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The study will test a sleep-health intervention that leverages the science on habit formation. It will evaluate if adding a text messaging intervention improves habit formation. The participants will be 18-30 years old.
The study will test a sleep-health intervention that leverages the science on habit formation. Additionally, the investigators will evaluate whether adding a text messaging intervention improves habit formation. The participants will be 18-30 years old. This is a distinct developmental period in which priorities shift toward self-sufficiency and personal responsibility, which are supported by developing adaptive habits.
Main Aim. To evaluate if adding a text messaging intervention, derived from learning theory, to HABITs improves the utilization of sleep health behavior and improves sleep and circadian outcomes and functioning in the five health-relevant domain outcomes in the short (post-treatment) and longer term (6 and 12-months later), relative to HABITs without text messaging.
Main Hypothesis. Relative to HABITs, youth in HABITs+Texts will (a) establish stronger sleep health behavior habits, (b) report utilizing more sleep health behaviors and (c) exhibit improved sleep and circadian functioning and lower health-relevant risk. These effects will be observed at post-treatment as well as 6 and 12-months later.
Exploratory Aim: To evaluate if the Habit-based Sleep Health Intervention ('HABITs') is associated with an improvement in the utilization of sleep health behavior, an improvement in sleep and circadian outcomes and an improvement in functioning in the five health-relevant domain outcomes in the short (post-treatment) and longer term (6 and 12-months later), relative to baseline.
Exploratory Hypothesis. Combining across the HABITs and HABITs+Texts treatment arms, receiving either intervention will be associated with (a) improved sleep health behavior habits, (b) more utilization of sleep health behaviors, (c) improved sleep and circadian functioning and (d) lower health-relevant risk at post-treatment, 6- and 12-month follow-up, relative to baseline.
Additional exploratory analyses: To examine (a) if sleep health behavior that has become habitual mediates the effects of treatment on improvement in sleep, circadian and health outcomes and (b) if intervention effects are moderated by selected variables (e.g., age, sex, minority group, socioeconomic status (SES), season).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Habit-based Sleep Health Intervention (HABITs) | Experimental | Participants in this condition participate in the HABITs intervention which includes 3x50-minute weekly sessions followed by 6x30-minute weekly sessions. Participants in this group will not receive the texts discussed below. |
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| Habit-based Sleep Health Intervention plus text messages (HABITs+texts) | Experimental | Participants in this condition participate in the HABITs intervention which includes 3x50-minute weekly sessions followed by 6x30-minute weekly sessions. Additionally, participants in this group will receive the text messaging intervention. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Habit-based Sleep Health Intervention | Behavioral | A novel low-cost approach derived by leveraging the science of habit formation |
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| Measure | Description | Time Frame |
|---|---|---|
| Self-Report Automaticity Habits Index integrated with the Utilization Scale | 16-item; 0-4 scale. Scores can range from 0 to 64 (Higher score means more automaticity in utilization). | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Utilization Scale | 16-item; 0-4 scale. Scores can range from 0 to 64 (Higher score means more utilization). | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Composite Sleep Health Score | Composite Sleep Health Score which is defined as the sum of scores on 6 sleep health dimensions: Regularity (Midpoint fluctuation), Satisfaction (Sleep quality question on PROMIS-SD), Alertness (Daytime sleepiness question on PROMIS-SRI), Timing (Mean midpoint), Efficiency (Sleep efficiency) and Duration (Total Sleep Time). The Sleep Health Composite was constructed such that higher score indicates better sleep health. | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Composite Scale of Morningness | Sum of 13-item; Mix of 4-point and 5-point response scale. Scores can range from 13 (extreme evening) to 55 (extreme morning). | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Patient-Reported Outcomes Measurement Information System - Sleep Related Impairment (PROMIS-SRI) | Sum of 8-items rated on a 5-point response scale. Scores can range from 8 to 40 (Higher score means more Sleep Related impairment) | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Patient-Reported Outcomes Measurement Information System - Sleep Disturbance (PROMIS-SD) |
| Measure | Description | Time Frame |
|---|---|---|
