An interventional study of FSSB/Sleep Leadership Training and Actigraphy Feedback in Well-Being, Sleep and Health Behavior, sponsored by Oregon Health and Science University. Completed at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-01-03.
Sponsored by Oregon Health and Science University · Not applicable, Interventional, and Prevention
This study is a randomized controlled trial that assesses the effects of (1) the Family-Supportive Supervisor Behavior (FSSB) and Sleep Leadership training and (2) sleep/cognitive effectiveness feedback intervention on health and well-being among full-time employees in the Oregon National Guard, their supervisors, and their families. The interventions involving both health protection and health promotion are expected to contribute to improvements in employees' and their supervisors' sleep, risk behaviors, mental and physical health, and injury, as well as employees' and their spouse/partners' family experiences, health and well-being, and workplace outcomes.
The overall goal of the Military Employee Sleep and Health (MESH) study is to improve safety, health and well-being of service members in the Oregon National Guard and their families. The MESH Study seeks to do this by training supervisors to support Oregon National Guard service members by focusing on a reduction in work-life stress while increasing sleep health.
The Oregon MESH Study proposes that leadership can influence a fundamental change in the recognition of sleep health and service members' overall well-being and the well-being of their family members. With the support of the Oregon National Guard, the MESH Study will provide family-support and sleep leadership training for supervisors while raising awareness of sleep through daily non-invasive sleep measurements.
The investigators of the Oregon MESH Study expect positive results for study participants, including reduced stress and increased social support. Longer term, these effects are expected to create a more supportive work environment, which has positive effects on safety, health, well-being, family, and organizational outcomes. The investigators also expect that providing service members with individual sleep feedback will reduce sleep problems and improve sleep awareness.
Oregon Health and Science University is the lead sponsor of 676 studies on the registry; 136 are open to participants now.
Of its 49 completed or terminated interventional studies of FDA-regulated products, 36 (73%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
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Supervisors in the intervention group will go through the FSSB/sleep leadership training and receive actigraphy feedback.
Behavioral: FSSB/Sleep Leadership Training · Behavioral: Actigraphy Feedback
Employees in the intervention group will receive actigraphy feedback.
Behavioral: Actigraphy Feedback
Supervisor training and actigraphy feedback provided AFTER final 9 month data collection.
Supervisors will receive a training addressing family-supportive supervisor behaviors and sleep leadership.
Supervisors and employees will receive personalized feedback on their sleep and activity measurements.
Self-Reported Sleep Duration
Total number of hours calculated from reported bed time and wake time. Minimum 0 hours, Maximum 24 hours. Longer duration indicates longer sleep duration. Ideal range is 7-9 hours of sleep per night.
Time frame: 4 months
Self-Reported Sleep Duration
Total number of hours calculated from reported bed time and wake time. Minimum 0 hours, Maximum 24 hours. Longer duration indicates longer sleep duration. Ideal range is 7-9 hours of sleep per night.
Time frame: 9 months
Patient Reported Outcomes Measurement Information System (PROMIS): Sleep Disturbance Insomnia Subscale
Four item subscale of the larger 8 item Sleep Disturbance scale. Likert-type responses: 1 = Not at all to 5 = Very much). T-Scores were created using HealthMeasures Scoring service, where data are uploaded into the HealthMeasures scoring service website, which generates T-Scores. This is considered the most accurate option. T-Scores estimates were developed using a population of 2,252 participants, 259 of which had clinical sleep disorders, and was intended to be representative of the US population. This is the reference population that the T-score means and SDs were calibrated and centered with. The T-Scores that HealthMeasures generates are not precisely at a mean of 50 and standard deviation of 10 because they are based on the unique MESH samples. A higher PROMIS T-score represents more of the concept being measured (worse).
