I-SLEPT: Integrated Sleep and Life Engagement Program for Transitions

About This Grant

Significance to VA: This project will create I-SLEPT (Integrated Sleep and Life Engagement Program for Transitions), a novel intervention to enhance sleep health and life engagement during the transition period following discharge from VA subacute rehabilitation. The development of I-SLEPT will be informed by both Veterans and experts. Including the Veteran perspective is essential [to reflect Veterans’ choice, ensure access to timely care, and prioritize effective care solutions to improve Veterans’ health and well-being.] Veterans are more likely to report poor sleep and medical complexities than non-Veterans [which may further complicate their readjustment to their home environment after discharge.] Innovation and Impact: VA is a leader in creating programs and interventions to support Veterans in their transitions from inpatient settings to home and the community. I-SLEPT will further add to VA efforts by being the first intervention to simultaneously target sleep health and life engagement during a vulnerable period of recovery. Experts guiding intervention development are from psychology, medicine, occupational therapy and [nursing], thus laying the groundwork for future trials where I-SLEPT is implemented by clinicians from an array of disciplines, allowing for greater accessibility and positive impact on [Veteran] health and well-being. Specific Aims: Aim 1. Define I-SLEPT and Develop Intervention [Protocol] (Years 1-2) 1.1 Identify core components of I-SLEPT integrating knowledge based on CDA-1 data, [the literature, and Veteran survey data (N=20)]. 1.2 Review and refine I-SLEPT based on Veteran feedback [(N=10)] in structured interviews. 1.3 Review and refine I-SLEPT based on expert panel feedback [(N=6)]. Aim 2. Refine I-SLEPT Intervention Protocol (Years 2-3) 2.1 Pilot I-SLEPT protocol in Veterans (N=5) discharged from VA Boston subacute rehabilitation. 2.2 Assess preliminary acceptability, [appropriateness, and feasibility] of intervention through structured interviews in Veterans. 2.3 Review and refine I-SLEPT for strength and efficiency based on preliminary results and expert panel feedback. Aim 3. Determine Proof-of-Concept for I-SLEPT Intervention (Years 3-5) 3.1 Conduct a preliminary evaluation of the I-SLEPT protocol in Veterans [(N=40)] discharged from VA Boston subacute rehabilitation. 3.2 Assess for clinically significant results of I-SLEPT intervention by examining within person changes. 3.3 Review progress of treatment with expert panelists. Methodology: The proposed study is a single arm clinical trial. Veterans aged 50+ discharged home from the subacute rehabilitation units at VA Boston’s Community Living Center will be recruited to complete [surveys and] interviews informing I-SLEPT creation (Aim 1), complete a preliminary trial (Aim 2) or complete a Proof-of- Concept trial (Aim 3). Veterans participating in Aims 2 or 3 will complete assessments of sleep health (e.g., [sleep satisfaction]) and life engagement (e.g., [participation in pleasant activities]), as well as acceptability measures. Path to Translation/Implementation: Results from this CDA-2 will provide preliminary data for future large- scale randomized controlled trials (RDT IIR Merit). Results may also inform future work adapting this intervention to other transitional phases (e.g., discharge from acute hospitalization), support Veterans across the lifespan, and support intervention implementation by staff from multiple disciplines [and specialties], including nursing, social work, physical therapy, occupational therapy, [and Veteran peer specialists].