SleepSteps Trial -- Clinical Masters or Research/Clinical PhD Opportunity

The well-being and health of each member of my team and of the people who participate with us in our research is my first priority. As a supervisor, that means I focus on designing projects with you that can be completed within the expected timeframe, schedule weekly 1:1 supervision for all masters and PhD students, agree on authorship upfront, and negotiate workload with you rather than demanding it. I want you to learn about science, conduct impactful research that can improve the lives of the communities we work with but never at the expense of enjoying your time and your work. ## Project SleepSteps is a two-stage randomised controlled trial of stepped care for insomnia in people affected by cancer. CBT-I is the best treatment we have, but there are not enough clinicians to deliver it to everyone who needs it, so we are testing a scalable, stepped care version. Stage 1 randomises people to self-management (short cancer-specific videos on a website, routed by the sleep mechanism driving their problem, with SMS prompts) or to waitlist. This is short and would be ~4 weeks. Stage 2 re-randomises anyone still symptomatic to step up to brief telehealth CBT-I, escalating to the Monash University Healthy Sleep Clinic, or to keep going with self-management. It is a hybrid effectiveness-implementation trial, so we are asking two questions at once: does it work, and could a health service actually run it. Recruitment is planned to run through social media, community organisations, and health service partners (e.g., Peter MacCallum Cancer Centre, Monash Health). ## Why this population Sleep problems after cancer are common. Stress and anxiety can make falling asleep harder or wake ups during the night longer. Chemotherapy and steroids can disrupt circadian timing. Symptoms like hot flushes, nausea, and pain can impact falling or staying asleep. At the same time, across their lifetimes, nearly 1 in 2 people will have a cancer diagnosis, so the need for help is enormous. Finally, cancer and its treatment are often burdensome, so supports and interventions that are flexible and do not take too much time to fit around the energy people have matter. Our group is committed to improving care for people living with and after cancer, and that shapes how we work. Lived experience experts are part of the trial's core team, and we aim to build a Consumer Advisory Committee as well. ## The team Beyond Joshua Wiley as main supervisor, we have a large team with a wealth of expertise, with one or more likely co-supervising. - Sleep and behavioural sleep medicine (e.g., Bei Bei, Sheila Garland, Alix Mellor) - Psycho-oncology (e.g., Maria Ftanou) - Medical Oncology (e.g., Michael Jefford, Daphne Day, Prue Francis) - Lived experience experts (e.g., Alysia Kepert, Daniel Johnstone) ## Example projects - Who does CBT-I actually work for? Model treatment moderators across 64 trials and 7,359 participants in the CBT-I IPD Collaborative dataset (already collected), then test those models in our cancer trials. - AI chat support. Benchmark the safety and accuracy of a chatbot constrained to study materials against clinician judgement. A Masters pilot is already running. - Why people engage, or don't. Interviews at each stage of the trial, deliberately including people who dropped out or barely used the program, analysed with framework methods and fed straight back into the intervention. - Correlates of sleep and cancer. Looking at baseline or screening data from the trial. - Trial effectiveness. Primary trial outcomes may be available to you depending on timelines. - Daily data and methods. We anticipate sleep diary data and perhaps wearables on a subset of participants which can feed into exploring what daily experiences and variation are. - Topics you want. We are open to talking with you about your interests and topics you want to explore that SleepSteps would have data to enable. Two papers that show the kind of work you would be building on: Bean, H. R. (former student), et al (2022). Light enhanced cognitive behavioral therapy for insomnia and fatigue during chemotherapy for breast cancer: A randomized controlled trial. https://doi.org/10.1093/sleep/zsab246 Maccora, J. (former student), et al (2022). The Sleep, Cancer and Rest (SleepCaRe) Trial: Rationale and design of a randomized, controlled trial of cognitive behavioral and bright light therapy for insomnia and fatigue in women with breast cancer receiving chemotherapy. https://doi.org/10.1016/j.cct.2022.106877 ## Research or clinical students This project can easily accommodate research only or clinical students. There is room to work directly with participants, to focus on trial design, modelling and data, or to train in and deliver clinical sleep interventions with supervision.