Time frame: 4 months
Patient Reported Outcomes Measurement Information System (PROMIS): Sleep Disturbance Insomnia Subscale
Four item subscale of the larger 8 item Sleep Disturbance scale. Likert-type responses: 1 = Not at all to 5 = Very much). T-Scores were created using HealthMeasures Scoring service, where data are uploaded into the HealthMeasures scoring service website, which generates T-Scores. This is considered the most accurate option. T-Scores estimates were developed using a population of 2,252 participants, 259 of which had clinical sleep disorders, and was intended to be representative of the US population. This is the reference population that the T-score means and SDs were calibrated and centered with. The T-Scores that HealthMeasures generates are not precisely at a mean of 50 and standard deviation of 10 because they are based on the unique MESH samples. A higher PROMIS T-score represents more of the concept being measured.
Time frame: 9 months
Patient Reported Outcomes Measurement Information System (PROMIS): Dissatisfaction With Sleep Subscale
Four item subscale of the larger 8 item Sleep Disturbance scale. Likert-type responses: 1 = Not at all to 5 = Very much. T-Scores were created using HealthMeasures Scoring service, where data are uploaded into the HealthMeasures scoring service website, which generates T-Scores. This is considered the most accurate option. T-Scores estimates were developed using a population of 2,252 participants, 259 of which had clinical sleep disorders, and was intended to be representative of the US population. This is the reference population that the T-score means and SDs were calibrated and centered with. The T-Scores that HealthMeasures generates are not precisely at a mean of 50 and standard deviation of 10 because they are based on the unique MESH samples. A higher PROMIS T-score represents more of the concept being measured (worse).
Time frame: 4 months
Patient Reported Outcomes Measurement Information System (PROMIS): Dissatisfaction With Sleep Subscale
Four item subscale of the larger 8 item Sleep Disturbance scale. Likert-type responses: 1 = Not at all to 5 = Very much). T-Scores were created using HealthMeasures Scoring service, where data are uploaded into the HealthMeasures scoring service website, which generates T-Scores. This is considered the most accurate option. T-Scores estimates for Dissatisfaction with Sleep were developed using a population of 2,252 participants, 259 of which had clinical sleep disorders, and was intended to be representative of the US population. This is the reference population that the T-score means and SDs were calibrated and centered with. The T-Scores that HealthMeasures generates are not precisely at a mean of 50 and standard deviation of 10 because they are based on the unique MESH samples. A higher PROMIS T-score represents more of the concept being measured (worse).
Time frame: 9 months
Patient Reported Outcomes Measurement Information System (PROMIS): Sleep Related Impairment Subscale (SRI)
8 item scale. Likert-type responses: 1 = Not at all to 5 = Very much). T-Scores were created using HealthMeasures Scoring service, where data are uploaded into the HealthMeasures scoring service website, which generates T-Scores. This is considered the most accurate option. T-Scores estimates for SRI were developed using a population of 2,252 participants, 259 of which had clinical sleep disorders, and was intended to be representative of the US population. This is the reference population that the T-score means and SDs were calibrated and centered with. The T-Scores that HealthMeasures generates are not precisely at a mean of 50 and standard deviation of 10 because they are based on the unique MESH samples. A higher PROMIS T-score represents more sleep impairment (worse).
Time frame: 4 months
Patient Reported Outcomes Measurement Information System (PROMIS): Sleep Related Impairment Subscale (SRI)
8 item scale. Likert-type responses: 1 = Not at all to 5 = Very much). T-Scores were created using HealthMeasures Scoring service, where data are uploaded into the HealthMeasures scoring service website, which generates T-Scores. This is considered the most accurate option. T-Scores estimates for SRI were developed using a population of 2,252 participants, 259 of which had clinical sleep disorders, and was intended to be representative of the US population. This is the reference population that the T-score means and SDs were calibrated and centered with. The T-Scores that HealthMeasures generates are not precisely at a mean of 50 and standard deviation of 10 because they are based on the unique MESH samples. A higher PROMIS T-score represents more sleep impairment (worse).
