facilitated virtual onboarding meetings with participants. Outpatient day shift nurses (n=86) responded to a background survey, 84 of whom completed 14 days of EMA and sleep actigraphy. Feasibility was assessed by compliance rates to the 14-day study protocol. Acceptability was assessed by analyzing qualitative feedback provided during onboarding meetings (n=82). The compliance rates of EMA (91.8%) and actigraphy (97.9%) were high. The EMA compliance was higher than that from a pre-COVID, non-remote study of inpatient day shift nurses from the same hospital (86.6%, p=.030). Themes from content analysis were mostly positive with 51.2% reporting “easy, clear, simple onboarding process” and 16.3% reporting “helpful website”. Only six participants provided solely negative feedback (e.g., “communication problems” or “technical difficulties/preferences”). Our remote study protocol was feasible and well-accepted by nurses. A similar methodology could be used in studies on broader healthcare workers and those caring for aging populations to better understand their unique challenges and develop effective strategies to help them, both during and after the pandemic.

Disentangling the Relationship between Food Insecurity and Poor Sleep Health.

The COVID-19 pandemic has created disruptions in global and national food supply chains. Along with an increase in the unemployment rate, this resulted in a rise in food insecurity at the community-level, threatening individual and family well-being. Food insecurity is associated with inadequate nutrient intakes, weight gain, and psychological distress, including anxiety and depressive symptoms, all of which are known to affect sleep. Yet, little is known about whether and how food insecurity is associated with sleep health, a critical but underrecognized health outcome. This paper reviews literature describing associations between food insecurity and sleep, summarizes key findings based on proposed mechanisms, and discusses directions for future research.