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NASA NTRS2005

Human behavioral research in space: quandaries for research subjects and researchers

With the advent of long-duration spaceflight on board the International Space Station (ISS) and possible future missions beyond low Earth orbit (LEO) such as Mars, it is critical that those at NASA have a realistic assessment of the challenges that will face individuals on long-duration missions so that they can develop preventive and real-time countermeasures to behavioral health issues. While space travellers are very interested in having countermeasures to the deleterious effects of space missions, they have a powerful disincentive to participate in this research if they feel it could in any way negatively affect their flight status. The behavioral issues of isolation and confinement for extended-duration space missions are reviewed. Areas of basic and clinical behavioral research are listed. And the classical clinical model for research is not considered appropriate for the current configuration of the space program. The use of analogue environments and advanced statistical analysis are suggested as ways to address the limited spaceflight research opportunities. The challenge of research subject or patient confidentiality vs. mission safety and issues of personal flight status are addressed.

Review, Tutorial↗
NASA NTRS2016

Review of NASA's Evidence Reports on Human Health Risks

NASA has requested a study from the Institute of Medicine (IOM) to provide an independent review of more than 30 evidence reports on human health risks for long duration and exploration spaceflight. The evidence reports, which are publicly available, are categorized into five broad categories: (1) behavioral health and performance; (2) human health countermeasures (with a focus on bone metabolism and orthopedics, nutrition, immunology, and cardiac and pulmonary physiology); (3) radiation; (4) human factors issues; and (5) exploration medical capabilities. The reports are revised on an ongoing basis to incorporate new scientific information. In conducting this study, an IOM ad hoc committee will build on the 2008 IOM report Review of NASA's Human Research Program Evidence Books. That report provided an assessment of the process used for developing the evidence reports and provided an initial review of the evidence reports that had been completed at that time. Each year, NASA staff will identify a set of evidence reports for committee review. Over the course of the study all evidence reports will be reviewed. The committee will hold an annual scientific workshop to receive input on the evidence reports it is reviewing that year and an update on the recent literature. The committee will issue an annual letter report that addresses the following questions relevant to each evidence report: 1. Does the evidence report provide sufficient evidence, as well as sufficient risk context, that the risk is of concern for long-term space missions? 2. Does the evidence report make the case for the research gaps presented? 3. Are there any additional gaps in knowledge or areas of fundamental research that should be considered to enhance the basic understanding of this specific risk? 4. Does the evidence report address relevant interactions among risks? 5. Is input from additional disciplines needed? 6. Is the breadth of the cited literature sufficient? 7. What is the overall readability and quality? 8. Is the expertise of the authors sufficient to fully cover the scope of the given risk? 9. Has the evidence report addressed previous recommendations made by the IOM in the 2008 letter report?

Scott-Conner, Carol E. H.↗
NASA NTRS2010

Survey of On-Orbit Sleep Quality: Short-Duration Flyers

The NASA Human Research Program (HRP) Behavioral Health and Performance Element (BHP), in conjunction with the NASA Space Medicine Division, is currently completing the largest systematic, subjective assessment of shuttle astronauts sleep behaviors and sleep quality on Earth, during training periods, and during space flight missions. Since July 2009, a total of 66 astronauts have completed a secure online survey regarding specific sleep strategies, crew policies, and mitigation effectiveness. In addition to the survey, each astronaut participant met individually with trained BHP and SD representatives for a structured, follow-up interview. Data are currently being assessed and the study s principal investigator will be providing some preliminary findings at the Investigators Workshop. Additional analyses will be conducted in the following months to examine predictors of optimal sleep in space, and to evaluate the differences in countermeasure effectiveness between groups based on their sleep experience on the ground and on orbit. A revised survey for a subsequent investigation on the experiences of long-duration flyers will be developed in the Spring and implemented in the Summer of 2010. Findings from both of these investigations will inform countermeasure strategies for astronauts, medical operations, and habitat designers for future exploration missions, as well as upcoming shuttle and ISS missions.

Locke, J.↗
NASA NTRS2012

Human Research Program: 2012 Fiscal Year Annual Report

Crew health and performance are critical to successful human exploration beyond low Earth orbit. Risks to health and performance include physiologic effects from radiation, hypogravity, and planetary environments, as well as unique challenges in medical treatment, human factors, and support of behavioral health. The scientists and engineers of the Human Research Program (HRP) investigate and reduce the greatest risks to human health and performance, and provide essential countermeasures and technologies for human space exploration. In its seventh year of operation, the HRP continued to refine its management architecture of evidence, risks, gaps, tasks, and deliverables. Experiments continued on the International Space Station (ISS), on the ground in analog environments that have features similar to those of spaceflight, and in laboratory environments. Data from these experiments furthered the understanding of how the space environment affects the human system. These research results contributed to scientific knowledge and technology developments that address the human health and performance risks. As shown in this report, HRP has made significant progress toward developing medical care and countermeasure systems for space exploration missions which will ultimately reduce risks to crew health and performance.