Time frame: 9 months
Actigraphic Sleep Duration: Total Sleep Time (TST)
Actigraphic measurements obtained using Actiwatch2 worn for 3 weeks Average sleep duration in hours Great duration generally better, with target range of 7-9 hours each sleep period.
Time frame: 9 months
Actigraphic Sleep Efficiency: Wake After Sleep Onset (WASO)
Actigraphic measurements obtained using Actiwatch2 worn for 3 weeks Average number of minutes spent awake during the sleep period. More minutes indicates worse outcome.
Time frame: 9-months
Overall Job Satisfaction Scale
Service member satisfaction with current job; Likert-type scale 1 = Strongly disagree to 5 = Strongly agree, mean created from the 3 items. Scores could range from 0-5 with higher levels indicating greater satisfaction. Source: Cammann et al., 1983
Time frame: 9-months
Turnover Intentions
Service member intention to quit current job; Two items with responses on Likert-type scale 1 = Strongly disagree to 5 = Strongly agree. Overall score created with a mean of the two items, with higher levels indicating greater intention to leave one's job. Source: Boroff \& Lewin, 1997
Time frame: 9-months
Perceived Stress Scale
Service member self-reported stress; Likert-type scale 0 = Never to 4 = Very often, combined to a mean score, with a possible range from 0 to 4. Higher scores indicate greater stress (worse). Source: Cohen \& Williamson, 1988
Time frame: 9-months
Walter Reed Functional Impairment: Occupational Subscale (OFI)
Service member difficulty with completing work tasks and quality; 6 items with Likert-type responses: 1 = No difficulty at all to 5 = Extreme difficulty, mean score created from all items, with possible score range from 1 to 5. Higher levels indicating greater impairment (worse). Source: Subscale of Overall Functional Impairment by Herrell et al., 2014
Time frame: 9-months
Walter Reed Functional Impairment Scale: Personal Functioning Subscale (PFI)
Service member difficulty with getting personal life skills completed; 2 items with Likert-type responses: 1 = No difficulty at all to 5 = Extreme difficulty, mean score created from all items, with possible score range from 1 to 5. Higher levels indicating greater impairment (worse). Source: Subscale of Overall Functional Impairment by Herrell et al., 2014
Time frame: 9-months
Walter Reed Functional Impairment Scale: Social Functional Impairment Subscale (SFI)
Service member difficulty functioning in social situations; 4 items with Likert-type responses: 1 = No difficulty at all to 5 = Extreme difficulty, mean score created from all items, with possible score range from 1 to 5. Higher levels indicating greater impairment (worse). Source: Subscale of Overall Functional Impairment by Herrell et al., 2014
Time frame: 9-months
Family Supportive Supervisor Behaviors (FSSB)
Perceived supervisor support for work-family integration as reported by service member, 4 items, with responses on Likert-type scale 1=Strongly disagree to 5= Strongly agree, overall score created by mean score, with possible scores ranging from 1 to 5.. Higher scores indicating higher levels of support (better) Source: Hammer et al., 2013
Time frame: 4-months
Sleep Leadership
Perceived supervisor support for sleep health as reported by service member, 8 items, with responses on Likert-type scale 1=Never to 5= Always, overall score created by mean score, with possible scores ranging from 1 to 5.. Higher scores indicating higher levels of support (better) Source: Modified version of Gunia et al., 2015
Time frame: 4-months
| Milestone | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Started | 358 | 346 |
| Completed | 295 | 289 |
| Not completed | 63 | 57 |
| Milestone | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Started | 295 | 289 |
| Completed | 275 | 274 |
| Not completed | 20 | 15 |
Total number of hours calculated from reported bed time and wake time. Minimum 0 hours, Maximum 24 hours. Longer duration indicates longer sleep duration. Ideal range is 7-9 hours of sleep per night.
| Hours | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Self-Reported Sleep Duration | 7.43 ± 1.10 | 7.34 ± 1.13 |
Total number of hours calculated from reported bed time and wake time. Minimum 0 hours, Maximum 24 hours. Longer duration indicates longer sleep duration. Ideal range is 7-9 hours of sleep per night.
