New England College Health Association Grant Application 2013

Transcription

1 New England College Health Association Grant Application 2013 The Get More Sleep! Campaign: A Campus Wide Intervention to Change the Sleeping Habits of College Students Submitted by: Caroline Y. Doyle, BA, Alumnus, Providence College Suzanne Bornschein, MD, Medical Director, Student Health Center, Providence College Introduction/General information: The Student Health Center at Providence College offers primary care services provided by two nurse practitioners and one physician, all of whom work in conjunction with the Health Educator & Wellness Coordinator, Director of Student Health Services, and an Administrative Assistant. Providence College is a small,liberal arts, independent, not for profit, Catholic institution of higher education that primarily serves about 3,810 undergraduates, 417 continuing education students, and 526 graduate students. 56.6% of students are female while 43.4% are male and about 21% of students are minority students. It has already been demonstrated that sleep qualityimpacts physical and mental health (Tanaka, et al, 2002; Lund, et al, 2010). Additionally,sleep has been shown to be a factor that affects academic performance (Gaultney, 2010; Arnold, 2012), depression,anxiety (Nyer, et al, 2013), and mood (Settineri, et al, 2012), in college students. A number of professionals have recommendedthe implementation of sleep quality monitoring and sleep hygiene education for said college students (Lund, et al, 2010; Marhefka, 2011). In 2011, the University of Arizona launched a campus wide media intervention for better student sleep. The intervention was successful and relatively inexpensive to implement, helping reportedly 10% of the student population find better ways to sleep (Orzech,Salafsky, & Hamilton, 2011). Recently, other universities around the country have started to implement different sleep campaigns as well, including Tufts, UPenn, and U of Missouri Kansas City. The Get More Sleep! Campaign would seek to make students aware of the all encompassing effects of sleep, and to educate students on what good sleep hygiene entails through a weeklong, campus wide intervention. In doing so, we would hope to help change student sleep habits as well as social norms surrounding the culture of sleep, such as the normality of all nighters amongcollege students: two aspects of sleep that could be improved uponat Providence College as per preliminary sleep survey data that was collected (described below). Statement of Purpose: According to the National College Health Association Fall 2012 survey of 28,237undergraduates, 24.9% of those surveyed reported difficulty handling sleeping issues. About 19.7% of participants reported sleep as a factor that affected their academic performance in some way. Additionally, 73.4% of participants reported that their college/university did not provide them with any information on sleeping difficulties (American College Health Association, 2012). Likewise, Providence College to date, has never implemented any organized, campus wide effort to provide students with information on better sleep habits. Thus, it seems that though sleeping difficulties tend to be a common issue in the lives of college students in the 1

2 U.S., not enough information has been provided to help them combat issues with sleep they might encounter, including Providence College students. Furthermore, sleeping difficulties can have much graver consequences over time related to mental and physical health. In an over the phone survey that assessed unhealthy sleep behaviors, the Center for Disease Control reported that 37.9% of adults surveyed unintentionally fell asleep during the day at least 1 day in the past month while 48.0% reported snoring (McKnight Eily, et al, 2011).The Institute of Medicine (US) Committee on Sleep Medicine and Researchhas reported that the effects of insufficient sleep include increased likelihood of developing diseases such as, stroke, heart attack, hypertension, depression, obesity and diabetes (Colten and Altevogt, 2006). Additionally, the National Department of Transportation has reported that about 1,550 fatalities and 40,000 nonfatal injuries due to drowsy drivingoccur annually in the United States. Since sleep habits start in adolescence and can carry into adulthood, intervening to stop and/or to prevent unhealthy sleep habits in college students may prove to be vital to their health. In order to assess sleep quality among students at Providence College, 150 randomly selected undergraduate students participated in an online sleep survey in which they were asked abouttheir sleep knowledge, sleep habits, and sleep hygiene. In items from a sleep knowledge survey provided by the NIH Office of Science Education, a relatively high percentage of students answered the following 3 questions incorrectly: Drinking coffee cures drowsiness (47% agreed, but the answer is false), Driving makes you sleepy (56% agreed but the answer is false), and Sleep is time for the body and brain to shut down for rest (84% agreed but the answer is false).this data alludes to misconceptions some Providence Collegestudents may have about sleep. If this conclusion is correct, students at PC may indeed benefit from an on campus sleep intervention/campaign. One goalof such a program would be to debunk sleep myths held by college students. Data concerning length of time asleep was collected as well. Though 78.1% of students reported getting 6 8 hours of sleep most nights, only 2.6% of students reported getting 9+ hours of sleep most nights while the remaining 19.2% of students reported getting under 6 hours most nights. According to the National Sleep Foundation, adults need 7 9 hours of sleep, but college students may need even more (National Sleep Foundation, 2011). 55.3% of students reported taking 0 1 naps per week. The majority of participants (61.7%) reported feeling groggy or sleepy after taking a nap, as opposed to refreshed. Such data may hint at the need for increased availability of effective nap technique information for students. According to the National Sleep Foundation, though we humans seem to be monophasic sleepers (i.e. have 2 distinct periods of the day for wakefulness and sleeping) we seem to benefit from naps. Thus, a short minute nap can improve mood, alertness, and performance (National Sleep Foundation, 2011). We also found that the average hours of sleep per night during the week was about hours of rest, while the average weekend hours of sleep per night were hours of rest. The mean bedtime during the week was 12:30 12:45am and mean wake time was 8:15am. Conversely, the mean weekend bedtime was 2:15 2:30am and the mean wake time was 10:30 10:45am. These results display a concept known as social jet lag at work the discrepancy between social and biological time (Wittmann, et al, 2006) for the average weekday bedtime and waketime compared to the weekend bedtime and waketime differed by about 2 hours. These results also allude to the all nighter sleep culture, with 6% of respondents reporting 4:30am as their latest bedtime in 2 weeks. With the help of 2

