A Tailored Intervention for PAP Adherence: The SCIP-PA Trial

Sawyer, Amy M.; King, Tonya S.; Weaver, Terri E.; Sawyer, Douglas A.; Varrasse, Miranda; Franks, Jamie; Watach, Alexa; Kolanowski, Ann; Richards, Kathy

doi:10.1080/15402002.2016.1276018

Cited by 18 publications

(19 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings may have clinical and policy implications. Similar to research on other health conditions [ 62 , 63 , 64 ], we recommend that DM interventions should be tailored by race and gender [ 63 , 65 , 66 ]. This is especially important as minority populations may be more receptive to programs and interventions that are tailored to their specific needs.…”

Section: Discussionmentioning

confidence: 95%

Socioeconomic Status and Glycemic Control in Type 2 Diabetes; Race by Gender Differences

et al. 2017

View full text Add to dashboard Cite

Background: This study aimed to investigate differences in the association between socioeconomic status (SES) and glycemic control in type 2 diabetes mellitus (DM) across race by gender groups. Methods: Using a convenient sampling strategy, participants were 112 patients with type 2 DM who were prescribed insulin (ns = 38 Black women, 34 Black men, 14 White women, and 26 White men, respectively). Linear regression was used to test the associations between sociodemographic variables (race, gender, SES, governmental insurance) and Hemoglobin A1c (HbA1c) in the pooled sample and within subgroups defined by race and gender. Results: In the pooled sample, neither SES nor governmental insurance were associated with HbA1c. However, the race by gender interaction approached statistical significance (B = 0.34, 95% CI = −0.24–3.00, p =0.094), suggesting higher HbA1c in Black women, compared to other race by gender groups. In stratified models, SES (B = −0.33, 95% CI = −0.10–0.00, p = 0.050), and governmental insurance (B = 0.35, 95% CI = 0.05–2.42, p = 0.042) were associated with HbA1c for Black men, but not for any of the other race by gender subgroups. Conclusion: Socioeconomic factors may relate to health outcomes differently across race by gender subgroups. In particular, SES may be uniquely important for glycemic control of Black men. Due to lack of generalizability of the findings, additional research is needed.

show abstract

Section: Discussionmentioning

confidence: 95%

Socioeconomic Status and Glycemic Control in Type 2 Diabetes; Race by Gender Differences

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Participants were categorized into 4 groups based on whether they had high or low efficacy and threat perceptions (ie, responsive, avoidance, proactive, and indifference). As stated earlier, an average score of 3 was used as a critical indicator threshold to dichotomize the responses into high and low following Sawyer et al [ 51 ], with a score >3 being high and all others being classified as low. The indifference group had all women, only the responsive group had nonwhites, and only the proactive group had participants who were aged 65 years.…”

Section: Resultsmentioning

confidence: 99%

“…Perceived threat was operationalized as the sum of the mean score of perceived severity and the mean score of perceived susceptibility as they are both considered as dimensions of the threat construct [ 11 ]. Sawyer and King [ 51 ] used the Self-Efficacy Measure for Sleep Apnea (SEMSA) with a score of 3 for each subscale as a critical indicator for tailoring an intervention. Thus, an average score of 3 was used as the critical indicator threshold to dichotomize the responses into high and low, with a score >3 being high and all others being classified as low.…”

Section: Methodsmentioning

confidence: 99%

A Tailored Motivational Messages Library for a Mobile Health Sleep Behavior Change Support System to Promote Continuous Positive Airway Pressure Use Among Patients With Obstructive Sleep Apnea: Development, Content Validation, and Testing

