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Project Title:  Standardized Behavioral Measures for Detecting Behavioral Health Risks during Exploration Missions Reduce
Images: icon  Fiscal Year: FY 2022 
Division: Human Research 
Research Discipline/Element:
HRP HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Start Date: 07/21/2015  
End Date: 09/30/2022  
Task Last Updated: 05/23/2022 
Download report in PDF pdf
Principal Investigator/Affiliation:   Dinges, David F. Ph.D. / University of Pennsylvania 
Address:  Department of Psychiatry 
423 Service Dr., 1013 Blockley Hall 
Philadelphia , PA 19104-4209 
Email: dinges@pennmedicine.upenn.edu 
Phone: 215-898-9949  
Congressional District:
Web:  
Organization Type: UNIVERSITY 
Organization Name: University of Pennsylvania 
Joint Agency:  
Comments:  
Co-Investigator(s)
Affiliation: 
Basner, Mathias  M.D. University of Pennsylvania 
Mollicone, Daniel  Ph.D. Pulsar Informatics, Inc. 
Stuster, Jack  Ph.D. Anacapa Sciences, Inc. 
Strangman, Gary  Ph.D. Harvard Medical School 
Stahn, Alexander  Ph.D. University of Pennsylvania 
Gur, Ruben  Ph.D. University of Pennsylvania 
Project Information: Grant/Contract No. NNX15AK76A 
Responsible Center: NASA JSC 
Grant Monitor: Whitmire, Alexandra  
Center Contact:  
alexandra.m.whitmire@nasa.gov 
Solicitation / Funding Source: 2013-14 HERO NNJ13ZSA002N-BMED Behavioral Health & Performance 
Grant/Contract No.: NNX15AK76A 
Project Type: FLIGHT,GROUND 
Flight Program: ISS 
TechPort: No 
No. of Post Docs:
No. of PhD Candidates:
No. of Master's Candidates:
No. of Bachelor's Candidates:
No. of PhD Degrees:
No. of Master's Degrees:
No. of Bachelor's Degrees:
Human Research Program Elements: (1) HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Human Research Program Risks: (1) Bmed:Risk of Adverse Behavioral Conditions and Psychiatric Disorders
(2) Team:Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team (IRP Rev F)
Human Research Program Gaps: (1) BMed-102:Given exposures to spaceflight hazards (space radiation, isolation), how do we identify individual susceptibility, monitor molecular/biomarkers and acceptable thresholds, and validate behavioral health and CNS/neurological/neuropsychological performance measures and domains of relevance to exploration class missions? (IRP Rev L)
(2) BMed-105:Given the potentially negative spaceflight associated CNS/cognitive changes and behavioral experiences of stressors during long-duration missions (e.g., isolation, confinement, reduced sensory stimulation, altered gravity, space radiation), what are validated medical or dietary countermeasures to mitigate stressors impacting on CNS / cognition / behavioral health? (IRP Rev L)
(3) Team-102:We need to identify a set of quantifiable and validated measures, based on 5-12 key indicators of mission-relevant and identified spaceflight acceptable thresholds (or ranges) of team function, to effectively monitor and measure team health and performance of integrated NASA and commercial/private crews, during shifting autonomy in increasingly earth independent, long duration exploration missions (IRP Rev L)
Flight Assignment/Project Notes: NOTE: End date changed to 9/30/2022 per L. Barnes-Moten/JSC (Ed., 4/7/21)

NOTE: End date changed to 2/28/2021 per PI and NSSC information (Ed., 5/20/2020)

NOTE: End date changed to 2/28/2020 per NSSC information (Ed., 5/22/19)

NOTE: End date changed to 7/20/2019 per NSSC information (Ed., 8/10/18)

NOTE: Element change to Human Factors & Behavioral Performance; previously Behavioral Health & Performance (Ed., 1/18/17)

Task Description: The success of long-duration spaceflight missions depends on astronauts’ abilities to appropriately respond to and cope with a variety of behavioral and psychosocial stressors throughout the mission, including prolonged confinement, isolation, and threat to life (Slack KJ, Williams TJ, Schneiderman JS, et al. Risk of adverse cognitive or behavioral conditions and psychiatric disorders: Evidence report. 2016.). NASA simulates these stressors in spaceflight analog environments to examine individual behavioral responses with the ultimate goal of predicting, preventing, and mitigating the consequences of these stressors during spaceflight. The space exploration analog missions we and others have studied for NASA have varied in duration (i.e., from 1 month to 14 months) and in the severity of stressors (e.g., magnitude of confinement, social isolation). To evaluate astronaut behavioral health and performance, NASA developed “Standardized Behavioral Measures,” (SBM) which is a battery of neurobehavioral assessments that probe astronaut neurocognitive and operational performance, as well as astronaut behavioral health and team cohesion.

Upon the completion of the original “Standardized Behavioral Measures for Detecting Behavioral Health Risks during Exploration Missions” project, we initiated two supplemental studies: (1) Data harmonization of the SBM across long duration spaceflight analogs; (2) Continued collection of the Robotic On-Board Trainer for Research (ROBoT-r) from astronauts on the International Space Station (ISS).

Research Impact/Earth Benefits: This project will deliver a suite of Standardized Behavioral Measures (SBM) that will be tested for feasibility, flexibility, and acceptability in research studies in both short and long duration space analog environments and on the International Space Station (ISS). With the SBM, it will be possible for NASA's HFBP (Human Factors & Behavioral Performance) program to much better assess and quantify the Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Outcomes for exploration class missions.

With the proposed work we will relevantly contribute to Human Research Program's (HRP) goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. More specifically, the SBM will constitute an important technology to provide mission planners and system developers with strategies for monitoring and mitigating crew health and performance risks.

Additionally, Standardized Behavioral Measures could be beneficial for monitoring behavioral health during Earth-based operations, especially those involving isolated, confined, and extreme environments (e.g., Antarctic research expeditions).

Task Progress & Bibliography Information FY2022 
Task Progress: (1) The data to be harmonized from the original sites and the 2018 and 2019 14-month missions in the Antarctic Neumayer Station III (Neumayer) are currently in the process of being compiled and the meta data is being generated. We are meeting regularly with our statistician, to discuss the dimensionality reduction technique and potential issues of combining the outcomes of the Standardized Behavioral Measures (SBM) into a single long-form database. These issues and their solutions have been recorded and will be included in the final report. We gained approval to use data collected from astronauts who participated in the Reaction SelfTest study on the International Space Station (ISS) through presentation of the project to the Lifetime Surveillance of Astronaut Health (LSAH) Advisory Board. We are in the process of submitting the Institutional Review Board (IRB) application for approval to use astronaut data.

(2) The task is proceeding smoothly with NASA Research Operations and Integration (ROI) and Dynamic Skills Trainer (DST) support. Subjects are being scheduled and run, while data is being processed, and preliminary analyses are being conducted. We were delayed by COVID-19 overall but are reasonably on schedule. We have planned data collection, and developed the initial version of the code for conducting group analysis on subjects.

Bibliography Type: Description: (Last Updated: 05/20/2022) 

Show Cumulative Bibliography Listing
 
 None in FY 2022
Project Title:  Standardized Behavioral Measures for Detecting Behavioral Health Risks during Exploration Missions Reduce
Images: icon  Fiscal Year: FY 2021 
Division: Human Research 
Research Discipline/Element:
HRP HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Start Date: 07/21/2015  
End Date: 09/30/2022  
Task Last Updated: 07/23/2021 
Download report in PDF pdf
Principal Investigator/Affiliation:   Dinges, David F. Ph.D. / University of Pennsylvania 
Address:  Department of Psychiatry 
423 Service Dr., 1013 Blockley Hall 
Philadelphia , PA 19104-4209 
Email: dinges@pennmedicine.upenn.edu 
Phone: 215-898-9949  
Congressional District:
Web:  
Organization Type: UNIVERSITY 
Organization Name: University of Pennsylvania 
Joint Agency:  
Comments:  
Co-Investigator(s)
Affiliation: 
Basner, Mathias  M.D. University of Pennsylvania 
Mollicone, Daniel  Ph.D. Pulsar Informatics, Inc. 
Stuster, Jack  Ph.D. Anacapa Sciences, Inc. 
Strangman, Gary  Ph.D. Harvard Medical School 
Stahn, Alexander  Ph.D. University of Pennsylvania 
Gur, Ruben  Ph.D. University of Pennsylvania 
Project Information: Grant/Contract No. NNX15AK76A 
Responsible Center: NASA JSC 
Grant Monitor: Whitmire, Alexandra  
Center Contact:  
alexandra.m.whitmire@nasa.gov 
Solicitation / Funding Source: 2013-14 HERO NNJ13ZSA002N-BMED Behavioral Health & Performance 
Grant/Contract No.: NNX15AK76A 
Project Type: FLIGHT,GROUND 
Flight Program: ISS 
TechPort: No 
No. of Post Docs:
No. of PhD Candidates:
No. of Master's Candidates:
No. of Bachelor's Candidates:
No. of PhD Degrees:
No. of Master's Degrees:
No. of Bachelor's Degrees:
Human Research Program Elements: (1) HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Human Research Program Risks: (1) Bmed:Risk of Adverse Behavioral Conditions and Psychiatric Disorders
(2) Team:Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team (IRP Rev F)
Human Research Program Gaps: (1) BMed-102:Given exposures to spaceflight hazards (space radiation, isolation), how do we identify individual susceptibility, monitor molecular/biomarkers and acceptable thresholds, and validate behavioral health and CNS/neurological/neuropsychological performance measures and domains of relevance to exploration class missions? (IRP Rev L)
(2) BMed-105:Given the potentially negative spaceflight associated CNS/cognitive changes and behavioral experiences of stressors during long-duration missions (e.g., isolation, confinement, reduced sensory stimulation, altered gravity, space radiation), what are validated medical or dietary countermeasures to mitigate stressors impacting on CNS / cognition / behavioral health? (IRP Rev L)
(3) Team-102:We need to identify a set of quantifiable and validated measures, based on 5-12 key indicators of mission-relevant and identified spaceflight acceptable thresholds (or ranges) of team function, to effectively monitor and measure team health and performance of integrated NASA and commercial/private crews, during shifting autonomy in increasingly earth independent, long duration exploration missions (IRP Rev L)
Flight Assignment/Project Notes: NOTE: End date changed to 9/30/2022 per L. Barnes-Moten/JSC (Ed., 4/7/21)

NOTE: End date changed to 2/28/2021 per PI and NSSC information (Ed., 5/20/2020)

NOTE: End date changed to 2/28/2020 per NSSC information (Ed., 5/22/19)

NOTE: End date changed to 7/20/2019 per NSSC information (Ed., 8/10/18)

NOTE: Element change to Human Factors & Behavioral Performance; previously Behavioral Health & Performance (Ed., 1/18/17)

Task Description: The success of long-duration spaceflight missions depends on astronauts’ abilities to appropriately respond to and cope with a variety of behavioral and psychosocial stressors throughout the mission, including prolonged confinement, isolation, and threat to life (Slack KJ, Williams TJ, Schneiderman JS, et al. Risk of adverse cognitive or behavioral conditions and psychiatric disorders: Evidence report. 2016.). NASA simulates these stressors in spaceflight analog environments to examine individual behavioral responses with the ultimate goal of predicting, preventing, and mitigating the consequences of these stressors during spaceflight. The space exploration analog missions we and others have studied for NASA have varied in duration (i.e., from 1 month to 14 months) and in the severity of stressors (e.g., magnitude of confinement, social isolation). To evaluate astronaut behavioral health and performance, NASA developed “Standardized Behavioral Measures,” (SBM) which is a battery of neurobehavioral assessments that probe astronaut neurocognitive and operational performance, as well as astronaut behavioral health and team cohesion.

