title: Real-time fatigue reduction in emergency care clinicians: The SleepTrackTXT randomized trial.
abstract: BACKGROUND
  We assessed performance characteristics and impact of a mobile phone text-message intervention for reducing intra-shift fatigue among emergency clinician shift workers.
  
  
  METHODS
  We used a randomized controlled trial of 100 participants. All participants received text-message assessments at the start, every 4 hr during, and at end of scheduled shifts over a 90-day period. Text-message queries measured self-rated sleepiness, fatigue, and difficulty with concentration. Additional text-messages were sent to intervention participants to promote alertness. A performance measure of interest was compliance with answering text-messages.
  
  
  RESULTS
  Ninety-nine participants documented 2,621 shifts and responded to 36,073 of 40,947 text-messages (88% compliance rate). Intervention participants reported lower mean fatigue and sleepiness at 4 hr, 8 hr, and at the end of 12 hr shifts compared to controls (P < 0.05). Intervention participants reported better sleep quality at 90-days compared to baseline (P = 0.01).
  
  
  CONCLUSIONS
  We showed feasibility and short-term efficacy of a text-message based assessment and intervention tool.
authors: Department of Emergency Medicine, Carolinas HealthCare System Medical Center, Charlotte, North Carolina.
authors: P Daniel
authors: PD
authors: Patterson
authors: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors: Daniel J
authors: DJ
authors: Buysse
authors: Harvard Medical School, Department of Medicine, Division of Sleep Medicine.
authors: Matthew D
authors: MD
authors: Weaver
authors: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors: Jack M
authors: JM
authors: Doman
authors: Dickson Advance Analytics Group, Carolinas HealthCare System Medical Center, Charlotte, North Carolina.
authors: Charity G
authors: CG
authors: Moore
authors: Department of Emergency Medicine, University of Pittsburgh School of Medicines, Pittsburgh, Pennsylvania.
authors: Brian P
authors: BP
authors: Suffoletto
authors: Department of Emergency Medicine, University of Pittsburgh School of Medicines, Pittsburgh, Pennsylvania.
authors: Kyle L
authors: KL
authors: McManigle
authors: Department of Emergency Medicine, University of Pittsburgh School of Medicines, Pittsburgh, Pennsylvania.
authors: Clifton W
authors: CW
authors: Callaway
authors: Department of Emergency Medicine, University of Pittsburgh School of Medicines, Pittsburgh, Pennsylvania.
authors: Donald M
authors: DM
authors: Yealy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004632:Emergency Medical Services; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology / Q000517:prevention & control*; D016037:Single-Blind Method; D012890:Sleep; D060145:Text Messaging; D016896:Treatment Outcome; D014940:Work Schedule Tolerance; D055815:Young Adult
keywords: fatigue; injury; mobile; shiftwork; sleepiness