3 a campus wide sleep campaign, Providence College students will be able to learn the academic consequences of poor sleep habits and sleep deprivation. Overarching Program Goal: To educate students on theeffects of poor sleep and onwhat good sleep hygiene entails. In doing so, we hope to provide students with the mental tools to make healthier sleep choices, to helpchange the allnighter sleep culture, and to instill good sleep practices in students. Behavioral Goals and Objectives Students should be able to define, list, and eventually practice good sleep hygiene Students should understand consequences of poor sleep practices and in doing so, change their personal sleep habits and hygiene. Students should understand that insufficient sleep is academically, mentally, and physically taxing. Ultimately, we want to increase the percentage of students with regularized sleep cycles and who get 7+ hours of sleep per night. PC Health Center will sponsor programs that illustrate the dangers and consequences of poor sleep and poor sleep habits One month before the campaign, a campus wide sleep survey based off of the preliminary sleep survey will serve as a pre test. The same survey will be re administered after the campaign finding: o Decreased percentage of students pulling all nighters o Decreased percentage of students getting 6 or less hours of sleep o Decreased frequency of social jet lag Additionally, differences in number of visits to the Student Health and Student Wellness Centers before and after the campaign will be analyzed. Program Design 1. Months before the sleep campaign, interested students (from any major, but we would look first to the Biology, Psychology, and Health Policy & Management departments) would be recruited to help lay down the ground work for the campaign (i.e. designing and planning events, designating who will work what events; poster design and production, etc.) with one motivated student leading the campaign (student will be monetarily compensated with grant funds; will organize team meetings, etc.) 2. Sleep Challenge : students will be recruited to participate in a three week long sleep diary study to assess the effectiveness of the campaign on a more detailed level. Students will be asked to keep a sleep journal for 3 weeks starting 1 week before the start of the campaign, and ending 1 week after the end of the campaign. The hope is that a shift toward better sleep habits will be evident via the diaries, showing the effectiveness of the sleep campaign by the last week. 3. Flash Nap Depending on student interest, week could start off with a flash mob style flash nap in the dining hall or on the quad in order to raise awareness 4. Sleep Squad on the Quad mattress with sleepers (students in pajamas) on the quad handing out info and answering questions (Would be put on by interested students and/or perhaps PC students involved in the theater department). 5. Posters and handouts with sleep facts will be posted around campus. Handouts can be posted in residence halls/slid under dorm doors, and residence hall programs can have something to do with sleep the month of the campaign 3

4 6. WDOM PC radio station: On air 1 minute sleep blurbs throughout the week; Visual sleep fact blurbs through PC TV, which will display in Student Health Center and the Slavin Student Center. 7. Nap Maps best places around campus to nap Map can be placed in Cowl (student newspaper); map handouts, along with free sleep masks and ear plugs, can be handed out in the Raymond dining hall (by setting up Ray Tables ), and as prizes/extras at any other events around campus that week (e.g. by collaborating with other clubs, such as the Board of Programmers (BOP), sleepthemed prizes can be distributed at events around campus, such as the ones mentioned, or larger prizes such as pillows or personal actigraphs. 8. A sleep themed Cowl that week could be negotiated 9. A sleep themed movie or a documentary on sleep can be arranged in conjunction with a sleep talk given by a guest speaker from either a specialist on campus or from the Providence area. Evaluation of Campaign How will we measure the impact of the Get More Sleep! campaign? o Aforementioned campus wide survey would be sent out about 1 month before the campaign; Battery of questions would ask about sleep habits as well as mental health, frequency of student health center and personal counseling center use, cumulative GPA, mood assessment, physical illness frequency, etc. Same survey would be sent out campuswide one week after the end of the sleep campaign. o The sleep diary sub study would also assess the effectiveness of the campaign on a more intimate scale. How can the project be sustained after the event? The hope is that the Get More Sleep! campaign willbecome an annual event at PC, either occurring in October/November so that students can learn healthy sleep practices early on in the school year, or during National Sleep Awareness Week in March. Depending on student interest, a student involved with the project could spearhead the synthesis of a sleep/napping club that could take this campaign, and others throughout the year, under its wing, working in conjunction with the PC Student Health Center.Otherwise, the Student Health Center would be able to recruit enthusiastic students to the cause months prior to the start of the campaign. Since many of the awareness projects do not require much money as much as they do student interest, the campaign shouldn t be hard to get off the ground each year. How other campuses could replicate program: Student Health Centers across the country could work in collaboration with interested and/or preexisting students groups to instigate their own Get More Sleep! campaign. The word can be spread across campus through visual and interactive programs, utilizingmeans of communication already in place on campus, such as poster space, radio and TV stations. This kind of utilization would mean the cost of the campaign would remain low, and given the differences in resources at every university, the program would remain highly customizable. Likewise, the campus wide preand post test sleep survey would be distributed to assess the effectiveness of the campaign. Relevance to College Health 4