Upon the completion of the original “Standardized Behavioral Measures for Detecting Behavioral Health Risks during Exploration Missions” project, we initiated two supplemental studies:

(1) Data harmonization of the SBM across long duration spaceflight analogs

(2) Continued collection of the Robotic On-Board Trainer for Research (ROBoT-r) from astronauts on the ISS.

Research Impact/Earth Benefits: This project will deliver a suite of Standardized Behavioral Measures (SBM) that will be tested for feasibility, flexibility, and acceptability in research studies in both short and long duration space analog environments and on the International Space Station (ISS). With the SBM, it will be possible for NASA's HFBP (Human Factors & Behavioral Performance) program to much better assess and quantify the Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Outcomes for exploration class missions.

With the proposed work we will relevantly contribute to Human Research Program's (HRP) goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. More specifically, the SBM will constitute an important technology to provide mission planners and system developers with strategies for monitoring and mitigating crew health and performance risks.

Additionally, Standardized Behavioral Measures could be beneficial for monitoring behavioral health during Earth-based operations, especially those involving isolated, confined, and extreme environments (e.g., Antarctic research expeditions).

Task Progress & Bibliography Information FY2021 
Task Progress: The data to be harmonized from the original sites and the 2018 and 2019 14 month missions in the Antarctic Neumayer station are currently in the process of being compiled and the meta data is being generated. We are meeting regularly with the statistician, Dr. Warren Bilker, to discuss the dimensionality reduction technique and potential issues of combining the outcomes of the SBM into a single long-form database. These issues and their solutions have been recorded and will be included in the final report. A submission to the LSDA (Life Sciences Data Archive) was completed in order to include the astronaut data from the Reaction Self Test (RST) on ISS study. A presentation to the Life Science Advisory Board is scheduled for July 27th, 2021, to justify the use of the astronaut data in the harmonization project.

Bibliography Type: Description: (Last Updated: 05/20/2022) 

Show Cumulative Bibliography Listing
 
 None in FY 2021
Project Title:  Standardized Behavioral Measures for Detecting Behavioral Health Risks during Exploration Missions Reduce
Images: icon  Fiscal Year: FY 2020 
Division: Human Research 
Research Discipline/Element:
HRP HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Start Date: 07/21/2015  
End Date: 09/30/2022  
Task Last Updated: 05/20/2020 
Download report in PDF pdf
Principal Investigator/Affiliation:   Dinges, David F. Ph.D. / University of Pennsylvania 
Address:  Department of Psychiatry 
423 Service Dr., 1013 Blockley Hall 
Philadelphia , PA 19104-4209 
Email: dinges@pennmedicine.upenn.edu 
Phone: 215-898-9949  
Congressional District:
Web:  
Organization Type: UNIVERSITY 
Organization Name: University of Pennsylvania 
Joint Agency:  
Comments:  
Co-Investigator(s)
Affiliation: 
Basner, Mathias  M.D. University of Pennsylvania 
Mollicone, Daniel  Ph.D. Pulsar Informatics, Inc. 
Stuster, Jack  Ph.D. Anacapa Sciences, Inc. 
Strangman, Gary  Ph.D. Harvard Medical School 
Stahn, Alexander  Ph.D. University of Pennsylvania 
Roma, Peter  Ph.D. KBRwyle / NASA Johnson Space Center 
Gur, Ruben  Ph.D. University of Pennsylvania 
Project Information: Grant/Contract No. NNX15AK76A 
Responsible Center: NASA JSC 
Grant Monitor: Williams, Thomas  
Center Contact: 281-483-8773 
thomas.j.will1@nasa.gov 
Solicitation / Funding Source: 2013-14 HERO NNJ13ZSA002N-BMED Behavioral Health & Performance 
Grant/Contract No.: NNX15AK76A 
Project Type: FLIGHT,GROUND 
Flight Program: ISS 
TechPort: No 
No. of Post Docs:
No. of PhD Candidates:
No. of Master's Candidates:
No. of Bachelor's Candidates:
No. of PhD Degrees:
No. of Master's Degrees:
No. of Bachelor's Degrees:
Human Research Program Elements: (1) HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Human Research Program Risks: (1) Bmed:Risk of Adverse Behavioral Conditions and Psychiatric Disorders
(2) Team:Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team (IRP Rev F)
Human Research Program Gaps: (1) BMed-102:Given exposures to spaceflight hazards (space radiation, isolation), how do we identify individual susceptibility, monitor molecular/biomarkers and acceptable thresholds, and validate behavioral health and CNS/neurological/neuropsychological performance measures and domains of relevance to exploration class missions? (IRP Rev L)
(2) BMed-105:Given the potentially negative spaceflight associated CNS/cognitive changes and behavioral experiences of stressors during long-duration missions (e.g., isolation, confinement, reduced sensory stimulation, altered gravity, space radiation), what are validated medical or dietary countermeasures to mitigate stressors impacting on CNS / cognition / behavioral health? (IRP Rev L)
(3) Team-102:We need to identify a set of quantifiable and validated measures, based on 5-12 key indicators of mission-relevant and identified spaceflight acceptable thresholds (or ranges) of team function, to effectively monitor and measure team health and performance of integrated NASA and commercial/private crews, during shifting autonomy in increasingly earth independent, long duration exploration missions (IRP Rev L)
Flight Assignment/Project Notes: NOTE: End date changed to 9/30/2022 per L. Barnes-Moten/JSC (Ed., 4/7/21)

NOTE: End date changed to 2/28/2021 per PI and NSSC information (Ed., 5/20/2020)

NOTE: End date changed to 2/28/2020 per NSSC information (Ed., 5/22/19)

NOTE: End date changed to 7/20/2019 per NSSC information (Ed., 8/10/18)

NOTE: Element change to Human Factors & Behavioral Performance; previously Behavioral Health & Performance (Ed., 1/18/17)

Task Description: Isolated and confined environments anticipated during exploration missions will include stressors such as small teams living and working in extreme conditions for prolonged periods separated from family and friends; loss of the day/light cycle; loss or delay of communications with ground; transitions in and out of partial gravity; and limited space, privacy, and food selection. NASA's Human Factors and Behavioral Performance Element seeks to maintain and enhance behavioral health and performance in such environments. The behavioral risk (Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders) is a high priority within the NASA Human Research Program (HRP) because it has face validity, but lacks sufficient evidence due to a deficiency in measurement of the risk. Thus, there is concern that the behavioral health of the crew will be challenged in a Mars mission, however there is no standardized method to detect and quantify the magnitude of the risk or its likelihood.

The overarching goal of this project is to build on a successful record of software-based measurement of behavioral health indicators (e.g., mood, cognitive function, performance, physical and mental fatigue, sleep quality) in order to develop a complementary standardized suite of behavioral core measures (SBM) that would be quite feasible to implement within the constraints of spaceflight research, ground-based analogs (both shortand long-duration), and prolonged missions in isolated, confined, extreme environments lasting up to 12 months or longer. Achievement of this goal would permit a more rapid and reliable assessment and quantification of the Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Outcomes for exploration class missions. The standardized behavioral medicine measures we are developing will be similar to the guidelines for standardization for bed-rest studies. Defining standardized measures will not only allow for the systematic collection of data across multiple analogs, but it will also facilitate risk characterization for the Behavioral Medicine (BMed) risk. Without a standardized suite of behavioral health measures, the unknown BMed risk for exploration-class missions will continue to be estimated based on anecdote and conjecture.

The elements of the SBM include the following:

(1) The Cognition test battery (a suite of 10 brief neuropsychological tests specifically designed for astronauts), (2) Actigraphy sleep/wake data, (3) Visual analog scales and brief questionnaires with proven validity and utility in space and space analog environments, (4) Journals (Audio/Video and/or typed), (5) The Robotic On-Board Trainer for Research (ROBoT-r, a robotic arm track-and-capture grappling task), (6) Team Measure Questionnaires designed to measure aspects of crew performance, team processes, team climate, and group living.

Research Impact/Earth Benefits: This project will deliver a suite of Standardized Behavioral Measures (SBM) that will be tested for feasibility, flexibility, and acceptability in research studies in both short and long duration space analog environments and on the International Space Station (ISS). With the SBM, it will be possible for NASA's HFBP (Human Factors & Behavioral Performance) program to much better assess and quantify the Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Outcomes for exploration class missions.

With the proposed work we will relevantly contribute to HRP's goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. More specifically, the SBM will constitute an important technology to provide mission planners and system developers with strategies for monitoring and mitigating crew health and performance risks.

Additionally, Standardized Behavioral Measures could be beneficial for monitoring behavioral health during Earth-based operations, especially those involving isolated, confined, and extreme environments (e.g., Antarctic research expeditions).

Task Progress & Bibliography Information FY2020 
Task Progress: Data collected during the 30-day missions in the Human Exploration Research Analog (HERA Campaign 3, N=16 subjects), a 12-14 month winter-over in the Antarctic Neumayer Station III (Neumayer III, N=7 subjects), and a 6-month mission on the International Space Station (ISS, N=2 astronauts) demonstrated that the Standardized Behavioral Measures (SBM) were feasible, acceptable, and reliable for tracking cognitive performance and behavioral health during long-duration missions in isolated, confined, and extreme conditions. Mission controllers completed a team performance questionnaire during HERA missions, and flight directors completed this brief questionnaire during the ISS study over the course of the expedition.

Two requests for supplemental funding were submitted to NASA under the SBM study during this reporting period:

(1) Post-flight ROBoT-r: This supplement aims to accelerate our readiness for conducting critical operations immediately post-landing on the surface of Mars. The specific goal of the supplement is to test an additional n=6 ISS astronauts at three distinct time points within the first 24 hours after return to Earth (R+0), thereby increasing our dataset from N=2 to N=8 astronauts.

(2) Data harmonization of NASA Behavioral Health and Performance (BHP) Standardized Behavioral Measures to identify behavioral responses across spaceflight analog missions: This supplement aims to examine the neurobehavioral responses of astronauts and astronaut-like individuals across NASA spaceflight analog missions. To achieve this goal, the project proposes to harmonize SBM data across different spaceflight analog missions. This harmonized database will provide the largest database to date of SBM data across different NASA spaceflight analogs and provide the opportunity to integrate the harmonized database with other study outcomes (e.g., other measures collected in these analogs by other investigators).

Bibliography Type: Description: (Last Updated: 05/20/2022) 

Show Cumulative Bibliography Listing
 
Abstracts for Journals and Proceedings Dinges D, Basner M, Strangman G, Stuster J, Roma P, Mollicone D, Gur R, Stahn A, Dennis L, Ecker A, Nasrini J, Kaizi-Lutu M, Mott C. "Standardized behavioral measures for detecting behavioral health risks during exploration missions." Oral presentation at the 2020 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 27-30, 2020.

