Project Summary

PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.

This PCORI-funded implementation project is expanding a phone-based peer support program to help patients with sleep apnea use continuous positive airway pressure, or CPAP, machines as prescribed.

Obstructive sleep apnea is a health problem that causes the throat muscles to relax and block the airway, making breathing stop and start during sleep. Sleep apnea affects millions of people in the United States. It places people at a higher risk for fatigue, accidents, and other health problems, including high blood pressure and heart disease.

What is the goal of this implementation project?

CPAP is a common treatment for sleep apnea. CPAP machines use a mask to give patients constant, steady air pressure while they sleep. But more than half of people don’t use CPAP machines the right way or decide not to use it at all. A PCORI-funded research study found that people in a phone-based peer support program used their CPAP machines as prescribed and were more satisfied with their treatment than those who received usual education about sleep apnea and CPAP.

This project is expanding the peer support program to sleep centers in the Southwest to improve CPAP use and prevent health problems due to sleep apnea.

What will this project do?

The project team is putting the program in place at 11 sleep centers in Arizona and Colorado. Using their phone, patients select from a menu of prompts to:

  • Meet with a peer buddy who has sleep apnea at their sleep center
  • Talk regularly by phone, text, or email with their peer buddy over several months
  • Talk with members of their care team, including doctors, nurses, or sleep technicians, to ask questions, request supplies, or schedule clinic visits

Using checklists and call logs, sleep center staff track peer-buddy interactions to make sure they are helpful to patients.

The project team is working with center staff to train 120 patients with experience using CPAP machines to become peers. To train peers in how to teach others about CPAP machines, the team is creating training manuals and an online session. The trained peers will then train 360 peer buddies to work with patients.

The project team is working with sleep centers to adapt the phone-based system to work with centers’ record systems. The team is also training a CPAP coordinator, nurse navigator, or other staff member at each center to oversee the program and enroll eligible patients.

What is the expected impact of this project?

The project is demonstrating what’s required to put the program in place at sleep centers. More than 2,000 patients with sleep apnea will receive support through the program. Sleep center staff, health system leaders, and sleep center directors are committed to continuing the program after the project ends.

The project evaluation will confirm that the program is working as intended to help people use their CPAP machines effectively.

More about this implementation project:

Stakeholders Involved in This Project

  • Leadership at Banner Health
  • Directors at each of the 11 participating sleep centers
  • American Sleep Apnea Association
  • American Academy of Sleep Medicine
  • Arizona Medicaid program
  • An advisory board made up of patients, clinicians (physicians, sleep technicians, behavioral therapists, clinical psychologists, respiratory therapists, and registered nurses), and representatives of CPAP device manufacturers

Implementation Strategies

  • Adapt in-person training for peers by transferring existing content to an online platform.
  • Adapt the peer support program to work with sites’ existing resources and workflows.
  • Use an electronic, phone-based, system for implementation.
  • Provide sites with tools to support implementation, including manuals and checklists.
  • Provide educational materials to peer buddies and patients, as online modules.
  • Train sleep center staff to deliver the peer support program, through a written manual and video.
  • Train peer buddies to educate patients about risks of untreated obstructive sleep apnea, share strategies for improving adherence, and help patients prepare for appointments, through a video.
  • Use train-the-trainer strategies to train additional peer buddies.
  • Use a phased implementation approach.
  • Identify and prepare local champions at sleep centers, typically a CPAP coordinator or nurse navigator.
  • Provide technical assistance to sites, including consultation.
  • Use or develop payment mechanisms to facilitate implementation.
  • Promote implementation using peer networks.
  • Partner with national stakeholder organization to promote implementation.

Evaluation Outcomes

To document implementation:

  • Number of eligible patients who receive the peer support program
  • Fidelity of peer support interactions between peer buddies and mentees (e.g., number of interactions, consistency of support provided)

To assess healthcare and health outcomes:

  • CPAP adherence
  • Patient satisfaction
  • Daytime sleepiness
  • Blood pressure

Project Information

Sairam Parthasarathy, MD
University of Arizona

Key Dates

February 2019
April 2023

Study Registration Information

Initial PCORI-Funded Research Study

This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Does a Peer Support Program Improve Satisfaction with Treatment among Patients with Obstructive Sleep Apnea?


Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
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Last updated: December 5, 2022