title: Evaluation of an mHealth intervention aiming to improve health-related behavior and sleep and reduce fatigue among airline pilots.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effects of an mHealth intervention (intervention using mobile technology) consisting of tailored advice regarding exposure to daylight, sleep, physical activity, and nutrition, and aiming to improve health-related behavior, thereby reducing sleep problems and fatigue and improving health perception of airline pilots.
  
  
  METHODS
  A randomized controlled trial was conducted among 502 airline pilots. The intervention group was given access to both the MORE Energy mobile application (app) with tailored advice and a website with background information. The control group was directed to a website with standard information about fatigue. Health-related behavior, fatigue, sleep, and health perception outcomes were measured through online questionnaires at baseline and at three and six months after baseline. The effectiveness of the intervention was determined using linear and Poisson mixed model analyses.
  
  
  RESULTS
  After six months, compared to the control group, the intervention group showed a significant improvement on fatigue (β= -3.76, P<0.001), sleep quality (β= -0.59, P=0.007), strenuous physical activity (β=0.17, P=0.028), and snacking behavior (β= -0.81, P<0.001). No significant effects were found for other outcome measures.
  
  
  CONCLUSIONS
  The MORE Energy mHealth intervention reduced self-reported fatigue compared to a minimal intervention. Some aspects of health-related behavior (physical activity and snacking behavior) and sleep (sleep quality) improved as well, but most did not. The results show offering tailored advice through an mHealth intervention is an effective means to support employees who have to cope with irregular flight schedules and circadian disruption. This kind of intervention might therefore also be beneficial for other working populations with irregular working hours.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands. crl.boot@vumc.nl.
authors.forename: Alwin
authors.initials: A
authors.lastname: van Drongelen
authors.forename: Cécile Rl
authors.initials: CR
authors.lastname: Boot
authors.forename: Hynek
authors.initials: H
authors.lastname: Hlobil
authors.forename: Jos Wr
authors.initials: JW
authors.lastname: Twisk
authors.forename: Tjabe
authors.initials: T
authors.lastname: Smid
authors.forename: Allard J
authors.initials: AJ
authors.lastname: van der Beek
mesh_terms: D000337:Aerospace Medicine; D020811:Biomedical Technology / Q000295:instrumentation; D002940:Circadian Rhythm / Q000502:physiology; D005081:Exercise Therapy; D005221:Fatigue / Q000517:prevention & control*; D005260:Female; D015438:Health Behavior; D006801:Humans; D020407:Internet; D008297:Male; D063731:Mobile Applications; D010789:Phototherapy; D040242:Risk Reduction Behavior; D057566:Self Report; D020178:Sleep Disorders, Circadian Rhythm / Q000178:diet therapy / Q000517:prevention & control* / Q000628:therapy; D014940:Work Schedule Tolerance / Q000502:physiology*