Abstracts. 2020 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 27-30, 2020. , Jan-2020

Articles in Peer-reviewed Journals Ivkovic V, Sommers B, Cefaratti DA, Newman G, Thomas DW, Alexander DG, Strangman GE. "Operationally relevant behavior assessment using the Robotic On-Board Trainer for Research (ROBoT-r)." Aerosp Med Hum Perform. 2019 Sep 1;90(9):819-25. https://doi.org/10.3357/AMHP.5324.2019 ; PMID: 31426899 , Sep-2019
Books/Book Chapters Roma PG, Beckner ME, Mehta SK, Nindl BC, Crucian BE. "Salivary bioscience in military, space, and operational research." in "Salivary Bioscience: Foundations of Interdisciplinary Saliva Research and Applications." Ed. D.A. Granger, M.K. Taylor. Cham: Springer, 2020. p. 585-610. https://doi.org/10.1007/978-3-030-35784-9_24 , Apr-2020
Project Title:  Standardized Behavioral Measures for Detecting Behavioral Health Risks during Exploration Missions Reduce
Images: icon  Fiscal Year: FY 2019 
Division: Human Research 
Research Discipline/Element:
HRP HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Start Date: 07/21/2015  
End Date: 02/28/2020  
Task Last Updated: 05/21/2019 
Download report in PDF pdf
Principal Investigator/Affiliation:   Dinges, David F. Ph.D. / University of Pennsylvania 
Address:  Department of Psychiatry 
423 Service Dr., 1013 Blockley Hall 
Philadelphia , PA 19104-4209 
Email: dinges@pennmedicine.upenn.edu 
Phone: 215-898-9949  
Congressional District:
Web:  
Organization Type: UNIVERSITY 
Organization Name: University of Pennsylvania 
Joint Agency:  
Comments:  
Co-Investigator(s)
Affiliation: 
Basner, Mathias  M.D. University of Pennsylvania 
Mollicone, Daniel  Ph.D. Pulsar Informatics, Inc. 
Stuster, Jack  Ph.D. Anacapa Sciences, Inc. 
Strangman, Gary  Ph.D. Harvard Medical School 
Stahn, Alexander  Ph.D. University of Pennsylvania 
Roma, Peter  Ph.D. KBRwyle / NASA Johnson Space Center 
Gur, Ruben  Ph.D. University of Pennsylvania 
Project Information: Grant/Contract No. NNX15AK76A 
Responsible Center: NASA JSC 
Grant Monitor: Williams, Thomas  
Center Contact: 281-483-8773 
thomas.j.will1@nasa.gov 
Solicitation / Funding Source: 2013-14 HERO NNJ13ZSA002N-BMED Behavioral Health & Performance 
Grant/Contract No.: NNX15AK76A 
Project Type: FLIGHT,GROUND 
Flight Program: ISS 
TechPort: No 
No. of Post Docs:
No. of PhD Candidates:
No. of Master's Candidates:
No. of Bachelor's Candidates:
No. of PhD Degrees:
No. of Master's Degrees:
No. of Bachelor's Degrees:
Human Research Program Elements: (1) HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Human Research Program Risks: (1) Bmed:Risk of Adverse Behavioral Conditions and Psychiatric Disorders
(2) Team:Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team (IRP Rev F)
Human Research Program Gaps: (1) BMed-102:Given exposures to spaceflight hazards (space radiation, isolation), how do we identify individual susceptibility, monitor molecular/biomarkers and acceptable thresholds, and validate behavioral health and CNS/neurological/neuropsychological performance measures and domains of relevance to exploration class missions? (IRP Rev L)
(2) BMed-105:Given the potentially negative spaceflight associated CNS/cognitive changes and behavioral experiences of stressors during long-duration missions (e.g., isolation, confinement, reduced sensory stimulation, altered gravity, space radiation), what are validated medical or dietary countermeasures to mitigate stressors impacting on CNS / cognition / behavioral health? (IRP Rev L)
(3) Team-102:We need to identify a set of quantifiable and validated measures, based on 5-12 key indicators of mission-relevant and identified spaceflight acceptable thresholds (or ranges) of team function, to effectively monitor and measure team health and performance of integrated NASA and commercial/private crews, during shifting autonomy in increasingly earth independent, long duration exploration missions (IRP Rev L)
Flight Assignment/Project Notes: NOTE: End date changed to 2/28/2020 per NSSC information (Ed., 5/22/19)

NOTE: End date changed to 7/20/2019 per NSSC information (Ed., 8/10/18)

NOTE: Element change to Human Factors & Behavioral Performance; previously Behavioral Health & Performance (Ed., 1/18/17)

Task Description: Isolated and confined environments anticipated during exploration missions will include stressors such as small teams living and working in extreme conditions for prolonged periods separated from family and friends; loss of the day/light cycle; loss or delay of communications with ground; partial gravity; and limited space, privacy, and food selection. NASA's Human Factors and Behavioral Performance Element seeks to maintain and enhance behavioral health and performance in such environments. The behavioral risk (Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders) is a high priority within the NASA Human Research Program (HRP) because it has face validity, but lacks sufficient evidence due to a deficiency in measurement of the risk. Thus, there is concern that the behavioral health of the crew will be challenged in a Mars mission, however there is no standardized method to detect and quantify the magnitude of the risk or its likelihood.

The overarching goal of this project is to build on a successful record of software-based measurement of behavioral health indicators (e.g., mood, cognitive function, performance, physical and mental fatigue, sleep quality) to develop a complementary standardized suite of behavioral core measures (BCM) that would be quite feasible to implement within the constraints of spaceflight research, ground-based analogs (both short- and long-duration), and prolonged missions in isolated, confined, extreme environments lasting up to 12 months or longer. Achievement of this goal would permit a more rapid and reliable assessment and quantification of the Risk of Adverse Cognitive or Behavioral Conditions Psychiatric Outcomes for exploration class missions. The standardized behavioral medicine measures we are developing will be similar to the guidelines for standardization for bed rest studies. Defining standardized measures will not only allow for the systematic collection of data across multiple analogs, but it will also facilitate risk characterization for the Behavioral Medicine (BMed) risk. Without a standardized suite of behavioral health measures, the unknown BMed risk for exploration-class missions will continue to be estimated based on anecdote and conjecture.

The elements of the BCM include the following: (1) The Cognition test battery (a suite of 10 brief neuropsychological tests specifically designed for astronauts), (2) actigraphy sleep/wake data, (3) visual analog scales and brief questionnaires with proven validity and utility in space and space analog environments, (4) Journals (Audio/Video and/or typed), (5) a robotic arm track-and-capture grappling task, (6) Team Measure Questionnaires designed to measure aspects of crew performance, team processes, team climate, and group living.

Data acquisition feasibility and flexibility, and user acceptability of BCM has been assessed in a short-duration NASA analog (4 missions in the Human Exploration Research Analog [HERA], N=16 subjects), in a long-duration remote location analog (10 months of data collection during a 12-14 month winter-over in the Antarctic Neumayer station, N=7 subjects), and is currently being further assessed on the International Space Station (ISS) for feasibility and acceptability (during a 6 month mission, N=2 astronauts). Mission controllers completed a team performance questionnaire during HERA missions, and flight directors will be asked to complete this brief questionnaire during the ISS study during the 58/59 expeditions.

Research Impact/Earth Benefits: This project will deliver a Behavioral Core Measures Tool (BCM) that will be tested for its feasibility, flexibility, and acceptability in research studies in both short and long duration space analog environments and on the ISS. With the BCM, it will be possible for NASA's HFBP (Human Factors & Behavioral Performance) program to much better assess and quantify the Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Outcomes for exploration class missions.

With the proposed work we will relevantly contribute to HRP's goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. More specifically, the BCM will constitute an important technology to provide mission planners and system developers with strategies for monitoring and mitigating crew health and performance risks.

Additionally, Behavioral Core Measures could also be beneficial for monitoring behavioral health during Earth-based operations, especially those involving isolated, confined, and extreme environments (e.g., Antarctic research expeditions).

Task Progress & Bibliography Information FY2019 
Task Progress: Cognition: Data acquisition on the Cognition (neurobehavioral) test battery in NASA's HERA facility was finalized on 10/26/2016. A total of N=288 full Cognition test bouts (100% of expected) were successfully collected as well as N=270 surveys (93.75% of expected) in N=16 crewmembers. We deployed and collected data on N=8 crewmembers during two out of the four Campaign 3 missions in NASA's Human Exploration Research Analog (HERA) facility. In HERA research participants performed the Cognition test battery on the Apple iPad, however, through discussions with the International Space Station Medical Program (ISSMP) it was determined that the iPad is not a feasible platform for data collection on ISS. Thus a Windows PC version of the Cognition software was developed and is being used on-board the ISS and in the Antarctic Neumayer station. Data acquisition on Neumayer station was finalized in November 2017. We received 82 full Cognition batteries from N=7 crewmembers in total (Cognition was performed on a monthly basis). We also received N=59 Psychomotor Vigilance Test (PVT) tests (the PVT plus survey only was performed 2 weeks after each full Cognition battery). Post-mission data acquisition at Charité Berlin was performed on 3/22/2018.

Data acquisition for the N=2 astronauts on ISS began on 11/9/2018 and is currently in progress. We have received 4 BCM Cognition test batteries with good data quality to date.

Self Report and Visual Analog Scale Measures: A set of visual analog scales and brief questionnaires with proven validity and utility in space and space analog environments were chosen in order to evaluate several key aspects of behavioral health and crew interaction. These questionnaires include (a) the Reaction Self-Test (RST) Visual Analog Scales (VAS) to evaluate perceived mental (mentally sharp—mentally fatigued) and physical (energetic—physically exhausted) exhaustion, fatigue (tired—fresh, ready to go), sleepiness (not sleepy at all—very sleepy), stress (not stressed at all—very stressed), and workload (very low—very high); (b) the Social Desirability Scale (SDS-17) to measure self-desirability bias; (c) sleep diaries to evaluate sleep quality and duration; (d) the Profile of Mood States, Short Form (POMS-SF) to evaluate mood; (e) the Beck Depression Inventory (BDI-II) to evaluate depression; and (f) the Conflict Scale (CS) to evaluate perceived conflict among crewmembers and between crewmembers and mission control. The Visual Analog Scales and sleep diaries have already proven useful for measuring neurobehavioral health during 6-month missions on ISS and these data informed the need for a one-year mission.

During the 14-month Neumayer missions these surveys were deployed using the University of Pennsylvania's Qualtrics electronic web-based survey tool in order to accommodate offline data collection and storage. Data were successfully collected on N=7 Neumayer crewmembers, and self-report measures were successfully collected with 88.4% response adherence. A total of N=501 BCM questionnaires were completed: n=82 nighttime Visual Analog Scales; n=82 Conflict Scales; n=165 morning Visual Analog Scales and sleep diaries; n=84 POMS-SF, n=81 BDI-II, and n=7 SDS-17 questionnaires.

ISS survey data collection began in November of 2018 and has continued during ISS expedition 58/59 using the on-board Data Collection Tool (DCT) software.

Journals: At the end of our previous reporting period, journal entries from all four of the HERA simulated asteroid rendezvous missions (N=16 crewmembers) had been transcribed and analyzed. Only one crewmember of the Neumayer III Antarctic station completed a confidential journal, which allowed limited analysis to be performed. Data-collection on the ISS began in December 2018 with two astronauts participating in the BCM study. Each astronaut has completed eight journal entries and the mid-mission questionnaire at the time of this writing, with two months remaining in the expedition. No analyses have been conducted yet.

Category Analysis

The numbers of parsed journal statements assigned to the 25 major topical categories were tabulated for each subject’s journal and then combined to calculate the overall total for each category. The subjects’ rankings are remarkably similar to the category ranking derived from the journals of ISS astronauts during the 13-year Journals Flight Experiment.

Subcategory Analysis: Adjustment

Statements extracted from the HERA A/V journals were assembled according to their category assignments and the mission quarter during which they were recorded. Only the primary, secondary, and tertiary assignments for the Adjustment category were subjected to a subcategory analysis in this study. Statements were assigned to subcategories based on similar content. A total of 20 subcategories emerged from the data. Journal statements assigned to the Adjustment category range from references to the positive effects of exercise to the importance of remaining busy with meaningful work.