Effenhauser, Laura↗
NASA NTRS2011

NASA Astronaut Selection 2009: Behavioral Overview

Behavioral Health and Performance (BHP) is an operational group under medical sciences at NASA/Johnson Space Center. Astronaut applicant screening and assessment is one function of this group, along with psychological training, inflight behavioral support and family services. Direct BHP assessment spans 6-7 months of a 17-month overall selection process.

Holland, A.↗
NASA NTRS2011

Human Health and Performance Considerations for Exploration of Near Earth Asteroids (NEA)

This slide presentation reviews some of the health and performance issues for an manned exploration mission to some of the Near Earth Asteroids (NEA). The issues that NASA is reviewing are: 1. Radiation exposure 2. Inadequate food and nutrition 3. Challenges to behavioral health 4. Muscle, cardiovascular, bone atrophy 5. Dust and volatiles 6. Remote medical care 7. Decompression sickness.

Kundrot, Craig E.↗
NASA NTRS2012

Astronaut Biography Project for Countermeasures of Human Behavior and Performance Risks in Long Duration Space Flights

This final report will summarize research that relates to human behavioral health and performance of astronauts and flight controllers. Literature reviews, data archival analyses, and ground-based analog studies that center around the risk of human space flight are being used to help mitigate human behavior and performance risks from long duration space flights. A qualitative analysis of an astronaut autobiography was completed. An analysis was also conducted on exercise countermeasure publications to show the positive affects of exercise on the risks targeted in this study. The three main risks targeted in this study are risks of behavioral and psychiatric disorders, risks of performance errors due to poor team performance, cohesion, and composition, and risks of performance errors due to sleep deprivation, circadian rhythm. These three risks focus on psychological and physiological aspects of astronauts who venture out into space on long duration space missions. The purpose of this research is to target these risks in order to help quantify, identify, and mature countermeasures and technologies required in preventing or mitigating adverse outcomes from exposure to the spaceflight environment

Banks, Akeem↗
NASA NTRS2015

Identifying the "Right Stuff": An Exploration-Focused Astronaut Job Analysis

Industrial and organizational (I/O) psychologists play a key role in NASA astronaut candidate selection through the identification of the competencies necessary to successfully engage in the astronaut job. A set of psychosocial competencies, developed by I/O psychologists during a prior job analysis conducted in 1996 and updated in 2003, were identified as necessary for individuals working and living in the space shuttle and on the International Space Station (ISS). This set of competencies applied to the space shuttle and applies to current ISS missions, but may not apply to longer-duration or long-distance exploration missions. With the 2015 launch of the first 12- month ISS mission and the shift in the 2020s to missions beyond low earth orbit, the type of missions that astronauts will conduct and the environment in which they do their work will change dramatically, leading to new challenges for these crews. To support future astronaut selection, training, and research, I/O psychologists in NASA's Behavioral Health and Performance (BHP) Operations and Research groups engaged in a joint effort to conduct an updated analysis of the astronaut job for current and future operations. This project will result in the identification of behavioral competencies critical to performing the astronaut job, along with relative weights for each of the identified competencies, through the application of job analysis techniques. While this job analysis is being conducted according to job analysis best practices, the project poses a number of novel challenges. These challenges include the need to identify competencies for multiple mission types simultaneously, to evaluate jobs that have no incumbents as they have never before been conducted, and working with a very limited population of subject matter experts. Given these challenges, under the guidance of job analysis experts, we used the following methods to conduct the job analysis and identify the key competencies for current and potential future missions.

