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Introduction Wrist actigraphy is a standard for monitoring sleep in the field; however, data quality is reduced if participants remove the device. The Actigpatch is a novel, adhesive water-resistant wearable that we have previously demonstrated as comparable to wrist actigraphy for traditional sleep-wake estimation. Here we compare assessment of nonparametric activity indexes. Methods While following fixed schedules, 39 participants simultaneously wore the Micro Motionlogger actigraph (Ambulatory Monitoring Inc., Ardley, NY) on their non-dominant wrist and the Actigpatch (Circadian Positioning Systems, Newport, RI) over the triceps of their dominant arm. Our analyses included 35 participants (21F; 32.9±13.2yrs) who contributed ≥four nights of data (range: 4-14 [mean: 10] nights). After matching devices’ tri-axial actimetry in one-minute epochs, we derived key non-parametric parameters of diurnal activity and calculated intraclass correlations to measure agreement. The non-parametric parameters include interdaily stability (IS), intradaily variability (IV), timing of the five hours of lowest activity (L5onset) and ten hours of highest activity (M10onset), and overall relative amplitude (RA). Results We observed agreement ranging from good for IS (ICC=0.77 [95%CI=0.59;0.88]; [all mean differences are patch-watch] mean difference=-0.21) to poor for IV (ICC=0.43 [0.12;0.67]; mean difference=0.29). ICC showed good agreement for M10onset (ICC=0.82 [0.67; 0.90]; mean difference=-37min) and excellent agreement for L5onset (ICC=0.91 [0.82;0.95]; mean difference=-2min). Finally, we identified good agreement when estimating the activity relative amplitude (RA ICC=0.86 [0.75; 0.93]; mean difference=0.03). An example of excellent agreement was manifested in the close estimation of L5onset (patch mean=1:04am, SD=70min; watch mean=1:06am, SD=68min). Conclusion Adding to our prior evidence that these two devices offer similar sleep-wake estimation using traditional algorithms, the present data indicate the Actigpatch offers good agreement to the Motionlogger for nonparametric analyses of IS, activity timing, and RA. Agreement was not as good for IV, with the Actigpatch showing more intradaily variability than the watch, perhaps due to the triceps placement. Because the Actigpatch is unobtrusive, water-resistant, and can be worn continuously for three weeks, it has potential benefits for studies of individuals who struggle with adherence to wearing wrist worn devices. Support (if any) R01AA025593, P20GM139743. Actigpatches provided by Circadian Positioning Systems.

For cancer survivors, insomnia is prevalent, distressing, and persists for years if unmanaged. Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment yet can be difficult to access and may require modification to address survivorship-specific barriers to sleep. In this 2-phase study, the authors adapted and assessed the feasibility, acceptability, and preliminary effects of synchronous, virtual CBT-I adapted for cancer survivors (the Survivorship Sleep Program [SSP]).From April to August 2020, cancer survivors with insomnia (N = 10) were interviewed to refine SSP content and delivery. From October 2020 to March 2021, 40 survivors were recruited for a randomized controlled trial comparing 4 weekly SSP sessions with enhanced usual care (EUC) (CBT-I referral plus a sleep hygiene handout). Feasibility and acceptability were assessed by enrollment, retention, attendance, fidelity, survey ratings, and exit interviews. Insomnia severity (secondary outcome), sleep quality, sleep diaries, and fatigue were assessed at baseline, postintervention, and at 1-month follow-up using linear mixed models.The SSP included targeted content and clinician-led, virtual delivery to enhance patient centeredness and access. Benchmarks were met for enrollment (56% enrolled/eligible), retention (SSP, 90%; EUC, 95%), attendance (100%), and fidelity (95%). Compared with EUC, the SSP resulted in large, clinically significant improvements in insomnia severity (Cohen d = 1.19) that were sustained at 1-month follow-up (Cohen d = 1.27). Improvements were observed for all other sleep metrics except sleep diary total sleep time and fatigue.Synchronous, virtually delivered CBT-I targeted to cancer survivors is feasible, acceptable, and seems to be efficacious for reducing insomnia severity. Further testing in larger and more diverse samples is warranted.

Objective: Health uncertainty among healthcare workers has yet to be examined as a contributor to the psychological toll of the COVID-19 pandemic. We aimed to (1) characterize health uncertainty levels among healthcare workers in a large, U.S. hospital system during the COVID-19 pandemic and (2) examine associations between health uncertainty and psychological outcomes.Methods: From March to June 2020, healthcare workers in a large, urban U.S. healthcare system were invited to complete an online questionnaire. Self-report measures assessed sociodemographic characteristics and job roles, health uncertainty, and emotional wellbeing variables (anxiety, depression, loneliness, self-compassion, and coping confidence). Health uncertainty (categorical and continuous scores) was compared across each variable using correlations and ANOVAs.Results: Healthcare workers (N = 440) were on average 44.5 years of age, 88.9% female, and 84.5% non-Hispanic white. Over half (52%) endorsed experiencing health uncertainty “sometimes” to “all the time”. While unrelated to sociodemographic characteristics (ps > .05), health uncertainty was highest among pharmacists and technicians, with levels significantly higher than other roles including physicians (p < .05) and mental health and spiritual counselors (p < .05). Higher health uncertainty was associated with higher anxiety (p < .001), depression (p < .001), and loneliness (p < .001), higher self-compassion (p = .02), and lower coping confidence (p < .001).Conclusions: Health uncertainty during the COVID-19 pandemic is common among healthcare workers, with higher levels related to poorer emotional wellbeing and less confidence in their coping abilities. Further research is needed to understand the relationships between healthcare workers’ health uncertainties and associated factors (i.e., job roles) and to identify whether health uncertainty may be a modifiable target for future interventions.