5 Sleep quality and sleep disorders have been topics of increasing interest as more studies are published on the importance of sleep each year. The National Institutes of Health (NIH), for example, implemented a sleep disorders research plan in 2011 in order to broaden the scope of knowledge on this topic.colleges across the country are now starting to catch wind of the importance of sufficient sleep, as this topic continues to get national attention. Changing the sleep culture and student sleep habits at Providence College will most likely lead to happier and healthier students, as national data has suggested. One study of 1,845 undergraduates at a large university showed that 27% of students surveyed were at risk for a sleep disorder. Those with GPA s <2.0 were overrepresented in this group (Gaultney, 2010). With studies like these, one can t help but think that there is a link between sufficient sleep and academic success. In other words, students who learn, implement, and maintain proper sleep habits may improve their grades as a result. Since sleep is also related to mental and physical health, it would not be surprising to see Wellness Center and Health Center visits drop after the sleep campaign. In a new study on the relationship between sleep disturbance, depression, and anxiety in college students, researchers found that students with sleep issues and depression endorsed higher rates and more intense feelings of anxiety, as well as poorer cognitive functioning (Nyer, et al, 2013). By providing students with much needed information on attaining better sleep habits through the Get More Sleep! campaign, students may increase their ability to regain control over their well being. Expense Report Providence College would be able to provide some funding for campaign programs in addition to the NECHA funds: Type of Expense NECHA funds Providence College Health Center (estimate) Lecture and/or movie $940 $550 Snacks (for various events) $160 Marketing $300 $150 Supplies (pens, posters, maps, eye masks, ear plugs, pillows, actigraph(s), sleep diaries) Sleep diary participant compensation $600 $10 x students: $ Team Leader compensation $100 $2,500 $700 5

6 References Gaultney, J. F. (2010). The prevalence of sleep disorders in college students: impact on academic performance. Journal of American College Health, 59(2), Arnold, O. R. (2012). Nothing to Yawn at: A Study Assessing the Importance of Sleep Habits for Academic Student Success (Doctoral dissertation, Youngstown State University). Nyer, M., Farabaugh, A., Fehling, K., Soskin, D., Holt, D., Papakostas, G. I.,... & Mischoulon, D. (2013). RELATIONSHIP BETWEEN SLEEP DISTURBANCE AND DEPRESSION, ANXIETY, AND FUNCTIONING IN COLLEGE STUDENTS. Depression and anxiety. Epub ahead of print. Lund, H. G., Reider, B. D., Whiting, A. B., & Prichard, J. R. (2010). Sleep patterns and predictors of disturbed sleep in a large population of college students. Journal of Adolescent Health, 46(2), Marhefka, J. K. (2011). Sleep deprivation: consequences for students. Journal of Psychosocial Nursing and Mental Health Services, 49, Orzech, K. M., Salafsky, D. B., & Hamilton, L. A. (2011). The state of sleep among college students at a large public university. Journal of American College Health, 59(7), Settineri, S., Gitto, L., Conte, F., Fanara, G., Mallamace, D., Mento, C.,... & Bramanti, P. (2012). Mood and sleep problems in adolescents and young adults: an econometric analysis. The Journal of Mental Health Policy and Economics, 15(1), 33. Tanaka, H., Taira, K., Arakawa, M., Masuda, A., Yamamoto, Y., Komoda, Y.,... & Shirakawa, S. (2002). An examination of sleep health, lifestyle and mental health in junior high school students. Psychiatry and Clinical Neurosciences, 56(3), American College Health Association. American College Health Association National College Health Assessment II: Reference Group Data Report Fall Hanover, MD: American College Health Association; "How Much Sleep Do Adults Need?" National Sleep Foundation. National Sleep Foundation, Web. 1 June Colten, H. R., & Altevogt, B. M. (Eds.). (2006). Sleep disorders and sleep deprivation: an unmet public health problem. National Academies Press. McKnight Eily, L. R., Liu, Y., Wheaton, A. G., Croft, J. B., Perry, G. S., Okoro, C. A., & Strine, T. (2011). Unhealthy sleep related behaviors 12 States, MMWR Morbidity and Mortality Weekly Report, 60, Wittmann, M., Dinich, J., Merrow, M., & Roenneberg, T. (2006). Social jetlag: misalignment of biological and social time. Chronobiology international, 23(1 2),