Multicultural sensitivity is important in clinical practice, yet we know little about how the physical environment projects this quality. Objects displayed in the therapy office are one possible source of multicultural expression. This study examined the display of art objects in a therapy office on judgments of the therapist's characteristics, including openness to multiculturalism. In a 2 (cultural emphasis of art objects) X 2 (number of art objects displayed) X 2 (student vs. community sample) between-subjects design, 154 undergraduate participants from a small liberal arts college in the Northeast and 57 adults, most of whom were Latino residents of the surrounding community, rated a therapist based on 1 of 4 photos of a room arranged as a therapist's office. Participants' ratings of 43 therapist characteristics were grouped through factor analysis into 4 factors: Competence, Multiculturalism, Welcomeness, and Direct Style. In general the students gave more favorable ratings than did the community sample. The community sample was more favorable toward the therapist when more of the objects on display could be characterized as multicultural. Practice recommendations for psychologists regarding office décor and art are discussed.
Introduction
Continuous Positive Airway Pressure (CPAP) is an effective treatment for Obstructive Sleep Apnea (OSA) in children. However, adherence to CPAP therapy is often suboptimal. CPAP telemonitoring with automated feedback messaging has been shown to improved adherence in adults with OSA, but has not been widely studied as an intervention for children with OSA. This pilot study was conducted to investigate if feedback messaging could similarly improve CPAP adherence in children.
Methods
Pediatric OSA subjects (ages 11–17) with poor CPAP compliance or newly prescribed CPAP were selected from an outpatient Sleep Medicine clinic to receive weekly text messages with scripted feedback on CPAP adherence. Patients already meeting adherence goals were excluded from the study. Parental consent was obtained and participants were given the option to have text messages sent to parents or directly to the patient. Adherence was monitored over a four-month intervention period and compared to pre-intervention usage as a self-matched control. Total hours of use per month and numbers of days used per month were collected through daily remote CPAP monitoring. Average hours per use and average daily use per 30-day period were additional adherence measurements calculated. Data was analyzed using two-tailed paired T-tests with level of significance set at p<0.05.
Results
There was no significant change in CPAP adherence (p>.05) after initiation of weekly feedback messaging for the five patients included in the study. No participant, before or after intervention, met the Medicare definition of compliance (≥4hr nightly use for ≥ 70% of nights) and average adherence declined following intervention.
Conclusion
In a small pilot study, weekly feedback text messaging did not improve CPAP adherence in pediatric patients with OSA. This finding contrasts with larger studies in adult patients with OSA that have demonstrated improved CPAP adherence with automated feedback messaging. With the increasing use of telemedicine for CPAP follow-up, new strategies to successfully utilize this approach in the pediatric population may be needed.
Support (if any)
None.
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