| Pittsburgh Sleep Quality Index | 19-item. First four items are integer responses. The rest of the items are on a 0-3 scale. Creates 7 composite scores, with the sum of the composite scores ranging from 0 to 21. (Higher score means increased severity of difficulty in all sleep area components). | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Adapted version of the Work and Social Adjustment Scale (individual items) | A measure of emotional, cognitive, physical, social and behavioral risk. The 5 items are each rated on a 0-8 scale. The 5 individual item scores will be reported separately (range: 0 to 8; Higher score means worse outcome). | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Allison Harvey, PhD | University of California, Berkeley | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of California | Berkeley | California | 94703 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39563407 | Derived | Diaz M, Ovalle Patino E, Oliver S, Tiab SS, Salazar N, Song J, Dong L, Sarfan LD, Susman ES, Agnew ER, Gardner B, Harvey AG. Integrating habit science and learning theory to promote maintenance of behavior change: does adding text messages to a habit-based sleep health intervention (HABITs) improve outcomes for eveningness chronotype young adults? Study protocol for a randomized controlled trial. Trials. 2024 Nov 20;25(1):782. doi: 10.1186/s13063-024-08599-4. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Jun 11, 2026 | |
| Reset | Jul 8, 2026 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Jun 11, 2026 | Jul 8, 2026 |
| ID | Term |
|---|---|
| D021081 | Chronobiology Disorders |
| D006184 | Habits |
| ID | Term |
|---|---|
| D009422 | Nervous System Diseases |
| D001519 | Behavior |
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| Text messaging intervention | Behavioral | In addition to the Habit-based Sleep Health Intervention, the participants will also receive the text messaging intervention. |
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Sum of 8-items rated on a 5-point response scale. Scores can range from 8 to 40 (Higher score means more Sleep Disturbance) |
| Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Adapted version of the Work and Social Adjustment Scale | A measure of emotional, cognitive, physical, social and behavioral risk. The 5 items are each rated on a 0-8 scale. The 5 individual item scores will be summed into a total score (range: 0 to 40; Higher score means worse outcome). | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Sleep Diary | (Not a scale); Night-to-night variability in the mid-point of sleep | Baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Actigraphy | (Not a scale); Night-to-night variability in the mid-point of sleep | Baseline to 1-week post treatment |
| Depression, Anxiety, and Stress Scale (DASS) | Three subscales-depression, anxiety, stress-of 7 items each, ranging from 0-3 per item. Subscale scores range from 0-21. Final scores are multiplied by two. Higher scores mean worse outcomes. Total score will also be calculated. | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Brief Sensation Seeking Scale | 8-item; 5-point response scale; Scores can range from 8 to 40 (Higher score means higher sensation seeking). | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Physical Health Questionnaire | Sum of 15-item, 0-2 response scale. Scores can range from 0 to 30 (Higher score means worse physical symptoms) | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| PROMIS-Cognitive Function | 6-item; 1-5 response scale. Scores can range from 6-30 (Higher score means better cognitive functioning) | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| PROMIS-Ability to participate | 4-item; 1-5 response scale. Scores can range from 4-20 (Higher score means better social functioning) | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Ecological Momentary Assessment Composite Risk Score of Functioning - Emotion | (Not a scale) Measured via Ecological Momentary Assessment. a 16-item version of the Positive and Negative Affect Schedule will be administered. The Positivity Ratio will also be calculated. | Change from baseline to 1-week post treatment |
| Ecological Momentary Assessment Composite Risk Score of Functioning - Cognitive Domain | (Not a scale) Measured via Ecological Momentary Assessment. Concentration, distractedness and focus are rated on a 5 point scale. | Change from baseline to 1-week post treatment |
| Ecological Momentary Assessment (EMA) Composite Risk Score of Functioning - Behavioral Domain | (Not a scale) Measured via Ecological Momentary Assessment. The investigators assess eating, caffeine, alcohol, nicotine, marijuana, opioids and prescription and over the counter (OTC) stimulants and sleep aids. Participants will also be asked to list the use of additional psychoactive drugs (e.g. cocaine). The investigators tabulate the average weekly frequency and intake of each substance. | Change from baseline to 1-week post treatment |
| Ecological Momentary Assessment Composite Risk Score of Functioning - Social Domain | (Not a scale) Measured via Ecological Momentary Assessment. will assess if the participant is with anyone at the time of the call. Positivity Ratio (see EMA for Emotional Health) will be calculated when the participant is alone, with a family member or with a friend. | Change from baseline to 1-week post treatment |