Barrett, J. D.↗
NASA NTRSDate not supplied

Assessment of the State of Communication Delay Research in Preparation for Missions Beyond Low Earth Orbit

NASA’s mission-operations paradigm, established during Project Mercury and minimally evolving through the Apollo Program, Space Shuttle Program, and ISS missions, has primarily depended on real-time support from a ground team of experts. This ground team has served as the safety net for crewed spaceflight missions over the past 60 years, managing the combined state of the mission, vehicle, and crew. However, this operational paradigm, which has seen little change in its Human-Systems Integration Architecture (HSIA), will face challenges during long-duration exploration missions beyond low Earth orbit. Lunar missions may experience one-way communication latencies ranging from 3 to 14 seconds, while Mars missions will encounter up to a 44-minute round-trip latency at a maximum distance from Earth. Communication delays negatively impact the behavioral health and performance of individuals and crews operating across the multi-team space-to-ground system. Previous research indicates that increased isolation and the challenges posed by delayed communication lead to heightened stress, frustration, adverse behavioral symptoms, and reduced individual performance. NASA has investigated the nature and effectiveness of managing this shift in complex operations since early 2000, but additional research is necessary to assess the issues associated with communication latencies and identify effective countermeasures. This work aimed to examine the evidence from 20 years of research on comm delays. We systematically reviewed the past 20 years of communication delay literature, focusing on how this research aligns with relevant, high-priority needs in the HSIA, Team, and BMed Risks. This type of panoramic review has not been done since 2013; a current, aggregated picture of what has been studied and how is needed to inform additional studies and mitigation development. Additional perspectives were gained from interviews with the research participants, operations experts, and communication delay researchers. Results from this effort will help characterize the risk posed by communication latency for upcoming Artemis missions and point toward potential mitigations. The final results will be presented. For the literature review, we formed a search term seed set drawing from languages used in two papers representative of the previous state of knowledge and supplemented it with additional search terms. We conducted literature searches on Google Scholar, PubMed, and Web of Science and searched NASA project archives for output from NASA-sponsored research. This search yielded 150 papers, of which 48 were relevant. SME interviews provided perspective on key communication delay issues and concerns and what is being worked on to mitigate those issues. Preliminary results of the literature review have been presented. Final results to be presented include the results of the literature review and findings from the interviews.

literature review↗
NASA NTRS2012

Countermeasures to Mitigate the Negative Impact of Sensory Deprivation and Social Isolation in Long-Duration Space Flight

Long-duration space flight presents several challenges to the behavioral health of crew members. The environment that they are likely to experience will be isolated, confined, and extreme (ICE) and, as such, crew members will experience extreme sensory deprivation and social isolation. The current paper briefly notes the behavioral, cognitive, and affective consequences of psychological stress induced by ICE environments and proposes nine countermeasures aimed at mitigating the negative effects of sensory deprivation and social isolation. Implementation of countermeasures aims to maintain successful crew performance and psychological well-being in a long-duration space flight mission.

Bachman, Katharine Ridgeway OBrien↗
NASA NTRS2017

Risk of Adverse Health Outcomes and Decrements in Performance Due to In-flight Medical Conditions

The drive to undertake long-duration space exploration missions at greater distances from Earth gives rise to many challenges concerning human performance under extreme conditions. At NASA, the Human Research Program (HRP) has been established to investigate the specific risks to astronaut health and performance presented by space exploration, in addition to developing necessary countermeasures and technology to reduce risk and facilitate safer, more productive missions in space (NASA Human Research Program 2009). The HRP is divided into five subsections, covering behavioral health, space radiation, habitability, and other areas of interest. Within this structure is the ExMC Element, whose research contributes to the overall development of new technologies to overcome the challenges of expanding human exploration and habitation of space. The risk statement provided by the HRP to the ExMC Element states: "Given that medical conditions/events will occur during human spaceflight missions, there is a possibility of adverse health outcomes and decrements in performance in mission and for long term health" (NASA Human Research Program 2016). Within this risk context, the Exploration Medical Capabilities (ExMC) Element is specifically concerned with establishing evidenced-based methods of monitoring and maintaining astronaut health. Essential to completing this task is the advancement in techniques that identify, prevent, and treat any health threats that may occur during space missions. The ultimate goal of the ExMC Element is to develop and demonstrate a pathway for medical system integration into vehicle and mission design to mitigate the risk of medical issues. Integral to this effort is inclusion of an evidence-based medical and data handling system appropriate for long-duration, exploration-class missions. This requires a clear Concept of Operations, quantitative risk metrics or other tools to address changing risk throughout a mission, and system scoping and system engineering. Because of the novel nature of the risks involved in exploration missions, new and complex ethical challenges are likely to be encountered. This document describes the relevant background and evidence that informs the development of an exploration medical system.

Antonsen,Erik↗
NASA NTRS2018

Validation and Norms of Cognition and Spaceflight Assessments with Senior Military Leaders

Spaceflight hazards include risks to cognitive performance. NASA requires sensitive neuropsychological screening tools to determine changes to cognitive risks to crew health and performance. Currently, NASA uses WinSCAT (Spaceflight Cognitive Assessment Tool for Windows) for neurocognitive screening and to monitor the status of astronauts during spaceflight. The CognitionTest Battery was recently developed by NASA-funded researchers at UPenn as part of the Behavioral Health and Performance component of NASA Standard Measures. This research provides independently validated norms and psychometric properties to compare WinSCAT to Cognition using a military population who operates in high demand, extreme environments similar to those experienced by astronauts (deployments, isolation, extreme environments).

