IMPROVE I

This study looks at the association between shift/emergency care work and staff psychological/physical health. The purpose is to evaluate the impact of Emergency Department (ED) stressors and disturbed sleep on cardiovascular and psychological risk in ED clinicians in a prospective cohort of ED clinicians, including physicians and nurses. We are examining ED stressors such as overcrowding (primary), insufficient staffing, high mean patient acuity, and patient deaths (exploratory), as well as short sleep (primary), cumulatively increased home blood pressure or HBP (primary cardiovascular outcome), and burnout (primary psychological outcome).

This study is completely remote, and participants are instructed to gather their own data using a Fitbit watch and home blood pressure machine. Participants collect data daily during a two-week “burst,” which is repeated once each year for a total of four years. Data is then submitted to the research team through an online questionnaire.

FAQs for IMPROVE I Participants

In order to support participants in our IMPROVE I study, our team has compiled the following answers to frequently asked questions about devices, apps, and more.

Account Issues  

What do I do if I can’t log into the app (OMRON/Fitbit)? It says “my account doesn’t exist.” 

Please make sure you’ve selected “Log in” and enter the provided email/password combination. If that does not work, please inform our team so we can reset your password.

I want to use my own personal account for this study, is that okay? 

We’re sorry, but no. Please log out of your existing account then log in using the email information provided by the study team. 

Fitbit Troubleshooting 

I have a rash from the Fitbit wristband. Can I get another one with different material? 

Absolutely! We have fabric wristbands that can be mailed to your address or given to you at your next shift. 

How do I restart the Fitbit?

Restart your device if you experience any of the following issues and you've checked your settings: 

  • Won't sync 
  • Won't respond to taps, swipes, or button press 
  • Won't track steps or other data 
  • Won't show notifications or reminders 

Restarting your device turns it off and on without deleting any activity data. Here is how to restart:

  1. Plug the charging cable into the USB port on your computer or any UL-certified USB wall charger. 
  2. Connect your device to the charging cable.  
  3. Press and hold the button or buttons on your tracker for five seconds. 
  4. Release the button(s). When you see a smile icon and the tracker vibrates, the tracker has restarted. 

How do I set up notifications on my mobile device? 

Inspire HR can display call, text, calendar, and app notifications from your phone to keep you informed. The phone and tracker must be within 30 feet of each other to receive notifications. Here is how to set up notifications:

  1. Check that Bluetooth on your phone is on and that your phone can receive notifications (often under Settings > Notifications). Then set up notifications following these steps: 
    1. With your tracker nearby, from the Fitbit app dashboard, tap the account icon for Inspire HR. 
    2. Tap Notifications. 
    3. Follow the on-screen instructions to pair your tracker. Inspire HR appears in the list of Bluetooth devices connected to your phone. Call, text, and calendar notifications are turned on automatically. 
  2. To turn on notifications from apps installed on your phone (including Fitbit and WhatsApp) tap App Notifications and turn on the notifications you want to see. 
    1. Note that if you have an iPhone, iPad, or Windows 10 device, Inspire HR shows notifications from all calendars synced to the Calendar app. If you have an Android phone, Inspire HR shows calendar notifications from the calendar app you choose during setup. For more information, see help.fitbit.com
  3. See incoming notifications 
    1. When your phone and Inspire HR are within range, a notification causes the tracker to vibrate: 
      1. Phone calls: the name or number of the caller scrolls once. Press the button to dismiss the notification. 
      2.  Text messages: the name of the sender scrolls once above the message. Swipe up to read the full message. 
      3. Calendar alerts: the name of the event scrolls once below the time and location. 
      4. App notifications: the name of the app or sender scrolls once above the message. Swipe up to read the full message. 

Your device shows the first 250 characters of the notification. Check your phone for the full message. 

How do I turn off the notifications on my phone? 

Turn off all notifications in the quick settings on Inspire HR, or turn off certain notifications in the Fitbit app by following these steps: 

  1. Press and hold the button on your tracker to reach the quick settings screen. 
  2. Tap Notifications to turn them off. The notifications icon dims to indicate that notifications are turned off. 

Turn off only certain notifications by following these steps:

  1. With your tracker nearby, from the Fitbit app dashboard, tap the account icon Inspire HR tile > Notifications. 
  2. Turn off the notifications you no longer want to receive on your tracker. 
  3. Tap Notifications > Inspire HR in the top left to return to device settings. Sync your tracker to save your changes. 

How can I see my sleep data in the app? 

All wrist-based Fitbit devices automatically detect your sleep when worn to bed. We recommend wearing your device in a snug wristband while sleeping; don’t wear your device in a clip or pendant accessory. When your body is completely at rest and you haven’t moved for about an hour, your Fitbit device records that you’re asleep. 

