Enhancing PAP Adherence Among Spanish-speaking Hispanic Adults With OSA
Purpose
This study seeks to enhance long-term positive airway pressure (PAP) adherence among Spanish-speaking Hispanics, a group with known PAP outcomes disparities. This study will assess the feasibility of a linguistically and culturally adapted tele-management intervention (Automated Management, AM) for Spanish-speaking Hispanic adults with OSA.
Condition
- Obstructive Sleep Apnea
 
Eligibility
- Eligible Ages
 - Over 18 Years
 - Eligible Sex
 - All
 - Accepts Healthy Volunteers
 - No
 
Inclusion Criteria
- Spanish-speaking and reading - Self-identified Hispanic - Adults ≥ 18 years-old - Males and females - Moderate-severe OSA defined as AHI ≥15 events/hour using a hypopnea criterion of a 4% oxygen desaturation (AHI4%) - Expected availability for the duration of the study (6 months from date of randomization) - Ownership of smartphone with unlimited text messaging capability - Referred to PAP treatment and able and willing to be treated with PAP
 
Exclusion Criteria
- Other sleep apnea or nocturnal respiratory insufficiency or failure diagnosis other than OSA established by polysomnogram (PSG) or home sleep apnea test (HSAT) - Requirement of supplemental oxygen or other non-invasive ventilation modality - Women referred to PAP because of new-onset OSA with pregnancy as PAP treatment may be time-limited (enrolled women who become pregnant during the trial and are already on PAP treatment will not be excluded) - Anticipated or scheduled bariatric surgery and/or referred to sleep evaluation by bariatric surgery
 
Study Design
- Phase
 - N/A
 - Study Type
 - Interventional
 - Allocation
 - Randomized
 - Intervention Model
 - Parallel Assignment
 - Primary Purpose
 - Treatment
 - Masking
 - None (Open Label)
 
Arm Groups
| Arm | Description | Assigned Intervention | 
|---|---|---|
| 
                        Experimental Automated Management (AM)  | 
                    Receipt of text-based behavioral intervention | 
                                                
  | 
                
| 
                        No Intervention Usual Care  | 
                    Control group receiving usual care for obstructive sleep apnea | 
                                                 | 
                
Recruiting Locations
Kansas City 4273837, Kansas 4273857 66160
More Details
- Status
 - Recruiting
 - Sponsor
 - Geisinger Clinic
 
Detailed Description
This feasibility study seeks to enhance long-term positive airway pressure (PAP) adherence among Spanish-speaking Hispanics, a group with known PAP outcomes disparities. This study will assess the feasibility, usability and 6-month effectiveness of a linguistically and culturally adapted efficacious tele-management intervention (Automated Management, AM) for Spanish-speaking Hispanic adults with obstructive sleep apnea (OSA) (N=50). A prospective, randomized, parallel group, unblinded, feasibility trial is proposed. AM is a tele-management strategy that includes evidence-based components for improving shorter-term PAP adherence consisting of education, support and troubleshooting, and brief targeted motivational enhancement delivered by tele-messaging. The automated two-way, interactive communication is algorithmic based on PAP use and behavioral profiles defined at baseline. The innovative, technology-based interventions are designed to ensure access to sustained care that overcomes barriers such as distance/geography, transportation limitations or lost work/productivity time. As such, AM can provide equitable access to quality long-term PAP management that may mitigate known PAP adherence disparities for minority adults with OSA. If effective for long-term PAP adherence, these strategies may alter OSA care paradigms, improve outcomes and associated healthcare costs, and reduce disparities.