Net Positivity/Negativity

Each parsed journal statement was assigned a code to indicate whether the statement was positive, negative, or neutral in its tone or content. A metric called Net Positivity/Negativity (NPN) was derived by subtracting the proportion of negative entries from the proportion of positive entries. This metric was calculated for all category assignments by quarter for each expedition. NPN analyses were performed by journal with data from all categories combined and by journal focusing exclusively on statements assigned to the Adjustment category. NPN analyses were conducted to test hypotheses concerning a “third quarter phenomenon,” a decline in affect, general attitude, or “morale” during the third quarters of missions, regardless of duration. The third quarter phenomenon was suggested by anecdotal accounts and evidence from previous content analyses of expedition journals.

Conclusion

Results of the Journals Component of the BCM study that was conducted during four HERA simulations in 2016 and the Neumayer Antarctic expedition in 2017 confirm previous experiences with French polar explorers and NASA astronauts that analysis of confidential journals can be used to assess the behavioral health of personnel in remote-duty environments. However, certain conditions must be met for the method to be effective: 1) The personnel must make at least weekly journal entries; 2) Audio entries must be at least eight minutes in duration, or one page of typed text; 3) Participants must describe events, experiences, and observations candidly; 4) Journal entries must be transmitted to an analyst who is outside of the participants’ organization soon after they are made for immediate review and analysis; and, 5) A mechanism must be in place to enable the analyst to intervene when a serious behavioral issue is detected without jeopardizing the confidentiality of participants.

ROBoT: In the most recent year of the BCM project, we initiated (and are still conducting) a feasibility study of ROBoT-r testing aboard the ISS. Preparations included Institutional Review Board (IRB) approvals, revising the ROBoT-r scoring system to better align with astronaut expectations, modifying the user feedback screens to avoid conflicts with ROBoT trainer feedback, developing training materials, holding informed consent briefings, team member training for astronaut instruction, and developing baseline data collection plans suitable for both US-based and Russia-based crews.

Data acquisition and analysis for this feasibility-test phase of the project is still underway. Baseline data collection on the ground led to a requested change in ROBoT-r trial difficulty—including a software patch for uplink to ISS—to more closely match the range of trial difficulties that are normally included in the standard astronaut training program for ROBoT. Comments after follow-up tests suggested these modifications were successful. To date we have collected data from 2 complete baseline sessions plus 12 complete in-flight sessions on ROBoT-r. One feasibility concern arose in-flight, namely conducting a ROBoT-r session (which involves capture of HTV-II) within 2 weeks of a planned capture of a Dragon spacecraft as part of planned operations. This led to the delay of the ROBoT-r session until after Dragon capture was achieved.

Preliminary data analysis suggests that astronaut performance on ROBoT-r is significantly better—and exhibits less variance—than HERA participants, Neumayer subjects, or relevant controls. This was particularly notable for angle error at the point of capture, where the worst mean performance by astronaut subjects was still better than the best mean performance by individuals in the other groups. Interestingly, there appears to be evidence of a modest learning effect across sessions in astronauts (simultaneous improvements in both speed and accuracy), although much less dramatic as compared to other groups. This was unexpected, given the 100s of hours of training on ROBoT that astronauts receive as part of their training flow. One possibility is that the runs used by ROBoT-r are not identical to those used in the standard ROBoT training and hence additional learning is occurring on these slightly different run types. This finding remains to be fully investigated.

In addition, in year 4 a supplementary effort with regard to ISS data collection was requested by NASA administration. The goal is to obtain ROBoT-r data on three occasions within 24 hr post-landing. The research question is whether or not astronauts can perform complex operational tasks like ROBoT-r effectively within this early post-landing period. The answer to this question will help lock-down the design of initial crewed Mars mission landing vehicles, as the current concept of operations is to have astronauts perform a complex electrical umbilical hook-up after landing to maintain their life support system. For this con-ops to work, the astronauts need to be capable of performing this maneuver within 24-hr of landing, or the life support system will fail. We have worked with Dr. Tom Williams, the ER/DST laboratory and ISSMP to determine the best way to achieve this goal. The plan is to conduct three tests: (1) in a tent in Kazakhstan within 3-6 hrs of landing, (2) in the Prestwick, Scotland airport during the refueling stop within 10-12 hrs of landing, and (3) in Building 21 on Johnson Space Center (JSC) campus after arrival in Houston and <24 hours post-landing. Preparations are still underway to achieve this supplementary data collection process.

Team Measure Questionnaires: Data from the Team Measures battery was successfully acquired from all four 30-day HERA C3 missions (N=16 individuals) with 100% compliance.

Preliminary analyses of the HERA data, thematic analysis of the initial Team Measures battery, and assessment of operational acceptability led to recommendations for a reduced and modified Team Measures battery and data collection schedule for long-duration missions in operational environments. This iteration of the Team Measures battery was deployed in a long-duration mission at Neumayer Station in Antarctica (N=7 individuals). The pre-mission demographics and IPIP-NEO-120 measures were completed by all participants (100% compliance). The in-mission measures included a combined Team Performance, Team Processes, and Team Climate session scheduled for completion every two weeks, as well as the BCM’s newly developed Group Living assessment scheduled for completion every month. Compliance for the bi-weekly team measures was generally high, with 75% of sessions completed. Notably, non-compliance was not distributed evenly across the mission. Specifically, no data were recorded for January or February 2018, although it is unknown why this lapse occurred. Interestingly, and despite the less frequent administration schedule, compliance for the Group Living measure was low, with only 32% of sessions completed (2017 February, July, November, and 2018 March). Feedback from the crew indicated that some participants were uncomfortable with the 360 nature of the assessment where every crewmember rates him/herself and every other crewmember. In addition, since the number of participants directly affects the duration of the assessment, this introduces a risk of unacceptable time burden. Lessons learned from this assessment have been incorporated into the development of Standard Measures for spaceflight. Specifically, the Group Living measure is no longer a 360 assessment where every crewmember rates every other crewmember, instead opting for a format where each item refers to the entire team. Although this provides lower resolution data, it is more operationally acceptable and still provides insight on this critical competency for long-duration exploration missions.

The final stage of data collection is BCM on ISS. This effort is currently ongoing with N=2 astronauts, with the Team Measures battery administered once every four weeks. The battery includes 28 ratings and two open-text items covering the Team Performance, Team Processes, Team Climate, and Group Living constructs. Despite the concerns raised and mixed compliance with the Neumayer crew in-mission, operational acceptability on ISS has been notably high, with 100% compliance thus far. Not surprisingly, team functioning was rated highly, although not suspiciously or artificially high. Although the range of responses was limited and there were no clear temporal trajectories, there were intra-individual variations, and very clear and consistent individual differences in perceived team functioning. Taken together, these data support the sensitivity of the BCM Team Measures’ design, specifically the adaptation of measures from ordinal Likert scales to continuous variables via visual analog scale formats, in order to enable detection of small but potentially operationally significant effects (cf. Wolfson & Mathieu, 2018).

Wolfson, M. A., & Mathieu, J. E. (2018). Sprinting to the finish: Toward a theory of Human Capital Resource Complementarity. Journal of Applied Psychology, 103(11), 1165-1180. https://doi.org/10.1037/apl0000323

Discussion:

Data collected during the 14-month Neumayer mission have shown that the standardized suite of Behavioral Core Measures is feasible, acceptable, and reliable for tracking cognitive performance and behavioral health during a long-duration mission in extreme conditions (12-14 months). However the possible exception of Journals (for which only 23% of expected data were acquired) may reflect a cultural bias of the German crew.

BCM on ISS has been fully implemented and data collection is ongoing for N=2 astronauts.

Bibliography Type: Description: (Last Updated: 05/20/2022) 

Show Cumulative Bibliography Listing
 
Abstracts for Journals and Proceedings Roma PG, Schorn JM, Qi K, Agrawal A. "Operational Performance Measures of Neurobehavioral Function for Long-Duration Space Missions." Presentation at the 16th Annual World Congress for Brain Mapping and Therapeutics of Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, March 15-17, 2019.

Abstracts. 16th Annual World Congress for Brain Mapping and Therapeutics of Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, March 15-17, 2019. , Mar-2019

Abstracts for Journals and Proceedings Dinges D, Basner M, Strangman G, Stuster J, Roma P, Mollicone D, Gur R, Stahn A, Dennis L, Ecker A, Nasrini J, Mott C. "Standardized behavioral measures for detecting behavioral health risks during exploration (Behavioral Core Measures)." Presentation at the 2019 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2019.

Abstracts. 2019 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2019. , Jan-2019

Abstracts for Journals and Proceedings Roma PG, Landon LB, Schneiderman JS. "Overview of NASA Behavioral Health & Performance Standard Measures." Presentation at the 2019 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2019.

Abstracts. 2019 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2019. , Jan-2019

Abstracts for Journals and Proceedings Roma PG, Landon LB, Schneiderman JS. "The NASA Behavioral Health & Performance Standard Measures Suite for Integrated Multidisciplinary Research in Isolated, Confined, and Extreme Environments." Presentation at the 2019 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2019.

Abstracts. 2019 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2019. , Jan-2019

Abstracts for Journals and Proceedings Wusk G, Basner M, Schneiderman J, Nasrini J, Baskin P, Dinges DF, Roma PG. "Individual differences in cognitive performance under chronic partial sleep restriction in isolation and confinement." Poster presentation 2019 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2019.

Abstracts. 2019 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2019. , Jan-2019

Abstracts for Journals and Proceedings Zwart S, Bloomberg J, Crucian B, Lee S, Ott M, Oubre C, Reschke M, Roma P, Smith S, Stenger M, Mullenax C. "Spaceflight standard measures." Presentation at the 2019 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2019.

Abstracts. 2019 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2019. , Jan-2019

Abstracts for Journals and Proceedings Roma PG, Schnedierman JS, Landon LB. "Overview of NASA Behavioral Health & Performance Standard Measures." 90th Aerospace Medicine Association Meeting, Las Vegas, NV, May 5-19, 2019.

