Background: Obstructive sleep apnea (OSA) affects more than 1 in 10 US adults, and contributes to cardiovascular disease morbidity, lower quality of life and mood, and higher mortality. First-line therapy for OSA, positive airway pressure (PAP), is efficacious; yet >50% of patients use PAP <4.0 hours/night, a level inadequate to improve symptoms. A chief limitation to optimal PAP use is the lack of patient support for enacting the behavioral changes required for nightly PAP use. As suboptimal PAP use is the primary barrier preventing widespread adoption of OSA treatment, disseminating these important findings is critical for reducing the burden of OSA, particularly among underserved areas with reduced access to care.
Proposed Solution to the Problem: The project team plans to disseminate findings from a recent PCORI-funded study demonstrating the efficacy of peer buddy support, as well as related findings from recent clinical guidelines, to diverse patient and provider groups to support PAP use.
Objectives: The objective is to develop, deploy, and evaluate a dissemination strategy to share findings of a novel, patient-centered approach (PDI-IVR), as well as recent clinical guidelines, to promote PAP use. The dissemination strategies will be directed to diverse patient groups with OSA and their providers with the purpose of generating awareness of PDI-IVR and supportive behavioral interventions; improving knowledge of behavioral interventions to optimize PAP use; and motivating/inciting improved PAP adherence.
Activities: The Knowledge Translation Plan (Barwick, 2011) will guide the team’s dissemination plan. First, the team will form a workgroup comprised of key stakeholders, including the intervention developers, patients with OSA, healthcare professionals, and researchers. The team will then conduct theory-informed focus groups and interviews with stakeholders and target users to identify barriers and enablers to dissemination, identify key messages for target users, refine dissemination goals, and inform the strategy to optimize uptake and sustainability in diverse settings. Users will include patients of myApnea.Org, an OSA web portal, and Davidson Medical Ministry Clinic staff and patients. The team will then develop a formal dissemination plan and evaluate the plan.
Outcomes: The initial analyses will focus on aligning target messaging, derived from the team’s qualitative work, with dissemination strategies, including portal development. To evaluate the impact of the plan, the team will evaluate the reach, adoption, usefulness, and sustainability of the strategy. Outputs will include the products of the team’s strategies, which will include workshops/webinars for providers and plain-language summaries for patients.
Patient and Stakeholder Engagement Plan: The project team’s work will include two patient partners with sleep apnea and stakeholders. The team will develop an advisory group, comprised of key stakeholders, that will meet quarterly. The team will conduct interviews and focus groups with patients and stakeholders to inform its dissemination work, and to assist with disseminating its strategies and findings.
Project Collaborators: This project will be led by Brigham and Women’s Hospital. Collaborators include University of Arizona (subcontract), Davidson Medical Ministries Clinic, MyApnea.Org, Alliance of Sleep Apnea Partners, American Academy of Sleep Medicine, and American Alliance for Healthy Sleep.