| Hours | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Self-Reported Sleep Duration | 7.50 ± 1.15 | 7.39 ± 1.21 |
Four item subscale of the larger 8 item Sleep Disturbance scale. Likert-type responses: 1 = Not at all to 5 = Very much). T-Scores were created using HealthMeasures Scoring service, where data are uploaded into the HealthMeasures scoring service website, which generates T-Scores. This is considered the most accurate option. T-Scores estimates were developed using a population of 2,252 participants, 259 of which had clinical sleep disorders, and was intended to be representative of the US population. This is the reference population that the T-score means and SDs were calibrated and centered with. The T-Scores that HealthMeasures generates are not precisely at a mean of 50 and standard deviation of 10 because they are based on the unique MESH samples. A higher PROMIS T-score represents more of the concept being measured (worse).
| t score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Patient Reported Outcomes Measurement Information System (PROMIS): Sleep Disturbance Insomnia Subscale | 50.90 ± 8.65 | 51.78 ± 8.01 |
Four item subscale of the larger 8 item Sleep Disturbance scale. Likert-type responses: 1 = Not at all to 5 = Very much). T-Scores were created using HealthMeasures Scoring service, where data are uploaded into the HealthMeasures scoring service website, which generates T-Scores. This is considered the most accurate option. T-Scores estimates were developed using a population of 2,252 participants, 259 of which had clinical sleep disorders, and was intended to be representative of the US population. This is the reference population that the T-score means and SDs were calibrated and centered with. The T-Scores that HealthMeasures generates are not precisely at a mean of 50 and standard deviation of 10 because they are based on the unique MESH samples. A higher PROMIS T-score represents more of the concept being measured.
| t score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Patient Reported Outcomes Measurement Information System (PROMIS): Sleep Disturbance Insomnia Subscale | 51.63 ± 8.48 | 52.00 ± 8.21 |
Four item subscale of the larger 8 item Sleep Disturbance scale. Likert-type responses: 1 = Not at all to 5 = Very much. T-Scores were created using HealthMeasures Scoring service, where data are uploaded into the HealthMeasures scoring service website, which generates T-Scores. This is considered the most accurate option. T-Scores estimates were developed using a population of 2,252 participants, 259 of which had clinical sleep disorders, and was intended to be representative of the US population. This is the reference population that the T-score means and SDs were calibrated and centered with. The T-Scores that HealthMeasures generates are not precisely at a mean of 50 and standard deviation of 10 because they are based on the unique MESH samples. A higher PROMIS T-score represents more of the concept being measured (worse).
| t score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Patient Reported Outcomes Measurement Information System (PROMIS): Dissatisfaction With Sleep Subscale | 52.28 ± 8.06 | 53.27 ± 7.98 |
Four item subscale of the larger 8 item Sleep Disturbance scale. Likert-type responses: 1 = Not at all to 5 = Very much). T-Scores were created using HealthMeasures Scoring service, where data are uploaded into the HealthMeasures scoring service website, which generates T-Scores. This is considered the most accurate option. T-Scores estimates for Dissatisfaction with Sleep were developed using a population of 2,252 participants, 259 of which had clinical sleep disorders, and was intended to be representative of the US population. This is the reference population that the T-score means and SDs were calibrated and centered with. The T-Scores that HealthMeasures generates are not precisely at a mean of 50 and standard deviation of 10 because they are based on the unique MESH samples. A higher PROMIS T-score represents more of the concept being measured (worse).
| t score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Patient Reported Outcomes Measurement Information System (PROMIS): Dissatisfaction With Sleep Subscale | 52.26 ± 7.79 | 53.32 ± 7.68 |
8 item scale. Likert-type responses: 1 = Not at all to 5 = Very much). T-Scores were created using HealthMeasures Scoring service, where data are uploaded into the HealthMeasures scoring service website, which generates T-Scores. This is considered the most accurate option. T-Scores estimates for SRI were developed using a population of 2,252 participants, 259 of which had clinical sleep disorders, and was intended to be representative of the US population. This is the reference population that the T-score means and SDs were calibrated and centered with. The T-Scores that HealthMeasures generates are not precisely at a mean of 50 and standard deviation of 10 because they are based on the unique MESH samples. A higher PROMIS T-score represents more sleep impairment (worse).