Aerospace Medicine and Human Performance. 2019 Mar;90(3). Abstract issue. , Mar-2019

Project Title:  Standardized Behavioral Measures for Detecting Behavioral Health Risks during Exploration Missions Reduce
Images: icon  Fiscal Year: FY 2018 
Division: Human Research 
Research Discipline/Element:
HRP HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Start Date: 07/21/2015  
End Date: 07/20/2019  
Task Last Updated: 08/20/2018 
Download report in PDF pdf
Principal Investigator/Affiliation:   Dinges, David F. Ph.D. / University of Pennsylvania 
Address:  Department of Psychiatry 
423 Service Dr., 1013 Blockley Hall 
Philadelphia , PA 19104-4209 
Email: dinges@pennmedicine.upenn.edu 
Phone: 215-898-9949  
Congressional District:
Web:  
Organization Type: UNIVERSITY 
Organization Name: University of Pennsylvania 
Joint Agency:  
Comments:  
Co-Investigator(s)
Affiliation: 
Basner, Mathias  M.D. University of Pennsylvania 
Mollicone, Daniel  Ph.D. Pulsar Informatics, Inc. 
Stuster, Jack  Ph.D. Anacapa Sciences, Inc. 
Strangman, Gary  Ph.D. Harvard Medical School 
Stahn, Alexander  Ph.D. University of Pennsylvania 
Roma, Peter  Ph.D. Johns Hopkins University School of Medicine 
Gur, Ruben  Ph.D. University of Pennsylvania 
Key Personnel Changes / Previous PI: August 2018: Sarah McGuire, Co-Investigator, left the University of Pennsylvania faculty to accept another position, and is no longer on the project.
Project Information: Grant/Contract No. NNX15AK76A 
Responsible Center: NASA JSC 
Grant Monitor: Williams, Thomas  
Center Contact: 281-483-8773 
thomas.j.will1@nasa.gov 
Solicitation / Funding Source: 2013-14 HERO NNJ13ZSA002N-BMED Behavioral Health & Performance 
Grant/Contract No.: NNX15AK76A 
Project Type: FLIGHT,GROUND 
Flight Program: ISS 
TechPort: No 
No. of Post Docs:
No. of PhD Candidates:
No. of Master's Candidates:
No. of Bachelor's Candidates:
No. of PhD Degrees:
No. of Master's Degrees:
No. of Bachelor's Degrees:
Human Research Program Elements: (1) HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Human Research Program Risks: (1) Bmed:Risk of Adverse Behavioral Conditions and Psychiatric Disorders
(2) Team:Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team (IRP Rev F)
Human Research Program Gaps: (1) BMed-102:Given exposures to spaceflight hazards (space radiation, isolation), how do we identify individual susceptibility, monitor molecular/biomarkers and acceptable thresholds, and validate behavioral health and CNS/neurological/neuropsychological performance measures and domains of relevance to exploration class missions? (IRP Rev L)
(2) BMed-105:Given the potentially negative spaceflight associated CNS/cognitive changes and behavioral experiences of stressors during long-duration missions (e.g., isolation, confinement, reduced sensory stimulation, altered gravity, space radiation), what are validated medical or dietary countermeasures to mitigate stressors impacting on CNS / cognition / behavioral health? (IRP Rev L)
(3) Team-102:We need to identify a set of quantifiable and validated measures, based on 5-12 key indicators of mission-relevant and identified spaceflight acceptable thresholds (or ranges) of team function, to effectively monitor and measure team health and performance of integrated NASA and commercial/private crews, during shifting autonomy in increasingly earth independent, long duration exploration missions (IRP Rev L)
Flight Assignment/Project Notes: NOTE: End date changed to 7/20/2019 per NSSC information (Ed., 8/10/18)

NOTE: Element change to Human Factors & Behavioral Performance; previously Behavioral Health & Performance (Ed., 1/18/17)

Task Description: Isolated and confined environments anticipated during exploration missions will include stressors such as small teams living and working in extreme conditions for prolonged periods separated from family, friends; loss of the day/light cycle; loss or delay of communications with ground; partial gravity; and limited space, privacy, and food selection. NASA's Human Factors and Behavioral Performance Element seeks to maintain and enhance behavioral health and performance in such environments. The behavioral risk (Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders) is a high priority within the NASA Human Research Program (HRP) because it has face validity, but lacks sufficient evidence due to a deficiency in measurement of the risk. Thus, there is concern that the behavioral health of the crew will be challenged in a Mars mission; however, there is no standardized method to detect and quantify the magnitude of the risk or its likelihood.

The overarching goal of this project is to build on a successful record of software-based measurement of behavioral health indicators (e.g., mood, cognitive function, performance, physical and mental fatigue, sleep quality) to develop a complementary standardized suite of behavioral core measures (BCM) that would be quite feasible to implement within the constraints of spaceflight research, ground-based analogs (both short- and long-duration), and prolonged missions in isolated, confined, extreme environments lasting up to 12 months or longer. Achievement of this goal would permit a more rapid and reliable assessment and quantification of the Risk of Adverse Cognitive or Behavioral Conditions Psychiatric Outcomes for exploration class missions. The standardized behavioral medicine measures we are developing will be similar to the guidelines for standardization for bed rest studies. Defining standardized measures will not only allow for the systematic collection of data across multiple analogs, but it will also facilitate risk characterization for the Behavioral Medicine (BMed) risk. Without a standardized suite of behavioral health measures, the unknown BMed risk for exploration-class missions will continue to be estimated based on anecdote and conjecture.

The elements of the BCM include the following: (1) The Cognition test battery (a suite of 10 brief neuropsychological tests specifically designed for astronauts), (2) actigraphy sleep/wake data, (3) several visual analog scales and brief questionnaires with proven validity and utility in space and space analog environments, (4) Journals (Audio/Video and/or typed), (5) a robotic arm track-and-capture grappling task, (6) Team Measure Questionnaires designed to measure aspects of crew performance, team processes, team climate, and group living.

Data acquisition feasibility and flexibility, and user acceptability of BCM has been assessed in a short duration analog (4 HERA (Human Exploration Research Analog) N=16 subjects), is currently being assessed in a long-duration analog (10 months of data collection during a 12-14 month winter-over in the Antarctic Neumayer station, N=7 subjects), and will be further assessed on the International Space Station (ISS) for feasibility and acceptability (during a 6 month mission, N=2 astronauts). Mission controllers completed a team performance questionnaire during HERA missions, and flight directors will complete this brief questionnaire during the ISS study.

Research Impact/Earth Benefits: This project will deliver a Behavioral Core Measures Tool (BCM) that will be tested for its feasibility, flexibility, and acceptability in research studies in both short and long duration space analog environments and on the ISS. With the BCM, it will be possible for NASA's HFBP (Human Factors & Behavioral Performance) program to much better assess and quantify the Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Outcomes for exploration class missions.

With the proposed work we will relevantly contribute to HRP's goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. More specifically, the BCM will constitute an important technology to provide mission planners and system developers with strategies for monitoring and mitigating crew health and performance risks.

Additionally, Behavioral Core Measures could also be beneficial for monitoring behavioral health during Earth-based operations, especially those involving isolated, confined and extreme environments (e.g., Antarctic research expeditions).

Task Progress & Bibliography Information FY2018 
Task Progress: Cognition: Data acquisition in NASA's Human Exploration Research Analog (HERA) facility was finalized on 10/26/2016. A total of N=288 full Cognition test bouts (100% of expected) were successfully collected as well as N=270 surveys (93.75% of expected) in N=16 crewmembers. During the current reporting period we have deployed and collected data on N=8 crewmembers during two out of the four Campaign 3 missions in NASA's Human Exploration Research Analog (HERA) facility. In HERA research participants perform the Cognition test battery on the Apple iPad; however, through discussions with the International Space Station Medical Program (ISSMP) it was determined that the iPad is not a feasible platform for data collection on ISS. Thus a Windows PC version of the Cognition software will be used on-board the ISS and, in the past year, the Windows version of Cognition was deployed in the Antarctic Neumayer station. Data acquisition on Neumayer station was finalized in November 2017. We received 82 full Cognition batteries from N=7 crewmembers in total (Cognition was performed on a monthly basis). We also received N=59 Psychomotor Vigilance Task (PVT) tests (the PVT plus survey only was performed 2 weeks after each full Cognition battery). Post-mission data acquisition at Charité Berlin was performed on 3/22/2018.

Self Report and Visual Analog Scale Measures: A set of visual analog scales and brief questionnaires with proven validity and utility in space and space analog environments were chosen in order to evaluate several key aspects of behavioral health and crew interaction. These questionnaires include (a) Visual Analog Scales (VAS) to evaluate perceived mental (mentally sharp—mentally fatigued) and physical (energetic—physically exhausted) exhaustion, fatigue (tired—fresh, ready to go), sleepiness (not sleepy at all—very sleepy), stress (not stressed at all—very stressed), and workload (very low—very high); (b) the Social Desirability Scale (SDS-17) to measure self-desirability bias; (c) sleep diaries to evaluate sleep quality and duration; (d) the Profile of Mood States, Short Form (POMS-SF) to evaluate mood; (e) the Beck Depression Inventory (BDI-II) to evaluate depression; and (f) the Conflict Scale (CS) to evaluate perceived conflict among crewmembers and between crewmembers and mission control. The Visual Analog Scales and sleep diaries have already proven useful for measuring neurobehavioral health during 6-month missions on ISS and these data informed the need for a one-year mission.

During the 14-month Neumayer missions these surveys were deployed using the University of Pennsylvania's Qualtrics electronic web-based survey tool in order to accommodate offline data collection and storage. Data were successfully collected on N=7 Neumayer crewmembers, and self-report measures were successfully collected with 88.4% response adherence. A total of N=501 BCM questionnaires were completed: n=82 nighttime Visual Analog Scales; n=82 Conflict Scales; n=165 morning Visual Analog Scales and sleep diaries; n=84 POMS-SF, n=81 BDI-II, and n=7 SDS-17 questionnaires.

ISS survey data collection is currently scheduled to begin in 2018 in ISS increment 57/58 using the on-board Data Collection Tool (DCT) software.

Journals: At the end of the reporting period, journal entries from all four of the HERA simulated asteroid rendezvous missions (N=16 crewmembers) had been transcribed and analyzed. Only one crewmember of the Neumayer III Antarctic station completed a confidential journal, which allowed limited analysis to be performed.

Category Analysis: The numbers of parsed journal statements assigned to the 25 major topical categories were tabulated for each subject’s journal and then combined to calculate the overall total for each category. The subjects’ rankings are remarkably similar to the category ranking derived from the journals of ISS astronauts during the 13-year Journals Flight Experiment.

Subcategory Analysis: Adjustment

Statements extracted from the HERA A/V journals were assembled according to their category assignments and the mission quarter during which they were recorded. Only the primary, secondary, and tertiary assignments for the Adjustment category were subjected to a subcategory analysis in this study. Statements were assigned to subcategories based on similar content. A total of 20 subcategories emerged from the data. Journal statements assigned to the Adjustment category range from references to the positive effects of exercise to the importance of remaining busy with meaningful work.

Net Positivity/Negativity: Each parsed journal statement was assigned a code to indicate whether the statement was positive, negative, or neutral in its tone or content. A metric called Net Positivity/Negativity (NPN) was derived by subtracting the proportion of negative entries from the proportion of positive entries. This metric was calculated for all category assignments by quarter for each expedition. NPN analyses were performed by journal with data from all categories combined and by journal focusing exclusively on statements assigned to the Adjustment category. NPN analyses were conducted to test hypotheses concerning a “third quarter phenomenon,” a decline in affect, general attitude, or “morale” during the third quarters of missions, regardless of duration. The third quarter phenomenon was suggested by anecdotal accounts and evidence from previous content analyses of expedition journals.

Conclusion

Results of the Journals Component of the BCM study that was conducted during four HERA simulations in 2016 and the Neumayer Antarctic expedition in 2017 confirm previous experiences with French polar explorers and NASA astronauts that analysis of confidential journals can be used to assess the behavioral health of personnel in remote-duty environments. However, certain conditions must be met for the method to be effective: 1) The personnel must make at least weekly journal entries; 2) Audio entries must be at least eight minutes in duration, or one page of typed text; 3) Participants must describe events, experiences, and observations candidly; 4) Journal entries must be transmitted to an analyst who is outside of the participants’ organization soon after they are made for immediate review and analysis; and, 5) A mechanism must be in place to enable the analyst to intervene when a serious behavioral issue is detected without jeopardizing the confidentiality of participants.

ROBoT: In the past year of the ROBoT project, we worked on four main efforts.

First, we completed running of our control subjects for the HERA portion of the project. This included N=14 subjects who were matched on age, sex, and education to the HERA participants.

Second, we conducted additional analyses on the data from the four HERA missions of Campaign 3. Our new analyses focused in particular on comparing the healthy controls to HERA subjects. Participants in both groups steadily improved on the task over time, and at the group level there was no significant difference in learning rates. Interestingly, however, HERA participants performed better (lower overall scores and higher percent success) yet significantly slower as compared to controls. This suggests the HERA participants adopted a different strategy as compared to controls. Specifically, HERA participants appeared to focus on more careful and accurate performance of the ROBoT-r task, trading this off against the time used to complete each run.