You will be able to see your averages for the week or longer periods of time for certain sleep stats, including: 

  • Hours slept: the number of hours you slept each night that week and your weekly average 
  • Sleep score: your sleep scores throughout the week and your weekly average
  • Sleep schedule: an overview of your  sleep  schedule that week (when you went to bed and when you woke up) 
  • Sleep stages: the number of hours you spent in each sleep  stage each night that week and your weekly average minutes asleep 

For sleep data on iPhones, iPads, and Android phones: 

  1. In the Fitbit app, tap the Today tab, then tap the sleep tile.
  2. Swipe through the sleep graphs at the top. On certain sleep graphs, tap the arrows to expand the graph. 
  3. Swipe right to see data from previous weeks. 
  4. Tap a length of time at the top to change the time period you want to see averages for. For example, tap 1 month to see your sleep data by the month and your monthly averages. 

For sleep data on the Fitbit device: 

  1. Swipe up from the clock face to see Fitbit Today. 
  2. Check the  sleep tile to see your sleep information. You may have to swipe up to find it. If you don't see the  sleep  tile, tap Settings at the bottom of Fitbit Today and make sure you turned on the sleep tile. 
  3. Swipe left on the  sleep  tile to see your sleep history for the past week.  

OMRON Troubleshooting

What happens if I take a reading before pairing the unit to my mobile device? 

If you take a reading before pairing the monitor to your mobile device, your data will not be saved. If you prefer to record your blood pressure manually, the study team can provide a worksheet.  

How do I use this blood pressure monitor with multiple users? 

To allow other people to use this blood pressure monitor, transfer all your readings to your OMRON connect US/CAN/EMEA app account so there are no unsent readings left in the blood pressure monitor memory. The person sharing this blood pressure monitor will need to create their own individual OMRON app account. Once the other person has their own OMRON connect US/CAN/EMEA account created, they can take their own blood pressure measurement using this device, and then pair the blood pressure monitor and transfer their readings to their OMRON connect US/CAN/EMEA account. 

Why are my readings not syncing automatically without opening the app?  

Make sure that auto-sync is turned ON in the app. To check, tap the plus (+) menu and go to the Profile Connected Devices screen. 

What if I can’t sync my device, and I’m getting an error message?

You may encounter one of the following problems or error messages:

  • I am seeing “could not find monitor message” on the app. 
  • I am continuously getting an error while syncing my blood pressure monitor. 
  • I am continuously seeing “Pairing Unsuccessful“ screen. 
  • I recently upgraded or changed my phone. 
  • I reset my monitor. 

If you are unable to pair/sync your blood pressure monitor to the OMRON connect US/CAN/EMEA mobile app, please follow these steps: 

  1. Remove the blood pressure monitor from your account with these steps:
    1. In the app, go to Profile > Connected Devices
    2.  Tap “Unpair” for the monitor you want to remove from your account. If you do not see your blood pressure monitor, then continue to Step 2. 
  2. Go to the Settings app on your smart device to remove the OMRON device from Bluetooth settings.

These are the steps to remove the blood pressure monitor from the Bluetooth Settings on iOS [Apple] smart devices:

  1. Open the Settings app on the smart device. 
  2. Locate “Bluetooth” and tap it. 
  3.  Check the list under “MY DEVICES” and find a device that starts with “HEM” or “BP” or “HN” or BCM.” 
  4. Tap the “i” button on right against the device. 
  5. Tap on “Forget This Device” button to remove from Bluetooth. 

These are the steps to remove the blood pressure monitor from Bluetooth Settings on Android smart devices. 

  1. Open the Settings app on the smart device.
  2.  Locate “Bluetooth” and tap it. 
  3. Check the list of “Paired devices” and find the device with “BP” or “HN” or “BCM” or “BLEsmart.” 
  4. Unpair the device from Bluetooth settings.

Once the steps above are completed, open the OMRON connect US/CAN/EMEA app. Go to Profile > Connected Devices and tap the “Add new device” button to pair the blood pressure monitor and start syncing your blood pressure readings. 

If you cannot find Bluetooth settings on your smart device, please check with the smart device provider.

I denied the location services prompt, and I cannot sync my data. What should I do? 

If the OMRON connect US/CAN/EMEA app prompted you to turn on location services and you denied the request, you will have to turn on location services to sync with the monitor. To tell the OMRON connect US/CAN/EMEA app that it has permission to access locations, do the following: 

  • For iOS: (Required for background data transfer only.) Go to Settings > Privacy > Location Services > Tap on “OMRON connect” app and turn ON Location. 
  • For Android: Go to Settings > Location > App permissions > Tap on “OMRON connect” app and turn ON Location. 

Reporting Your Data in “Bursts”

How many bursts do I have to do? 

We ask participants to complete their two-week data burst once a year for a total of four years. After each year we send a $150 Amazon gift card for a total of $600! We understand life can be unpredictable so if you end up leaving the Emergency Department or the NYP-Columbia system, you are still able to participate. 

I finished my burst! Now what? 

Congrats! You should receive an automated email with an invitation to complete the second survey along with instructions on how to send your blood pressure data. Once the team is alerted that the second survey is completed and we’ve received your blood pressure data, your $150 gift card will be sent via email. 

I finished my burst, but I haven’t received my gift card, what should I do? 

If you completed the second survey but haven’t heard from us or received the gift card in your inbox, please reach out to us to make sure you get your compensation. Look for an email from Trucentive in your inbox. 

Contact Us

If you have additional questions or would like more information about our study, please contact us: em-improve@cumc.columbia.edu