| t score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Patient Reported Outcomes Measurement Information System (PROMIS): Sleep Related Impairment Subscale (SRI) | 51.10 ± 9.58 | 52.33 ± 8.66 |
8 item scale. Likert-type responses: 1 = Not at all to 5 = Very much). T-Scores were created using HealthMeasures Scoring service, where data are uploaded into the HealthMeasures scoring service website, which generates T-Scores. This is considered the most accurate option. T-Scores estimates for SRI were developed using a population of 2,252 participants, 259 of which had clinical sleep disorders, and was intended to be representative of the US population. This is the reference population that the T-score means and SDs were calibrated and centered with. The T-Scores that HealthMeasures generates are not precisely at a mean of 50 and standard deviation of 10 because they are based on the unique MESH samples. A higher PROMIS T-score represents more sleep impairment (worse).
| t score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Patient Reported Outcomes Measurement Information System (PROMIS): Sleep Related Impairment Subscale (SRI) | 50.91 ± 9.12 | 51.91 ± 8.33 |
Actigraphic measurements obtained using Actiwatch2 worn for 3 weeks Average sleep duration in hours Great duration generally better, with target range of 7-9 hours each sleep period.
| Hours | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Actigraphic Sleep Duration: Total Sleep Time (TST) | 6.65 ± .79 | 6.54 ± .96 |
Actigraphic measurements obtained using Actiwatch2 worn for 3 weeks Average number of minutes spent awake during the sleep period. More minutes indicates worse outcome.
| Minutes | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Actigraphic Sleep Efficiency: Wake After Sleep Onset (WASO) | 42.76 ± 13.90 | 42.71 ± 13.73 |
Service member satisfaction with current job; Likert-type scale 1 = Strongly disagree to 5 = Strongly agree, mean created from the 3 items. Scores could range from 0-5 with higher levels indicating greater satisfaction. Source: Cammann et al., 1983
| score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Overall Job Satisfaction Scale | 3.86 ± .82 | 3.80 ± .94 |
Service member intention to quit current job; Two items with responses on Likert-type scale 1 = Strongly disagree to 5 = Strongly agree. Overall score created with a mean of the two items, with higher levels indicating greater intention to leave one's job. Source: Boroff \& Lewin, 1997
| score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Turnover Intentions | 2.25 ± 1.00 | 2.32 ± 1.27 |
Service member self-reported stress; Likert-type scale 0 = Never to 4 = Very often, combined to a mean score, with a possible range from 0 to 4. Higher scores indicate greater stress (worse). Source: Cohen \& Williamson, 1988
| score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Perceived Stress Scale | 1.35 ± .71 | 1.38 ± .67 |
Service member difficulty with completing work tasks and quality; 6 items with Likert-type responses: 1 = No difficulty at all to 5 = Extreme difficulty, mean score created from all items, with possible score range from 1 to 5. Higher levels indicating greater impairment (worse). Source: Subscale of Overall Functional Impairment by Herrell et al., 2014
| score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Walter Reed Functional Impairment: Occupational Subscale (OFI) | 1.79 ± .77 | 1.73 ± .76 |
Service member difficulty with getting personal life skills completed; 2 items with Likert-type responses: 1 = No difficulty at all to 5 = Extreme difficulty, mean score created from all items, with possible score range from 1 to 5. Higher levels indicating greater impairment (worse). Source: Subscale of Overall Functional Impairment by Herrell et al., 2014