Williams, T. J.↗
NASA NTRS2016

Psychological Support Operations and the ISS One-Year Mission

Since NASA began human presence on the International Space Station (ISS) in November 1998, crews have spent two to seven months onboard. In March 2015 NASA and Russia embarked on a new era of ISS utilization, with two of their crewmembers conducting a one-year mission onboard ISS. The mission has been useful for both research and mission operations to better understand the human, technological, mission management and staffing challenges that may be faced on missions beyond Low Earth Orbit. The work completed during the first 42 ISS missions provided the basis for the pre-flight, in-flight and post-flight work completed by NASA's Space Medicine Operations Division, while our Russian colleagues provided valuable insights from their long-duration mission experiences with missions lasting 10-14 months, which predated the ISS era. Space Medicine's Behavioral Health and Performance Group (BHP) provided pre-flight training, evaluation, and preparation as well as in-flight psychological support for the NASA crewmember. While the BHP team collaboratively planned for this mission with the help of all ISS international partners within the Human Behavior and Performance Working Group to leverage their collective expertise, the US and Russian BHP personnel were responsible for their respective crewmembers. The presentation will summarize the lessons and experience gained within the areas identified by this Working Group as being of primary importance for a one-year mission.

Beven, G.↗
NASA NTRS2011

An Earthling to an Astronaut: Medical Challenges

Humans can travel safely into space in low Earth orbit (LEO) or to near-Earth objects if several medical, physiological, environmental, and human factors issues risks are mitigated. Research must be performed in order to set standards in these four areas, and current NASA standards are contained in the Space Flight Human System Standards volumes 1 and 2, and crew medical certification standards. These three sets of standards drive all of the clinical, biomedical research and environmental technology development for the NASA human space flight program. These standards also drive the identification of specific risks to crew health and safety, and we currently manage 65 human system risks within the human space flight program. Each risk has a specific program of research, technology development, and development of operational procedures to mitigate the risks. Some of the more important risks tat will be discussed in this talk include exposure to radiation, behavioral health due to confinement in a closed cabin, physiological changes such as loss of bone, muscle and exercise capability, reduction in immune system capability, environmental threats of maintaining an adequate atmosphere and water for drinking, avoidance of toxic or infectious material, protection of hearing, and human factors issues of equipment and task design. A nutritious and varied food supply must also be provided. All of these risks will be discussed and current strategies for mitigating these risks for long-duration human space flight. In mitigating these 65 human system risks, novel approaches to problem solving must be employed to find the most appropriate research and technology based applications. Some risk mitigations are developed internally to NASA while others are found through research grants, technology procurements, and more recently open innovation techniques to seek solutions from the global technical community. Examples and results will be presented from all of these approaches including the more recent use of prizes to stimulate innovation.

Davis, Jeffrey R.↗
NASA NTRSDate not supplied

Development of A Crew Health and Performance System Probabilistic Risk Assessment Tool: Proof-of-Concept Approach

The crew health and performance (CHP) system represents the span of technological interventions and tested processes and procedures that in combination address the human risk to space flight. The Human Research Program (HRP) mental model of the CHP system breaks the capabilities needed to meet NASA human flight systems standards into specific categories (i.e., countermeasures, behavioral health, medical intervention). These categories are further broken down into specific sub-groups generally associated with the human system risks that these capabilities seek to mitigate. Like the approach used to develop the Integrated Medical Model (IMM) and the Medical Extensible Dynamic Probabilistic Risk Analysis Tool (MEDPRAT), HRP tasked NASA GRC’s Cross-Cutting Computational Modeling Project with developing a CHP probabilistic risk assessment tool, the CHP-PRA. The CHP-PRA model seeks to quantify and relatively assess the human risk state within the crew health and performance domain, using a combination of knowledge about human system risks and technology and practices likely to be applied during space flight missions. This modeling system will incorporate customer and stakeholder feedback and be flexible enough to address multiple different questions about important low-level mission-specific parameters. This presentation will introduce the initial concept and development timeline for this tool and demonstrate proof-of-concept through an application addressing a specific human risk question posed within the Artemis program.