The data show a clear learning curve, where task scores improve, they perform the tasks faster, and the capture success is higher. Also, controls perform significantly worse but also significantly faster than HERA participants, suggesting a strategy difference between the two groups. These strategy differences were evident across all difficulty levels, although the groups were more similar in performance and duration on the most-difficult trials. The performance effects were largely driven by errors in angular alignment at the point of contact, and not linear displacement error.

Third, we completed data collection from crewmembers at Neumayer station and conducted preliminary analysis of the data. Data included monthly ROBoT-r sessions monthly from Feb through November 2017 (10 months) from each of N=7 crewmembers. Data collection from these subjects was >96% complete, expecting 12 runs from each of 7 subjects (84 total) per month.

Preliminary analyses showed significant differences in angle error at grapple as a function of difficulty, no significant differences in distance error as a function of difficulty, and no significant differences in overall score as function of difficulty. A notable performance improvement in overall score appeared in May (month=6), but this was not significant due to substantial between-subject variability.

Trials come in groups of 3 (trials 1-3=25%, of maximum ROBoT-r task difficulty, whereas trials 4-6=50%, trials 7-9=75% and trials 10-12=100%). Angle error exhibits the largest effect of difficulty, as found in prior studies.

Thus, while there were generally clear effects of trial difficulty, there was no significant group effect of time in mission. That result, however, masks the substantial intra-individual variability (from month to month) as well as between-subject variability. In the coming year, we will investigate optimal approaches to characterize this type of within- and between-subject variability and seek to develop methods for individualized performance prediction.

Subject N6-17 showed steady performance early, followed by steady improvement (scale=0-10, with 0=best). Subject N7-17 exhibited one particularly good month (June), with poorer performance most of the rest of the year.

Fourth, and finally, we continued working towards the feasibility study of ROBoT-r testing aboard the ISS. This involved IRB (Institutional Review Board) approvals, revising the ROBoT-r scoring system to better align with astronaut expectations, modifying the user feedback screens to avoid conflicts with ROBoT trainer feedback, developing training materials, informed consent briefings, team member training for astronaut instruction, and developing baseline data collection plans suitable for both US-based and Russia-based crews. All such steps are essentially complete and two crewmembers have agreed to participate in the in-flight BCM feasibility study, including ROBoT-r.

Team Measure Questionnaires: Data from the Team Measures battery was successfully acquired from all four 30-day HERA C3 missions (N=16 individuals) with 100% compliance. At the end of the previous reporting period, data from the initial battery of Team Measures was collected in two four-person crews (N=8) throughout two 30-day missions in the HERA facility. During the current reporting period Team Measures data was collected in the remaining two 30-day missions (N=8). Preliminary analyses of the HERA data, thematic analysis of the initial Team Measures battery, and assessment of operational acceptability led to recommendations for a reduced and modified Team Measures battery and data collection schedule for long-duration missions in operational environments. This iteration of the Team Measures battery was deployed in a long-duration mission at Neumayer Station in Antarctica (N=7 individuals). Data processing is currently in progress. The pre-mission demographics and IPIP-NEO-120 measures were completed by all participants (100% compliance). The in-mission measures included a combined Team Performance, Team Processes, and Team Climate session scheduled for completion every two weeks, as well as the BCM’s newly developed Group Living assessment scheduled for completion every month. Compliance for the bi-weekly team measures was generally high, with 75% of sessions completed. Notably, non-compliance was not distributed evenly across the mission. Specifically, no data were recorded for January or February 2018, although it is uncertain why this lapse occurred. Interestingly, and despite the less frequent administration schedule, compliance for the Group Living measure was low, with only 32% of sessions completed (2017 February, July, November, and 2018 March).

Lessons learned from this assessment have been incorporated into the development of Standard Measures for spaceflight. Specifically, the Group Living measure is no longer a 360 assessment where every crewmember rates every other crewmember, instead opting for a format where each item refers to the entire team. Although this provides lower resolution data, it is more operationally acceptable and still provides insight on this critical competency for long-duration exploration missions.

Discussion: Data collected during the 14-month Neumayer mission have shown that the standardized suite of Behavioral Core Measures is feasible, acceptable, and reliable for tracking cognitive performance and behavioral health during a long-duration mission in extreme conditions (12-14 months). The possible exception of Journals (only 23% of expected data were acquired) may reflect a cultural bias of the German crew.

We are currently working with ISSMP on finalizing implementation of the BCM measures for deployment on-board the ISS during which feasibility and acceptability will be determined for spaceflight conditions.

Bibliography Type: Description: (Last Updated: 05/20/2022) 

Show Cumulative Bibliography Listing
 
Articles in Peer-reviewed Journals Roma PG, Reed DD, DiGennaro Reed, FD, Hursh SR. "Progress of and prospects for hypothetical purchase task questionnaires in consumer behavior analysis and public policy." The Behavior Analyst. 2017 Nov;40(2):329-42. Review. https://doi.org/10.1007/s40614-017-0100-2 , Nov-2017
Books/Book Chapters Roma PG, Bedwell WL. "Key factors and threats to team dynamics in long-duration extreme environments." in "Team Dynamics Over Time: Advances in Theory, Methods, and Practice, vol. 18." Ed. E. Salas, W.B. Vessey, L.B. Landon. Bingley, UK: Emerald Publishing, 2017. p. 155-187. https://www.emeraldinsight.com/doi/full/10.1108/S1534-085620160000018007 , Aug-2017
Project Title:  Standardized Behavioral Measures for Detecting Behavioral Health Risks during Exploration Missions Reduce
Images: icon  Fiscal Year: FY 2017 
Division: Human Research 
Research Discipline/Element:
HRP HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Start Date: 07/21/2015  
End Date: 07/20/2019  
Task Last Updated: 05/19/2017 
Download report in PDF pdf
Principal Investigator/Affiliation:   Dinges, David F. Ph.D. / University of Pennsylvania 
Address:  Department of Psychiatry 
423 Service Dr., 1013 Blockley Hall 
Philadelphia , PA 19104-4209 
Email: dinges@pennmedicine.upenn.edu 
Phone: 215-898-9949  
Congressional District:
Web:  
Organization Type: UNIVERSITY 
Organization Name: University of Pennsylvania 
Joint Agency:  
Comments:  
Co-Investigator(s)
Affiliation: 
Basner, Mathias  M.D. University of Pennsylvania 
Mollicone, Daniel  Ph.D. Pulsar Informatics, Inc. 
Stuster, Jack  Ph.D. Anacapa Sciences, Inc. 
Strangman, Gary  Ph.D. Harvard Medical School 
McGuire, Sarah  Ph.D. University of Pennsylvania 
Stahn, Alexander  Ph.D. University of Pennsylvania 
Roma, Peter  Ph.D. Johns Hopkins University School of Medicine 
Gur, Ruben  Ph.D. University of Pennsylvania 
Project Information: Grant/Contract No. NNX15AK76A 
Responsible Center: NASA JSC 
Grant Monitor: Williams, Thomas  
Center Contact: 281-483-8773 
thomas.j.will1@nasa.gov 
Solicitation / Funding Source: 2013-14 HERO NNJ13ZSA002N-BMED Behavioral Health & Performance 
Grant/Contract No.: NNX15AK76A 
Project Type: FLIGHT,GROUND 
Flight Program: ISS 
TechPort: No 
No. of Post Docs:
No. of PhD Candidates:
No. of Master's Candidates:
No. of Bachelor's Candidates:
No. of PhD Degrees:
No. of Master's Degrees:
No. of Bachelor's Degrees:
Human Research Program Elements: (1) HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Human Research Program Risks: (1) Bmed:Risk of Adverse Behavioral Conditions and Psychiatric Disorders
(2) Team:Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team (IRP Rev F)
Human Research Program Gaps: (1) BMed-102:Given exposures to spaceflight hazards (space radiation, isolation), how do we identify individual susceptibility, monitor molecular/biomarkers and acceptable thresholds, and validate behavioral health and CNS/neurological/neuropsychological performance measures and domains of relevance to exploration class missions? (IRP Rev L)
(2) BMed-105:Given the potentially negative spaceflight associated CNS/cognitive changes and behavioral experiences of stressors during long-duration missions (e.g., isolation, confinement, reduced sensory stimulation, altered gravity, space radiation), what are validated medical or dietary countermeasures to mitigate stressors impacting on CNS / cognition / behavioral health? (IRP Rev L)
(3) Team-102:We need to identify a set of quantifiable and validated measures, based on 5-12 key indicators of mission-relevant and identified spaceflight acceptable thresholds (or ranges) of team function, to effectively monitor and measure team health and performance of integrated NASA and commercial/private crews, during shifting autonomy in increasingly earth independent, long duration exploration missions (IRP Rev L)
Flight Assignment/Project Notes: NOTE: End date changed to 7/20/2019 per NSSC information (Ed., 8/10/18)

NOTE: Element change to Human Factors & Behavioral Performance; previously Behavioral Health & Performance (Ed., 1/18/17)

Task Description: Isolated and confined environments anticipated during exploration missions will include stressors such as small teams living and working in extreme conditions for prolonged periods separated from family, friends; loss of the day/light cycle; loss or delay of communications with ground; partial gravity; and limited space, privacy, and food selection. NASA's Human Factors and Behavioral Performance Element seeks to maintain and enhance behavioral health and performance in such environments. The behavioral risk (Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders) is a high priority within the NASA Human Research Program (HRP) because it has face validity, but lacks sufficient evidence due to a deficiency in measurement of the risk. Thus, there is concern that the behavioral health of the crew will be challenged in a Mars mission, however there is no standardized method to detect and quantify the magnitude of the risk or its likelihood.

The overarching goal of this project is to build on a successful record of software-based measurement of behavioral health indicators (e.g., mood, cognitive function, performance, physical and mental fatigue, sleep quality) to develop a complementary standardized suite of behavioral core measures (BCM) that would be quite feasible to implement within the constraints of spaceflight research, ground-based analogs (both short- and long-duration), and prolonged missions in isolated, confined, extreme environments lasting up to 12 months or longer. Achievement of this goal would permit a more rapid and reliable assessment and quantification of the Risk of Adverse Cognitive or Behavioral Conditions Psychiatric Outcomes for exploration class missions. The standardized behavioral medicine measures we are developing will be similar to the guidelines for standardization for bed rest studies. Defining standardized measures will not only allow for the systematic collection of data across multiple analogs, but it will also facilitate risk characterization for the Behavioral Medicine (BMed) risk. Without a standardized suite of behavioral health measures, the unknown BMed risk for exploration-class missions will continue to be estimated based on anecdote and conjecture.

The elements of the BCM include the following: (1) The Cognition test battery (a suite of 10 brief neuropsychological tests specifically designed for astronauts), (2) actigraphy sleep/wake data, (3) several visual analog scales and brief questionnaires with proven validity and utility in space and space analog environments, (4) Journals (Audio/Video and/or typed), (5) a robotic arm track-and-capture grappling task, (6) Team Measure Questionnaires designed to measure aspects of crew performance, team processes, team climate, and group living.

Data acquisition feasibility and flexibility, and user acceptability of BCM has been assessed in a short duration analog (4 HERA (Human Exploration Research Analog) N=16 subjects), is currently being assessed in a long-duration analog (10 months of data collection during a 12-14 month winter-over in the Antarctic Neumayer station, N=7 subjects), and will be further assessed on the International Space Station (ISS) for feasibility and acceptability (during a 6 month mission, N=2 astronauts). Mission controllers completed a team performance questionnaire during HERA missions, and flight directors will complete this brief questionnaire during the ISS study.