Alismail¹,

Olfman²

2020

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

Background Continuous positive airway pressure (CPAP) therapy is the most effective treatment for obstructive sleep apnea (OSA). Despite the reported benefits of CPAP therapy in treating OSA, its effectiveness is reduced by less-than-optimal adherence or use. Up to 50% of patients who accept CPAP therapy fail to adhere to it. As a lack of commitment to CPAP therapy is one of the most significant factors that hinder OSA treatment effectiveness, patient motivation and education are critical to help alleviate the problem of poor CPAP adherence or use. Objective This study aims to support the development of mobile health interventions or information systems solutions to promote CPAP adherence and use among patients with OSA through development, content validation, and testing of tailored motivational messages. Methods In phase 1, an initial library of 60 messages was developed to promote CPAP use among patients with OSA. In phase 2, draft messages were evaluated for content validation testing for relevance and clarity by research and clinical experts. In phase 3, patients with OSA (N=24) were recruited through a Qualtrics panel to rate the perceived persuasiveness of the messages in terms of threat and efficacy perceptions, as per their computed extended parallel process model (EPPM) response states. The average score of the ratings was calculated for each message. The messages were sorted according to their average (from highest to lowest) to select the best 12 messages for each tailored set based on the potential responses from the EPPM. Results In phase 1, 60 messages were developed based on the existing literature and a review of existing materials. In phase 2, the enumerated content validity of the messages was established through the use of the content validity index for items. A total of 57 messages were found to have acceptable content relevance and clarity. In phase 3, patients with OSA perceived the final library of 48 messages to be persuasive. Conclusions After the process of content validation and testing, the final library of messages met the criteria for clarity, relevance, and perceived persuasiveness. This study emphasizes the importance of developing and validating the content of motivational messages, grounded in EPPM theory, across the 4 possible response states in terms of high or low efficacy and threat perceptions.

show abstract

“…Greater success has been described with cognitive behavioural or motivational strategies in improving adherence . These behavioural strategies again recognize the psychosocial influences on PAP adherence.…”

Section: Augmenting Adherencementioning

confidence: 99%

“…Greater success has been described with cognitive behavioural or motivational strategies in improving adherence. 35,[45][46][47][48][49][50][51] These behavioural strategies again recognize the psychosocial influences on PAP adherence. In a meta-analysis assessing the effectiveness of educational, supportive or behavioural strategies in encouraging CPAP use, most studies incorporated elements of more than one intervention.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Strategies to augment adherence in the management of sleep‐disordered breathing

Sunwoo

Malhotra

2019

Respirology

View full text Add to dashboard Cite

Continuous positive airway pressure (CPAP) is highly effective in treating sleep‐disordered breathing (SDB). However, unlike surgical interventions, this treatment modality relies heavily on patient acceptance and adherence. The current definition of adherence is largely arbitrary and is mainly used by third‐party payers to determine CPAP reimbursement but CPAP adherence remains sub‐optimal. Strategies to augment adherence, especially early in the course of a CPAP trial, are needed in the management of SDB. An understanding of the basis for observed differences in CPAP and oral appliance (OA) use is necessary in developing these strategies, but to date no single factor has been consistently identified. Consequently, a multidimensional approach using educational, behavioural, technological and potentially pharmacological strategies to target (i) disease characteristics, (ii) patient characteristics including psychosocial factors, (iii) treatment protocols and (iv) technological devices and side effects that may influence adherence, is likely required to augment the complex behaviour of CPAP and OA use. In the near future, we envision a personalized medicine approach to determine the risk of non‐adherence and set individualized adherence goals aimed at treating specific symptoms (e.g. excessive daytime sleepiness) and reducing the risk of patient‐specific SDB consequences (e.g. atherosclerosis). Resources for interventions to improve adherence such as educational programmes and telemedicine encounters could then be more efficiently allocated.

show abstract

A Tailored Intervention for PAP Adherence: The SCIP-PA Trial

Cited by 18 publications

References 58 publications

Socioeconomic Status and Glycemic Control in Type 2 Diabetes; Race by Gender Differences

Socioeconomic Status and Glycemic Control in Type 2 Diabetes; Race by Gender Differences

A Tailored Motivational Messages Library for a Mobile Health Sleep Behavior Change Support System to Promote Continuous Positive Airway Pressure Use Among Patients With Obstructive Sleep Apnea: Development, Content Validation, and Testing

Strategies to augment adherence in the management of sleep‐disordered breathing

Contact Info

Product

Resources

About