Risk analysis↗
NASA NTRS2009

Human Research Program Requirements Document (Revision C)

The purpose of this document is to define, document, and allocate the Human Research Program (HRP) requirements to the HRP Program Elements. It establishes the flow-down of requirements from Exploration Systems Mission Directorate (ESMD) and Office of the Chief Health and Medical Officer (OCHMO) to the various Program Elements of the HRP to ensure that human research and technology countermeasure investments are made to insure the delivery of countermeasures and technologies that satisfy ESMD's and OCHMO's exploration mission requirements. Requirements driving the HRP work and deliverables are derived from the exploration architecture, as well as Agency standards regarding the maintenance of human health and performance. Agency human health and performance standards will define acceptable risk for each type and duration of exploration mission. It is critical to have the best available scientific and clinical evidence in setting and validating these standards. In addition, it is imperative that the best available evidence on preventing and mitigating human health and performance risks is incorporated into exploration mission and vehicle designs. These elements form the basis of the HRP research and technology development requirements and highlight the importance of HRP investments in enabling NASA's exploration missions. This PRD defines the requirements of the HRP which is comprised of the following major Program Elements: Behavioral Health and Performance (BHP), Exploration Medical Capability (ExMC), Human Health Countermeasures (HHC), ISS Medical Project (ISSMP), Space Human Factors and Habitability (SHFH), and Space Radiation (SR).

Vargas, Paul R.↗
NASA NTRSDate not supplied

Supporting Crew Medical Decisions on Deep Space Missions: A Real-Time Performance Monitoring

Crewed missions into deep space will require astronauts to respond autonomously to safety- and time-critical anomalies. These and other potential issues will require the continuous monitoring and recognition of potentially subtle, but complex, anomalous data patterns. NASA continues to investigate real-time metrics for Extravehicular Operations1 and for providing feedback to improve performance2. Since it is unknown how long-term exposure to deep space will affect crew health, continuous monitoring of clinical and subclinical status is warranted. NASA is characterizing crew medical decision-support needs and identifying the recommended requirements of a Clinical Decision Support System (CDSS) within the Exploration Medical Capability Element (ExMC) of the Human Research Program3. Early detection, and continuous monitoring, of performance may provide an effective prognostic capability for assessing crew health state, and the identified requirements could be provided for an in-vehicle CDSS that acts as an assistant for delivering optimal health and performance and medical care during exploration missions. There is evidence to suggest that automatic, unobtrusive collection of keystroke features, such as alphanumeric key latencies, backspaces or typing rhythm, could be a valuable performance screening tool. Keystroke features show significant differences between control subjects and patients with overt clinical illness, such as multiple sclerosis4 and Parkinson’s disease5, as well as behavioral health and performance issues, such as mild cognitive impairment6 and depression7. This work is exploring a capability for the assessment of early task performance decline in crew as they perform daily activities. Timestamped keyboard entries are continuously collected and stored. Nominal keystroke interactions are compared to those obtained after exposure to spaceflight stressors, e.g., fatigue, to determine the methods sensitivity. This work will pave the way toward an objective detection tool that may be deployed in a spaceflight setting.

clinical↗
NASA NTRS2010

Different Perspectives on Asthenia in Astronauts and Cosmonauts: International Research Literature

The Behavioral Health and Performance (BHP) Element is one of the six elements within the NASA Human Research Program (HRP) and is responsible for managing four risks: a) The Risk of Performance Decrements due to inadequate Cooperation, Coordination, Communication and Psychological Adaptation within a Team (Team), b) the Risk of Performance Errors due to Sleep Loss, Circadian De-synchronization, Fatigue and Work Overload (Sleep), c) Risk of Behavioral Conditions (BMed), and d) the Risk of Psychiatric Disorders (BMed). The aim of this report is to address some of the recommendations made by the recent NASA HRP Standing Review Panel for the Behavioral Medicine Risk of Psychiatric Disorders. Such recommendations included: a) the inclusion of important national and international literature in English and non-English language materials; including journals, books, magazines, conference reports and b) an extensive literature review of certain types of psychological states to predict, detect, and assess adverse mental states that may negatively affect the psychological well being of the astronauts, specifically asthenia. This report was a collaborative international work effort focused on the evaluation and determination of the importance of continuing research on asthenia as a possible psychological problem that might affect the optimal psychological functioning among crewmembers during long-duration space flight missions. Russian medical personnel (flight surgeons and psychologist) have observed symptoms of asthenia (weakness, increased fatigue, irritability, and attention and memory disorders) in cosmonauts after four months in space (Myasnikov& Zamaleddinov1996; Grigorieve, 1996 ) and believe that asthenia is one of the greater risks that will affect crews? optimal psychological functioning.

Sandoval, Luis↗