Research Impact/Earth Benefits: This project will deliver a Behavioral Core Measures Tool (BCM) that will be tested for its feasibility, flexibility, and acceptability in research studies in both short and long duration space analog environments and on the ISS. With the BCM, it will be possible for NASA's HFBP (Human Factors & Behavioral Performance) program to much better assess and quantify the Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Outcomes for exploration class missions.

With the proposed work we will relevantly contribute to HRP's goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. More specifically, the BCM will constitute an important technology to provide mission planners and system developers with strategies for monitoring and mitigating crew health and performance risks.

Additionally, Behavioral Core Measures could also be beneficial for monitoring behavioral health during Earth-based operations, especially those involving isolated, confined and extreme environments (e.g., Antarctic research expeditions).

Task Progress & Bibliography Information FY2017 
Task Progress: Cognition: Data acquisition in NASA's Human Exploration Research Analog (HERA) facility was finalized on 10/26/2016. We successfully collected a total of 288 full Cognition test bouts (100% of expected) and 270 surveys (93.75% of expected) in N=16 crewmembers. During the current reporting period we have deployed and collected data on N=8 crewmembers during two out of the four Campaign 3 missions in NASA's HERA facility. In HERA research participants perform the Cognition test battery on the Apple iPad; however, through discussions with the International Space Station Medical Project (ISSMP) it was determined that the iPad is not a feasible platform for data collection on ISS. Thus a Windows PC version of the Cognition software will be used on-board the ISS and in the Neumayer III Antarctic station. The Windows version of Cognition was deployed in the Antarctic Neumayer station during the reporting period. A full test battery plus survey (i.e., all 10 Cognition tests) is performed by the crewmembers that consented on a monthly basis. We have collected 27 full batteries so far, and expect to collect 56 more batteries until 7/21/2017.

Self-Report and Visual Analog Scale Measures: A set of visual analog scales and brief questionnaires with proven validity and utility in space and space analog environments were chosen in order to evaluate several key aspects of behavioral health and crew interaction. These questionnaires include (a) Visual Analog Scales (VAS) to evaluate perceived mental (mentally sharp—mentally fatigued) and physical (energetic—physically exhausted) exhaustion, fatigue (tired—fresh, ready to go), sleepiness (not sleepy at all—very sleepy), and stress (not stressed at all—very stressed); (b) the Social Desirability Scale (SDS-17) to measure one's self-desirability bias; (c) sleep diaries to evaluate sleep quality and duration; (d) the Profile of Mood States, Short Form (POMS-SF) to evaluate mood; (e) the Beck Depression Inventory (BDI-II) to evaluate depression; and (f) the Conflict Scale (CS) to evaluate perceived conflict among crewmembers and between crewmembers and mission control. These Visual Analog Scales and sleep diaries have already proven useful for measuring neurobehavioral health during 6-month missions on ISS and this data informed the need for a one-year mission.

During the four HERA missions these surveys were deployed using the University of Pennsylvania's REDCap electronic web based survey tool and data was successfully collected data on N=16 HERA crewmembers. During the current reporting period we collected data on N=8 crewmembers from the last two HERA Campaign 3 missions. Across all four Campaign 3 missions, self-report measures were successfully collected with 99.8% response adherence. A total of N=2,108 BCM questionnaires were completed: n=480 nighttime Visual Analog Scales; n=480 Conflict Scales; n=480 morning Visual Analog Scales and sleep diaries; n=572 POMS-SF, n=80 BDI-II, and n=16 SDS-17 questionnaires. Analyses show that the BCM psychological self-report scales reliably track behavioral states throughout a short-duration analog mission, including changes in mood and stress in response to sleep deprivation. Successful completion of all psychological self-report measures in HERA and thorough crew debriefs confirmed the feasibility of these BCM measures in a short-duration space-analog environment, and provided useful data to inform improvements to the implementation of each measure.

Journals: At the end of the reporting period, journal entries from all four HERA simulated asteroid rendezvous missions (N=16 crewmembers) have been completed successfully; the final few audio/video journals are currently being transcribed in preparation for analysis. Journals are currently being written using Microsoft Word at the Neumayer III Antarctic station and preparations are being made for astronauts on-board ISS to maintain journals.

ROBoT: In the second year of the ROBoT project, we worked on four main efforts. First, we continued data collection in HERA, completing Missions 3 and 4. Some 99.1% of anticipated data was successfully collected from subjects in HERA. Performance curves were preliminarily analyzed and found general improvement over the course of the mission, as would be expected from a task with a substantial learning curve, and performance differences associated with changes in grappling task difficulty. More detailed analysis is ongoing. Second, we also prepared for and initiated ROBoT deployment in Antarctica, including shipping of all hardware to Charite, Berlin, Germany and then to Neumayer station, training in Dr. Alexander Stahn on ROBoT setup and performance so he could set up the system and train the crew while visiting Neumayer, and initiating the study. We have thus far received 1 set of ROBoT data from Neumayer station—which appeared to be nominal—and expect the Neumayer crew to provide additional ROBoT data on a monthly basis, along with the other BCM measures. Third, also along with the rest of BCM, we have initiated ROBoT preparations for use aboard the International Space Station. This has involved making sure the research version of the ROBoT software is properly integrated with the operations version of the software, and planning for the uplink of that software to the ISS. Finally, we have begun collecting ROBoT data from control subjects for the HERA study in our research lab at MGH. This will begin to provide norms for performance on the ROBoT task to which HERA, Neumayer, and ISS performance can be compared. With the exception of the HERA data collection, the remainder of the above efforts will continue through the end of the current reporting period.

Team Measure Questionnaires: Data from the Team Measures battery was successfully acquired from all four 30-day HERA C3 missions (N=16 individuals) with 100% compliance. At the end of the previous reporting period, data from the initial battery of Team Measures was collected in two four-person crews (N=8) throughout two 30-day missions in the HERA facility. Preliminary analyses of the HERA data, thematic analysis of the initial Team Measures battery, and assessment of operational acceptability led to recommendations for a reduced and modified Team Measures battery and data collection schedule for long-duration missions in operational environments. This iteration of the Team Measures battery is currently being deployed and evaluated in a long-duration mission at Neumeyer Station in Antarctica (N=7 individuals). By the end of this reporting period, we expect 6 months of data from Neumayer. However, the currently available dataset (9 weeks of data) has been acquired with 87% compliance (one crewmember did not complete one session). Finally, with the assistance of ISSMP, we are also preparing for deployment on ISS Increments 55/56 along with the rest of the BCM measures.

Bibliography Type: Description: (Last Updated: 05/20/2022) 

Show Cumulative Bibliography Listing
 
Books/Book Chapters Roma PG, Bedwell WL. "Key factors and threat to team dynamics in long-duration extreme environments." in "Team Dynamics Over Time. Book series: Research on Managing Groups and Teams, Vol. 18." Ed. E. Salas. Bingley, UK: Emerald Group Publishing Limited, 2017 (in press)., May-2017
Project Title:  Standardized Behavioral Measures for Detecting Behavioral Health Risks during Exploration Missions Reduce
Images: icon  Fiscal Year: FY 2016 
Division: Human Research 
Research Discipline/Element:
HRP HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Start Date: 07/21/2015  
End Date: 07/20/2018  
Task Last Updated: 05/19/2016 
Download report in PDF pdf
Principal Investigator/Affiliation:   Dinges, David F. Ph.D. / University of Pennsylvania 
Address:  Department of Psychiatry 
423 Service Dr., 1013 Blockley Hall 
Philadelphia , PA 19104-4209 
Email: dinges@pennmedicine.upenn.edu 
Phone: 215-898-9949  
Congressional District:
Web:  
Organization Type: UNIVERSITY 
Organization Name: University of Pennsylvania 
Joint Agency:  
Comments:  
Co-Investigator(s)
Affiliation: 
Basner, Mathias  M.D. University of Pennsylvania 
Kayser, Matthew  M.D. Hospital of the University of Pennsylvania 
Mollicone, Daniel  Ph.D. Pulsar Informatics, Inc. 
Stuster, Jack  Ph.D. Anacapa Sciences, Inc. 
Strangman, Gary  Ph.D. Harvard Medical School 
McGuire, Sarah  Ph.D. University of Pennsylvania 
Stahn, Alexander  Ph.D. Charite University, Berlin 
Project Information: Grant/Contract No. NNX15AK76A 
Responsible Center: NASA JSC 
Grant Monitor: Williams, Thomas  
Center Contact: 281-483-8773 
thomas.j.will1@nasa.gov 
Solicitation / Funding Source: 2013-14 HERO NNJ13ZSA002N-BMED Behavioral Health & Performance 
Grant/Contract No.: NNX15AK76A 
Project Type: FLIGHT,GROUND 
Flight Program: ISS 
TechPort: No 
No. of Post Docs:
No. of PhD Candidates:
No. of Master's Candidates:
No. of Bachelor's Candidates:
No. of PhD Degrees:
No. of Master's Degrees:
No. of Bachelor's Degrees:
Human Research Program Elements: (1) HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Human Research Program Risks: (1) Bmed:Risk of Adverse Behavioral Conditions and Psychiatric Disorders
(2) Team:Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team (IRP Rev F)
Human Research Program Gaps: (1) BMed-102:Given exposures to spaceflight hazards (space radiation, isolation), how do we identify individual susceptibility, monitor molecular/biomarkers and acceptable thresholds, and validate behavioral health and CNS/neurological/neuropsychological performance measures and domains of relevance to exploration class missions? (IRP Rev L)
(2) BMed-105:Given the potentially negative spaceflight associated CNS/cognitive changes and behavioral experiences of stressors during long-duration missions (e.g., isolation, confinement, reduced sensory stimulation, altered gravity, space radiation), what are validated medical or dietary countermeasures to mitigate stressors impacting on CNS / cognition / behavioral health? (IRP Rev L)
(3) Team-102:We need to identify a set of quantifiable and validated measures, based on 5-12 key indicators of mission-relevant and identified spaceflight acceptable thresholds (or ranges) of team function, to effectively monitor and measure team health and performance of integrated NASA and commercial/private crews, during shifting autonomy in increasingly earth independent, long duration exploration missions (IRP Rev L)
Flight Assignment/Project Notes: NOTE: Element change to Human Factors & Behavioral Performance; previously Behavioral Health & Performance (Ed., 1/18/17)

Task Description: Isolated and confined environments anticipated during exploration missions will include stressors such as small teams living and working in extreme conditions for prolonged periods separated from family, friends; loss of the day/light cycle; loss or delay of communications with ground; partial gravity; and limited space, privacy, and food selection. NASA's Behavioral Health and Performance Element seeks to maintain and enhance behavioral health and performance in such environments. The behavioral risk (Risk of Adverse Behavioral Conditions and Psychiatric Disorders) is a high priority within the NASA Human Research Program (HRP) because it has face validity, but lacks sufficient evidence due to a deficiency in measurement of the risk. Thus, there is concern that the behavioral health of the crew will be challenged in a Mars mission; however, there is no standardized method to detect and quantify the magnitude of the risk or its likelihood. The overarching goal of this project is to build on a successful record of software-based measurement of behavioral health indicators (e.g., mood, cognitive function, performance, physical and mental fatigue, sleep quality) to develop a complementary standardized suite of behavioral core measures (BCM) that would be quite feasible to implement within the constraints of spaceflight research, ground-based analogs (both short- and long-duration), and prolonged missions in isolated, confined, extreme environments lasting up to 12 months or longer. Achievement of this goal would permit a more rapid and reliable assessment and quantification of the Risk of Adverse Behavioral Conditions Psychiatric Outcomes for exploration class missions.

