# Real-time intervention to reduce fatigue among Emergency Medical Service Workers

> **NIH ALLCDC R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2022 · $603,721

## Abstract

Abstract
More than half of Emergency Medical Services (EMS) workers report work-related mental and physical fatigue.
Odds of injury among fatigued EMS workers – most of which include musculoskeletal injuries and exposure to
blood borne pathogens – are nearly double that of non-fatigued workers. There is a compelling need to reduce
fatigue among EMS workers, yet few EMS organizations have a formal fatigue management program and
many may not be cost-effective or evidence-based. Recent research supports prompting EMS workers in real-
time with mobile phone text-messages to adopt alertness promoting behaviors as a strategy to manage work-
related fatigue. We recently completed two randomized trials and demonstrated feasibility and impact on work-
related fatigue using real-time text-message prompts (Clinicaltrials.gov NCT02063737 & NCT02783027).
Our overarching goals are to 1) help EMS workers reduce fatigue at work, reduce fatigue-related injury, and
improve sleep health; and 2) improve EMS organization-level fatigue risk management. Our global hypothesis
is that dissemination of tailored sleep health information combined with tailored alertness promoting strategies
in real-time can improve intra-shift fatigue, sleep health, and ultimately workplace safety culture. We base our
hypothesis on our recent pilot trial (SleepTrackTXT). In that trial, 99 of 100 enrolled EMS workers participated
for 90 days and reported sleepiness and fatigue in real-time before, during, and after scheduled shifts. Workers
prospectively documented 2,621 shifts and responded to 36,073 text-messages in real-time. Compliance with
answering text-messages was 88.1%, and end of shift fatigue was lower in the intervention group that worked
12-hour extended shifts compared to control subjects (p=0.0004). Preliminary analyses of our second trial
show findings similar to our first trial. Participants responded to 61,571 of 69,530 text-message queries (an
89% response rate; Unpublished Data), and end of shift fatigue was lower at the end of 12-hour shifts in the
intervention group compared to the control group. We seek to test effectiveness of an enhanced version of our
SleepTrackTXT intervention on work-related fatigue and sleep health indicators.
Aim 1: Determine the impact of the enhanced intervention on EMS worker fatigue and sleep health in a
cluster-randomized trial.
Aim 2: Identify worker-level and EMS agency-level conditions linked to a reduction in worker fatigue.
Aim 3: Perform exploratory analyses to determine impact of the enhanced intervention on the
incidence of work-related injury and workplace safety culture.
Significance: This proposal addresses fatigued EMS workers, for which there has been no standard for
fatigue risk management. This proposal logically builds on our pilot trial, which demonstrated feasibility, high
compliance, and a positive impact on indicators of sleep and fatigue. This proposal addresses national goals of
the National Occupational Research Agend...

## Key facts

- **NIH application ID:** 10412892
- **Project number:** 5R01OH011502-04
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Francis X. Guyette
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2022
- **Award amount:** $603,721
- **Award type:** 5
- **Project period:** 2019-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10412892

## Citation

> US National Institutes of Health, RePORTER application 10412892, Real-time intervention to reduce fatigue among Emergency Medical Service Workers (5R01OH011502-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10412892. Licensed CC0.

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