| score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Walter Reed Functional Impairment Scale: Personal Functioning Subscale (PFI) | 1.66 ± .67 | 1.68 ± .69 |
Service member difficulty functioning in social situations; 4 items with Likert-type responses: 1 = No difficulty at all to 5 = Extreme difficulty, mean score created from all items, with possible score range from 1 to 5. Higher levels indicating greater impairment (worse). Source: Subscale of Overall Functional Impairment by Herrell et al., 2014
| score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Walter Reed Functional Impairment Scale: Social Functional Impairment Subscale (SFI) | 1.55 ± .70 | 1.54 ± .68 |
Perceived supervisor support for work-family integration as reported by service member, 4 items, with responses on Likert-type scale 1=Strongly disagree to 5= Strongly agree, overall score created by mean score, with possible scores ranging from 1 to 5.. Higher scores indicating higher levels of support (better) Source: Hammer et al., 2013
| score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Family Supportive Supervisor Behaviors (FSSB) | 4.12 ± .91 | 3.98 ± .94 |
Perceived supervisor support for sleep health as reported by service member, 8 items, with responses on Likert-type scale 1=Never to 5= Always, overall score created by mean score, with possible scores ranging from 1 to 5.. Higher scores indicating higher levels of support (better) Source: Modified version of Gunia et al., 2015
| score on a scale | Intervention Combined: Service Member/Employees | Waitlist Control |
|---|---|---|
| Sleep Leadership | 2.54 ± 1.05 | 2.32 ± .95 |
Collected over 9 months. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Intervention Combined: Service Member/Employees | 0/358 (0%) | 0/358 (0%) | 0/358 (0%) |
| Waitlist Control | 0/346 (0%) | 0/346 (0%) | 0/346 (0%) |
| Age, Continuous(years) | Intervention Combined: Service Member/Employees | Waitlist Control | Total |
|---|---|---|---|
| Mean | 35.94 ± 8.98 | 36.49 ± 9.18 | 36.21 ± 9.08 |
| Sex: Female, Male(Participants) | Intervention Combined: Service Member/Employees | Waitlist Control | Total |
|---|---|---|---|
| Female | 90 | 87 | 177 |
| Male | 267 | 259 | 526 |
| Race/Ethnicity, Customized(Participants) | Intervention Combined: Service Member/Employees | Waitlist Control | Total |
|---|---|---|---|
| Dichotomized Race/Ethnicity — White | 289 | 276 | 565 |
| Dichotomized Race/Ethnicity — Non-White/Multiple | 67 | 68 | 135 |
| Region of Enrollment(participants) | Intervention Combined: Service Member/Employees | Waitlist Control | Total |
|---|---|---|---|
| United States | 358 | 346 | 704 |
| Self-Reported Sleep Duration(Hours) | Intervention Combined: Service Member/Employees | Waitlist Control | Total |
|---|---|---|---|
| Mean | 7.29 ± 1.09 | 7.28 ± 1.06 | 7.28 ± 1.08 |
| Patient Reported Outcomes Measurement Information System (PROMIS): Sleep Disturbance Insomnia Subsca(units on a scale) | Intervention Combined: Service Member/Employees | Waitlist Control | Total |
|---|---|---|---|
| Mean | 52.47 ± 8.52 | 52.79 ± 7.86 | 52.63 ± 8.20 |
| Patient Reported Outcomes Measurement Information System (PROMIS): Dissatisfaction With Sleep Subsca(units on a scale) | Intervention Combined: Service Member/Employees | Waitlist Control | Total |
|---|---|---|---|
| Mean | 53.88 ± 7.68 | 54.08 ± 7.33 | 53.98 ± 7.51 |
| Patient Reported Outcomes Measurement Information System (PROMIS): Sleep Related Impairment Subscale(units on a scale) | Intervention Combined: Service Member/Employees | Waitlist Control | Total |
|---|---|---|---|
| Mean | 53.07 ± 8.85 | 53.35 ± 8.40 | 53.21 ± 8.63 |
8 further baseline measures are reported on the registry.
Documents are hosted by the registry — open the source record to download them.
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Oregon Health and Science University