Evaluation of Emory University's Online Sleep Enhancement Curriculum for Students Open Access

Abstract

SleepWell@Emory - Online was a voluntary, 5-week self-improvement program offered to students by Emory University's Office of Health Promotion in the Blackboard Learn system. The interactive online course was based on a psychoeducational model intended to improve participants' sleep-related knowledge, behaviors, and beliefs during and after the course. Content included information on sleep hygiene and stimulus control instructions tailored for a college audience. This study evaluated the process and outcomes associated with piloting the online course to two student cohorts. Quantitative and qualitative data were collected through a mixed-methods approach in order to answer the evaluation questions. Outcomes were assessed through course reports and electronic pre-, post-, and 6-week post-course participant surveys. Process data was gathered through course observation, instructor communications, and participant interviews. Rates of course participation and survey completion were low and declined over time. In the two cohorts, 80% of the 65 registrants participated in some content during the course timeframe, while 11% of registrants participated in all 5 weeks. Findings indicated that participants' sleep knowledge and some key behaviors (e.g. sleep schedule consistency) and beliefs (e.g. confidence in ability to improve sleep without medication) improved during and 6 weeks after the course. Course participation was not associated with improved academic performance. School-related demands were positively correlated with a lack of course participation and stopping a learned sleep enhancing behavior 6 weeks after the course. Students perceived the course's educational materials, references, and tools as helpful and relevant. Results suggest that online content should be available to a broad audience for an extended period of time and require minimal interaction. Specific recommendations are described, including techniques for refining course content, minimizing barriers for students related to competing priorities, and expanding university partnerships. This evaluation demonstrated that an online sleep curriculum for university students offers benefits consistent with those described in the literature, and provided information on the challenges of virtually engaging and retaining students in health promotion educational practices during the academic semester.

Table of Contents

CHAPTER 1: INTRODUCTION

Introduction

1

Overview of the Problem

1

Description of the Program: SleepWell@Emory

3

Description of the Program: SleepWell@Emory - Online

7

Logic Model

12

Inputs

12

Activities

13

Outputs

14

Outcomes

14

Impact

15

Evaluation Purpose

17

Evaluation Questions

18

CHAPTER 2: REVIEW OF THE LITERATURE

Introduction

20

Empirical Foundation of the Program

20

Findings from Prior Evaluations of SleepWell@Emory

21

Similar Studies

27

Findings from in-person (face-to-face) sleep interventions with college students

28

Findings from online (internet-based) sleep interventions with adults

29

Findings from online (internet-based) sleep interventions with college students

31

Recommendations for sleep education content for college students

32

The role of theory in intervention design

34

Evidence-supported recommendations for institutions

35

CHAPTER 3: METHODOLOGY

Evaluation Process

37

Stakeholders

37

Intended Users

40

Population and Sample

41

Research Design

42

Procedures

44

Instruments

45

Registration and pre-test

45

Post-test

47 Six-week post-test 48 Data Analysis 50 Limitations and Delimitations 51

CHAPTER 4: RESULTS

Introduction 54 Findings 54 Participation 54 Withdrawals 57 Course extension 59 Assessment 59 Analysis 61

Evaluation Question 1 Is SleepWell - Online effective at increasing students' sleep-related knowledge?

62

Evaluation Question 2 Is SleepWell - Online effective at improving students' sleep-related behaviors?

65

Evaluation Question 3 Do students experience longer-term (i e six weeks or more post-course) benefits from participating in SleepWell - Online?

78

Evaluation Question 4 What is the overall user satisfaction with SleepWell - Online's course curriculum and delivery model?

89

Evaluation Question 5 What are the strengths of SleepWell - Online's course curriculum and delivery model?

95

Quality of course information 95 Adaptability of course materials 96 Ability to expand audience reach 97 Efficiencies of time and cost 98

Evaluation Question 6 What modifications, if any, should be made to SleepWell - Online's course curriculum and delivery model prior to future offerings?

99

Other Findings 101 Technology 101 Social connectedness 102 Barriers to behavior change 103 Summary 105

CHAPTER 5: CONCLUSION, IMPLICATIONS, AND RECOMMENDATIONS

Introduction 106 Summary of Findings 106 Knowledge 107 Behaviors 107 Longer-term benefits 108 Course satisfaction 109 Course delivery model 110 Implications 111 Course content 111 Online intervention 112 Course satisfaction 113 Knowledge 114 Beliefs 114 Sustained behavior change 115 Recommendations 116 Revise course timing 117 Refine curriculum 119 Streamline assessment 122 Market strategically 124 Expand partnerships 125 Future considerations 128 Summary 130 REFERENCES 132 APPENDICES

Appendix A Selected Course Screens from SleepWell@Emory - Online (2012)

135

Appendix B Emory University Student Health and Counseling Services Organizational Chart (2013)

142

Appendix C SleepWell@Emory - Online Registration and Pre-Test Survey (2012)

143

Appendix D SleepWell@Emory - Online Post-Test Survey (2012)

149

Appendix E SleepWell@Emory - Online 6-week Post-Test Survey (2012)

156

Appendix F Responses on SleepWell@Emory - Online Medical Outcomes Survey (MOS) Sleep Scale Questions (2012 - 2013)

162

About this Master's Thesis

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School	Rollins School of Public Health
Department	Career Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Education Health Sciences, Public Health Psychology, Behavioral
Keyword	online learning online intervention insomnia university health promotion program evaluation college health promotion program improvement
Committee Chair / Thesis Advisor	Baldwin, Grant T., Emory University
Committee Members	Zesiger, Heather, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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