OurSleepKit: A Couple-focused mHealth Tool to Support Adherence to CPAP Treatment

OurSleepKit：一款以夫妻为中心的移动健康工具，支持坚持 CPAP 治疗

• 批准号: 10338889
• 负责人: Lichuan Ye
• 金额: $ 66万
• 依托单位: NORTHEASTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-05 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10338889
• 关键词: Address; Adherence; Adopted; Affect; Age; Caring; Characteristics; Clinic; Clinical Trials; Continuous Positive Airway Pressure; Control Groups; Couples; Custom; Data; Development; Diagnosis; Disease; Drowsiness; Effectiveness; Emotional; Evaluation; Exposure to; Family; Frequencies; Gender; Goals; Health; Health Benefit; Health Care Costs; Health Professional; Health Technology; Individual; Intervention; Interview; Life; Link; Maintenance; Measures; Modeling; Morbidity - disease rate; Newly Diagnosed; Notification; Obstructive Sleep Apnea; Patients; Periodicity; Play; Preparation; Problem Solving; Process; Qualitative Methods; Quality of life; Race; Randomized; Role; Secure; Self Efficacy; Self Management; Sleep; Sleep disturbances; Snoring; Standardization; Subgroup; Technology; Testing; Time; Treatment outcome; Update; Work; base; coping; demographics; effective therapy; experience; field study; group intervention; handheld mobile device; improved; innovation; mHealth; mortality; pilot test; promoter; prototype; secondary outcome; sleep quality; social; socioeconomics; success; tool; treatment adherence; treatment optimization

PROJECT SUMMARY Poor adherence to continuous positive airway pressure (CPAP) treatment remains the single largest impediment to effective management for obstructive sleep apnea (OSA) leading to increased morbidity, mortality, and higher health care costs. Existing interventions promoting CPAP adherence focus only on the diagnosed individual and are delivered mostly by health professionals, with limited success. As supported by the findings of the PI’s R15 project, the partners of patients play a significant role – either positive or negative – in CPAP adherence, and are part of all of the major facilitative aspects and barriers to CPAP use. A dyadic approach engaging both the patient and partner to promote CPAP adherence remains an untapped opportunity. Our interdisciplinary team has developed a prototype of OurSleepKit, which is an innovative couple-focused mHealth tool to promote CPAP adherence. Guided by the conceptual framework of partner involvement in CPAP adherence, the goal of OurSleepKit is to coach mutual engagement and model positive partner involvement in CPAP treatment, thus motivating greater CPAP adherence. Responding to the PA-18- 722, the goal of this R01 project is to refine and test OurSleepKit to support adherence to CPAP treatment. We will refine and deploy OurSleepKit on an established secure mHealth platform, NUCoach. Getting users to engage with an mHealth intervention is critical to its success, and low user engagement with existing mHealth tools remains a big concern. To address this issue, we will use a participatory approach to refine OurSleepKit and comprehensively evaluate both its effect on CPAP adherence and user engagement. Specifically, we will 1) Refine OurSleepKit using qualitative methods within a standardized iterative participatory approach by working with end users (OSA patients and their partners); 2) Examine the effectiveness of OurSleepKit on CPAP adherence by conducting a 6-month randomized parallel group controlled trial in 180 couples (newly diagnosed OSA patients and their partners); and 3) Evaluate user engagement in the intervention group by tracking objective OurSleepKit usage and understanding the subjective user experience. Results of this project will support the development of an effective and engaging mHealth tool which can be readily adopted by OSA patients and their partners to support adherence to CPAP treatment. Given the frequency and depth of interaction that most patients have with their partner, OurSleepKit is likely to succeed with a sustainable effect on CPAP adherence leading to significant health benefits. If shown to be successful, OurSleepKit can be easily integrated with other interventions and existing technology to better promote CPAP use. This new mHealth intervention facilitates changing the current care of OSA from a reactive disease-focused model to a more proactive self-management model. Going beyond OSA, OurSleepKit can be an exemplar of using mHealth technology to optimize treatment adherence and self-management involving family care partners.

项目概要 持续气道正压通气 (CPAP) 治疗依从性差仍然是最大的问题 妨碍有效管理阻塞性睡眠呼吸暂停（OSA），导致发病率增加， 死亡率和更高的医疗费用，促进 CPAP 依从性的现有干预措施仅关注于 经诊断的个人，主要由卫生专业人员提供，但成功率有限。 根据 PI R15 项目的调查结果，患者的伴侣发挥着重要作用——无论是积极的还是消极的—— CPAP 坚持的影响，并且是 CPAP 使用的所有主要促进因素和障碍的一部分。 让患者和伴侣共同促进 CPAP 坚持的方法仍然尚未开发 我们的跨学科团队开发了 OurSleepKit 的原型，这是一个创新的产品。 以夫妻为中心的移动医疗工具，以伴侣概念框架为指导，促进 CPAP 依从性。 参与 CPAP 坚持，OurSleepKit 的目标是指导相互参与并树立积极的榜样 合作伙伴参与 CPAP 治疗，从而激励更多人遵守 PA-18-。 722，这个 R01 项目的目标是完善和测试 OurSleepKit 以支持我们坚持 CPAP 治疗。 将在已建立的安全 mHealth 平台 NUCoach 上完善和部署 OurSleepKit 让用户 参与移动医疗干预对其成功至关重要，而用户对现有移动医疗的参与度较低 为了解决这个问题，我们将使用参与式方法来完善 OurSleepKit。 并综合评估其对 CPAP 依从性和用户参与度的影响。 1) 使用标准化迭代参与方法中的定性方法来完善我们的睡眠套件 与最终用户（OSA 患者及其伴侣）合作；2) 检查 OurSleepKit 在以下方面的有效性： 通过对 180 对夫妇进行为期 6 个月的随机平行组对照试验（新近 3) 通过以下方式评估干预组中的用户参与度 跟踪 OurSleepKit 的客观使用情况并了解该项目的主观用户体验。 将支持开发有效且有吸引力的移动医疗工具，该工具可以很容易被 OSA 采用 考虑到 CPAP 治疗的频率和深度，患者及其伴侣支持其坚持治疗。 大多数患者与其伴侣的互动，OurSleepKit 可能会取得成功并产生可持续的效果 坚持 CPAP 可以带来显着的健康益处，如果证明成功，OurSleepKit 可以轻松实现。 与其他干预措施和现有技术相结合，更好地促进 CPAP 的使用。 干预措施有助于将目前 OSA 的护理从以反应性疾病为中心的模式转变为更注重治疗的模式。 OurSleepKit 超越了 OSA，可以成为使用移动医疗的典范。 优化治疗依从性和涉及家庭护理伙伴的自我管理的技术。