The standardized behavioral medicine measures we are developing will be similar to the guidelines for standardization for bed rest studies. Defining standardized measures will not only allow for the systematic collection of data across multiple analogs, but it will also facilitate risk characterization for the Behavioral Medicine (BMed) risk. Without a standardized suite of behavioral health measures, the unknown BMed risk for exploration-class missions will continue to be estimated based on anecdote and conjecture.

Most elements of the BCM will be implemented on a Windows platform and will include the following:

(1) The Cognition test battery (a suite of 10 brief neuropsychological tests specifically designed for astronauts), (2) software integration of actigraphy sleep/wake data, (3) several visual analog scales and brief questionnaires with proven validity and utility in space and space analog environments, (4) Journals (Audio/Video and/or typed), (5) software integration of results derived from a robotic arm training task, (6) Team Measure Questionnaires designed to measure aspects of crew performance, team processes, team climate, team cohesion, and group living.

Data acquisition feasibility and flexibility, and user acceptability of BCM will be assessed in a short duration analog ((4 HERA (Human Exploration Research Analog), missions, N=16 subjects)), in a long-duration analog (one 12-14 month winter-over in the Antarctic Neumayer station, N=9 subjects), and on the International Space Station (ISS) feasibility (during 6-12 month missions, N=2 astronauts). During the HERA missions, a number of mission controllers will be offered to participate in the team measures questionnaires.

Research Impact/Earth Benefits: This project will deliver a Behavioral Core Measures Tool (BCM) that will be tested for its feasibility, flexibility, and acceptability in research studies in both short and long duration space analog environments and on the ISS. With the BCM, it will be possible for NASA's BHP program to much better assess and quantify the Risk of Adverse Behavioral Conditions and Psychiatric Outcomes for exploration class missions.

With the proposed work we will relevantly contribute to HRP's goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. More specifically, the BCM will constitute an important technology to provide mission planners and system developers with strategies for monitoring and mitigating crew health and performance risks.

Task Progress & Bibliography Information FY2016 
Task Progress: Cognition: At the end of the reporting period for the first year we will have deployed and collected data on N=8 crewmembers during two out of the four Campaign 3 missions in NASA's Human Exploration Research Analog (HERA) facility. In HERA research participants perform the Cognition test battery on the Apple iPad; however, through discussions with the International Space Station Medical Program (ISSMP) it was determined that the iPad is not a feasible platform for data collection on ISS. Thus a Windows PC version of the Cognition software will be used on-board the ISS and in the Neumayer III Antarctic station.

Self Report and Visual Analog Scale Measures: During the first year of the project, work was done to identify several visual analog scales and brief questionnaires with proven validity and utility in space and space analog environments that could be used to evaluate several key aspects of behavioral health and crew interaction. This set of measures evaluates perceived mental and physical exhaustion, fatigue, sleepiness and stress, self-desirability bias, sleep quality and duration, mood, depression, and perceived conflict among crewmembers and between crewmembers and mission control. The final set of selected measures were transposed into the University of Pennsylvania's REDCap electronic web based survey tool. The REDCap versions of the survey have been deployed in HERA and at the end of the reporting period data will have been collected data on N=8 crewmembers. We are preparing to deploy these measures in the Neumayer III Antarctic station. With the assistance of ISSMP, we are in the process of determining the most feasible way to deploy these measures on ISS.

Journals: At the end of the reporting period, journal entries from two of the four HERA simulated asteroid rendezvous missions (N=8 crewmembers) will have been completed successfully; these audio/video journals are currently being transcribed in preparation for analysis. Journals will be completed using Microsoft Word in the Neumayer III Antarctic station and on-board ISS.

ROBoT: In the first year of the ROBoT project, we worked with the NASA DST lab (original developers of ROBoT) and the NASA astronaut trainers for ROBoT to make the planned software modifications. As part of these, we began to develop a quantitative performance scoring system based on the trainers’ current practices in astronaut evaluation. A first version of this system, with a draft performance scoring system, was tested in the 30-day HERA Campaign 3, Mission 1 in February 2016. No significant difficulties were encountered in the deployment of the modified ROBoT, and all crewmembers found the task both challenging and enjoyable. Performance generally improved over the course of the mission, as would be expected from a task with a substantial learning curve. Following Mission 1, a notable re-design of the scoring system was implemented, to make the scoring align much more closely with current trainer procedures. As with Mission 1, 4 new subjects were pre-trained for Mission 2 at the end of April 2016, and entered the HERA facility for the 30-day Mission 2 on May 2, 2016. Missions 3 and 4 in HERA are planned for later in 2016. In parallel, ROBoT hardware is (1) being readied for shipment to Charite, Berlin, Germany for transfer to the Neumayer Antarctic station for testing in 2017, and (2) being evaluated by ISSMP for any needed payload certifications for deployment of the enhanced ROBoT software onboard the ISS in 2018.

Team Measure Questionnaires: In October 2015, the NASA Behavioral Health and Performance (BHP) Element convened a Team Risk Standardized Measures Workshop featuring multiple subject matter experts and stakeholders from the research and operations communities to discuss and nominate empirically-supported team measures for the Behavioral Core Measures (BCM) project. The Workshop considered various theoretical frameworks and available measurement tools applicable to the team risks of long-duration missions in isolated, confined, and extreme environments. Drawing largely from the Organizational Psychology and Behavioral Health literatures as well as the NASA BHP Team Risk research portfolio, a broad Input-Process-Output model of team performance was adopted, and various measures were selected to efficiently capture a wide variety of critical team-relevant constructs and topics. The measurement targets include personality, demographics, conflict, task and social cohesion, performance effectiveness, mission strategy/planning, performance monitoring, cooperation, communication, coordination, team climate, social support, and group living competencies. At the end of the reporting period, data from the initial battery of Team Measures will have been collected in two four-person crews (N=8) throughout two 30-day missions in the HERA facility, and are scheduled for collection in remaining two HERA missions for this year. Preliminary quantitative analyses of the HERA data, thematic analysis of the initial Team Measures battery, and assessment of operational acceptability led to recommendations for a reduced and modified Team Measures battery and data collection schedule for long-duration missions in operational environments. This iteration of the Team Measures battery will be deployed and evaluated in forthcoming long-duration missions at Neumeyer Station in Antarctica and the International Space Station (ISS). With the assistance of ISSMP, we are determining the most feasible way to deploy these measures on ISS.

Bibliography Type: Description: (Last Updated: 05/20/2022) 

Show Cumulative Bibliography Listing
 
 None in FY 2016
Project Title:  Standardized Behavioral Measures for Detecting Behavioral Health Risks during Exploration Missions Reduce
Images: icon  Fiscal Year: FY 2015 
Division: Human Research 
Research Discipline/Element:
HRP HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Start Date: 07/21/2015  
End Date: 07/20/2018  
Task Last Updated: 08/14/2015 
Download report in PDF pdf
Principal Investigator/Affiliation:   Dinges, David F. Ph.D. / University of Pennsylvania 
Address:  Department of Psychiatry 
423 Service Dr., 1013 Blockley Hall 
Philadelphia , PA 19104-4209 
Email: dinges@pennmedicine.upenn.edu 
Phone: 215-898-9949  
Congressional District:
Web:  
Organization Type: UNIVERSITY 
Organization Name: University of Pennsylvania 
Joint Agency:  
Comments:  
Co-Investigator(s)
Affiliation: 
Basner, Mathias  M.D. University of Pennsylvania 
Goel, Namni  Ph.D. University of Pennsylvania 
Gur, Ruben  Ph.D. University of Pennsylvania 
Kayser, Matthew  M.D. Hospital of the University of Pennsylvania 
Mollicone, Daniel  Ph.D. Pulsar Informatics, Inc. 
Stuster, Jack  Ph.D. Anacapa Sciences, Inc. 
Project Information: Grant/Contract No. NNX15AK76A 
Responsible Center: NASA JSC 
Grant Monitor: Leveton, Lauren  
Center Contact:  
lauren.b.leveton@nasa5.gov 
Solicitation / Funding Source: 2013-14 HERO NNJ13ZSA002N-BMED Behavioral Health & Performance 
Grant/Contract No.: NNX15AK76A 
Project Type: FLIGHT,GROUND 
Flight Program: ISS 
TechPort: No 
No. of Post Docs:  
No. of PhD Candidates:  
No. of Master's Candidates:  
No. of Bachelor's Candidates:  
No. of PhD Degrees:  
No. of Master's Degrees:  
No. of Bachelor's Degrees:  
Human Research Program Elements: (1) HFBP:Human Factors & Behavioral Performance (IRP Rev H)
Human Research Program Risks: (1) Bmed:Risk of Adverse Behavioral Conditions and Psychiatric Disorders
(2) Team:Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team (IRP Rev F)
Human Research Program Gaps: (1) BMed-102:Given exposures to spaceflight hazards (space radiation, isolation), how do we identify individual susceptibility, monitor molecular/biomarkers and acceptable thresholds, and validate behavioral health and CNS/neurological/neuropsychological performance measures and domains of relevance to exploration class missions? (IRP Rev L)
(2) BMed-105:Given the potentially negative spaceflight associated CNS/cognitive changes and behavioral experiences of stressors during long-duration missions (e.g., isolation, confinement, reduced sensory stimulation, altered gravity, space radiation), what are validated medical or dietary countermeasures to mitigate stressors impacting on CNS / cognition / behavioral health? (IRP Rev L)
(3) Team-102:We need to identify a set of quantifiable and validated measures, based on 5-12 key indicators of mission-relevant and identified spaceflight acceptable thresholds (or ranges) of team function, to effectively monitor and measure team health and performance of integrated NASA and commercial/private crews, during shifting autonomy in increasingly earth independent, long duration exploration missions (IRP Rev L)
Task Description: The behavioral health of the crew during a mission to Mars mission could challenged due to the conditions required by the flight. However there is no standardized method to detect and quantify the magnitude of the risk or its likelihood. The overarching goal of this project is to build on a successful record of unobtrusive, software-based measurement of behavioral health indicators (e.g., mood, cognitive function, physical and mental fatigue, sleep quality) to develop an integrated standardized suite of behavioral health measurement tools that would be quite feasible to implement within the constraints of spaceflight research, ground-based analogs (both short- and long-duration), and prolonged missions in isolated, confined, extreme environments lasting up to 12 months or longer. Achievement of this goal would permit a more rapid and reliable assessment and quantification of the Risk of Adverse Behavioral Conditions Psychiatric Outcomes for exploration class missions. The suite of behavioral medicine measures we are developing will be integrated on Apple's iPad platform for their standardized use in ground analogs relevant to the spaceflight context (i.e., Standardized Behavioral Measures Tool or SBMT). It will include (a) the Cognition battery, (b) Visual Analog Scales (VAS) of perceived mental and physical exhaustion, fatigue, stress, workload, conflict and sleep quality, (c) actigraphy for monitoring sleep/wake activity, (d) an audio journal, (e) the Space Dock task as an operational performance measure, and (f) additional non-invasive measures relevant to behavioral medicine informed by a comprehensive literature review. The SBMT will be evaluated for its including the task of taking the information on measurement feasibility, flexibility, and acceptability during post-mission assessments in the participants studied in Human Exploration Research Analog (HERA), Hawai'i Space Exploration Analog and Simulation (HI-SEAS), and on International Space Station (ISS). It will be improved as needed, and an operational procedures document will be developed to make it use convenient and unobtrusive for detecting the incident rate of behavioral health risks in space and on Earth.

Research Impact/Earth Benefits:

Task Progress & Bibliography Information FY2015 
Task Progress: New project for FY2015.

Bibliography Type: Description: (Last Updated: 05/20/2022) 

Show Cumulative Bibliography Listing
 
 None in FY 2015