ABSTRACT
OBJECTIVES: To evaluate the effects of a workplace-based intervention on actigraphic and self-reported sleep outcomes in an extended care setting. DESIGN: Cluster randomized trial. SETTING: Extended-care (nursing) facilities. PARTICIPANTS: US employees and managers at nursing homes. Nursing homes were randomly selected to intervention or control settings. INTERVENTION: The Work, Family and Health Study developed an intervention aimed at reducing work-family conflict within a 4-month work-family organizational change process. Employees participated in interactive sessions with facilitated discussions, role-playing, and games designed to increase control over work processes and work time. Managers completed training in family-supportive supervision. MEASUREMENTS: Primary actigraphic outcomes included: total sleep duration, wake after sleep onset, nighttime sleep, variation in nighttime sleep, nap duration, and number of naps. Secondary survey outcomes included work-to-family conflict, sleep insufficiency, insomnia symptoms and sleep quality. Measures were obtained at baseline, 6-months and 12-months post-intervention. RESULTS: A total of 1,522 employees and 184 managers provided survey data at baseline. Managers and employees in the intervention arm showed no significant difference in sleep outcomes over time compared to control participants. Sleep outcomes were not moderated by work-to-family conflict or presence of children in the household for managers or employees. Age significantly moderated an intervention effect on nighttime sleep among employees (p=0.040), where younger employees benefited more from the intervention. CONCLUSION: In the context of an extended-care nursing home workplace, the intervention did not significantly alter sleep outcomes in either managers or employees. Moderating effects of age were identified where younger employees' sleep outcomes benefited more from the intervention.
Subject(s)
Long-Term Care , Nursing Homes , Occupational Health , Sleep/physiology , Work Schedule Tolerance , Work-Life Balance/methods , Workplace , Actigraphy , Adult , Age Factors , Female , Humans , Long-Term Care/organization & administration , Male , Middle Aged , Nursing Homes/organization & administration , Role Playing , Self Report , United States , Work Schedule Tolerance/physiology , Work Schedule Tolerance/psychology , Workforce , Workload/psychologyABSTRACT
STUDY OBJECTIVES: The Work, Family, and Health Network Study tested the hypothesis that a workplace intervention designed to increase family-supportive supervision and employee control over work time improves actigraphic measures of sleep quantity and quality. DESIGN: Cluster-randomized trial. SETTING: A global information technology firm. PARTICIPANTS: US employees at an information technology firm. INTERVENTIONS: Randomly selected clusters of managers and employees participated in a 3-month, social, and organizational change process intended to reduce work-family conflict. The intervention included interactive sessions with facilitated discussions, role playing, and games. Managers completed training in family-supportive supervision. MEASUREMENTS AND RESULTS: Primary outcomes of total sleep time (sleep duration) and wake after sleep onset (sleep quality) were collected from week-long actigraphy recordings at baseline and 12 months. Secondary outcomes included self-reported sleep insufficiency and insomnia symptoms. Twelve-month interviews were completed by 701 (93% retention), of whom 595 (85%) completed actigraphy. Restricting analyses to participants with e3 valid days of actigraphy yielded a sample of 473-474 for intervention effectiveness analyses. Actigraphy-measured sleep duration was 8 min/d greater among intervention employees relative to controls (P < .05). Sleep insufficiency was reduced among intervention employees (P = .002). Wake after sleep onset and insomnia symptoms were not different between groups. Path models indicated that increased control over work hours and subsequent reductions in work-family conflict mediated the improvement in sleep sufficiency. CONCLUSIONS: The workplace intervention did not overtly address sleep, yet intervention employees slept 8 min/d more and reported greater sleep sufficiency. Interventions should address environmental and psychosocial causes of sleep deficiency, including workplace factors.