| Ecological Momentary Assessment Composite Risk Score of Functioning - Physical Domain | (Not a scale) Measured via Ecological Momentary Assessment. Physical activity and sedentary behaviors will be assessed. | Change from baseline to 1-week post treatment |
| Self Report Habit Index: Primary habit bundle to build | 6 items rated on 1-5 scale. Scores can range from 1 to 30 | At the end of the 2nd through last treatment session, which starts 2 to 3 weeks after the beginning of treatment. Also at 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Self Report Habit Index: Primary habit bundle to dismantle | 6 items rated on 1-5 scale. Scores can range from 0 to 30 | At the end of the 2nd through last treatment session, which starts 2 to 3 weeks after the beginning of treatment. Also at 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Self Report Habit Index: Secondary habit bundle to build | 1 item rated on 1-5 scale. Scores can range from 1 to 5 | At the end of the 2nd through last treatment session, which starts 2 to 3 weeks after the beginning of treatment. Also at 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Self Report Habit Index: Secondary habit bundle to dismantle | 1 items rated on 1-5 scale. Scores can range from 1 to 5 | At the end of the 2nd through last treatment session, which starts 2 to 3 weeks after the beginning of treatment. Also at 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Height | (cm) | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Weight | Pounds (lbs) | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Hip circumference | (cm) | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Waist circumference | (cm) | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Sleep Diary | (Not a scale); Consensus sleep diary variables, including total sleep time, bedtime, and wake-time, calculated separately for weekdays and weekends. | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Actigraphy | (Not a scale); Sleep parameters, including sleep onset time, sleep offset time, and total sleep time, calculated separately for weekdays and weekends. | Change from baseline to 1-week post treatment |
| Sussex-Oxford Compassion Scale (SOCS) | Sum of 20-item, 5-point response scale. Scores can range from 20 to 100 (Higher score means higher compassion for self). Sub-scale items included. | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Suicidal Behavior Questionnaire - Revised | 4-item. Total scores can range from 3-18 (Higher Score means higher Suicidal ideation) Sub-scale items included. | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Alexian Brothers Urge to Self Injure Scale | 5-item. 0-6 point scale. Total scores can range from 0-30 (Higher Score means higher Suicidal ideation) | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| State authenticity | A measure of state authenticity. The 4 items are each rated on a 1-7 scale. The sum is averaged (range 1-7; higher scores mean more authenticity) | Change from baseline to 1-week post treatment, 6-month follow-up and 12-month follow-up |
| Past month estimates of sleep mid-point workfree days and night-to-night sleep variability | Questions to assess mid-point and night-to-night variability eligibility criteria | Once at baseline |
| Sleep Medication Log | Questions to assess use of medications | Once at baseline |
| Credibility Expectancy Questionnaire | first 3 items are on a 1-9 scale. The final item is on a 0-100 scale. (Higher score means the treatment was evaluated as more credible). | After the 2nd treatment session, which is 2 to 3 weeks after the beginning of treatment. Again at the post-treatment assessment which is 1-week post treatment |
| Adverse Events Checklist | 16 items to assess adverse events experienced during treatment | At the 1-week post treatment assessment only |
| Proportion of text messages read | 1 item rated from 0% to 100% | At the 1-week post treatment assessment only |
| Script Elicitation Worksheet | (Not a scale); Individualized for each patient, the worksheet includes primary and secondary habit bundles to build and dismantle (e.g., sleep-onset habits, WASO habits, rise-up habits, daytime habits, sleep efficiency habits), and strategy to dismantle primary and secondary habit bundles (e.g., substitution, removing or curtailing, reorganizing) | After starting treatment, at the end of the 1st through 3rd treatment session (week 1 through week 3 of treatment) |
| Proportion of text message prompts participants responded to | (Not a scale) Calculated as the number of times a participant responded to a text prompt, divided by the total number of text prompts sent, and multiplied by 100 to produce a percentage from 0% to 100%. In this trial, the total number of prompts sent to individual participants varied (range: 37 to 105), and the total number of responses from participants ranged from 0 to 76. | After the third treatment session to the ninth and final treatment session (week 3 to week 8) |