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Background Shift work is a necessary part of many industries; however, it can have detrimental effects on health over time. Purpose This study investigated the effect of a massage intervention on the cardiac autonomic activity and blood inflammatory markers of healthy medical residents working night shifts. Setting This trial was conducted at British Columbia Children’s and Women’s Hospital between February 2014 and June 2016. Participants Included participants were generally healthy medical residents and were working rotating night shifts on a regular basis. Research Design This was a randomized, controlled, crossover, open-label trial (NCT02247089). Interventions Participants received either a 30-min massage intervention or reading control after consecutive periods of night shift. Main Outcome Measures The primary outcome was high frequency, a proxy for the cardiac parasympathetic activity, measured via heart rate variability. Secondary outcomes included other heart rate variability measures, blood markers of inflammation, and blood pressure. Results Twelve participants were recruited (nine female) with median age of 28 years. There was no significant difference between the massage intervention and the reading control for the primary outcome, (median relative change between pre- and postmassage [interquartile range]: 62% [−1 to 150], pre- and postreading: 14% [−10 to 51], p = .16). Similarly, there was no difference with respect to blood inflammatory markers and blood pressure. Median high frequency significantly increased between pre- and postmassage (185 vs. 358 ms2, p = .04). Conclusion This pilot study found no statistically significant difference between the massage intervention and the reading control; however, we did observe a significant increase in median high frequency from before massage to after massage, indicative of increased parasympathetic activity. This study may help inform planning of larger trials evaluating massage interventions on the activity of the autonomic nervous system and managing shift work stress.

Mirkaber Mosavianpour,1–3 Hamideh Helen Sarmast,2,3 Niranjan Kissoon,1–3 Jean-Paul Collet1–3 1Department of Pediatrics, Faculty of Medicine, University of British Columbia, 2British Columbia Children’s Hospital, 3Child and Family Research Institute, Vancouver, BC, Canada Background: Theoretical domains framework (TDF) provides an integrative model for assessing barriers to behavioral changes in order to suggest interventions for improvement in behavior and ultimately outcomes. However, there are other tools that are used to assess barriers.Objective: The objective of this study is to determine the degree of concordance between domains and constructs identified in two versions of the TDF including original (2005) and refined version (2012) and independent studies of other tools.Methods: We searched six databases for articles that studied barriers to health-related behavior changes of health care professionals or the general public. We reviewed quantitative papers published in English which included their questionnaires in the article. A table including the TDF domains of both original and refined versions and related constructs was developed to serve as a reference to describe the barriers assessed in the independent studies; descriptive statistics were used to express the results.Results: Out of 552 papers retrieved, 50 were eligible to review. The barrier domains explored in these articles belonged to two to eleven domains of the refined TDF. Eighteen articles (36%) used constructs outside of the refined version. The spectrum of barrier constructs of the original TDF was broader and could meet the domains studied in 48 studies (96%). Barriers in domains of “environmental context and resources”, “beliefs about consequences”, and “social influences” were the most frequently explored in 42 (84%), 37 (74%), and 33 (66%) of the 50 articles, respectively.Conclusion: Both refined and original TDFs cataloged barriers measured by the other studies that did not use TDF as their framework. However, the original version of TDF explored a broader spectrum of barriers than the refined version. From this perspective, the original version of the TDF seems to be a more comprehensive tool for assessing barriers in practice. Keywords: theoretical domains framework, TDF, practice change, health care quality improvement, barriers