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

项目摘要 对持续气道正压通气（CPAP）治疗的依从性差仍然是最大的单一原因。 阻塞性睡眠呼吸暂停（OSA）的有效管理障碍导致发病率增加， 死亡率和更高的医疗费用。促进持续气道正压通气依从性的现有干预措施仅侧重于 目前，艾滋病病毒/艾滋病是针对个人诊断的，主要由卫生专业人员提供，但成功率有限。支持的 根据PI的R15项目的调查结果，患者的伴侣扮演着重要的角色-无论是积极的还是消极的- 在CPAP依从性方面，并且是CPAP使用的所有主要促进方面和障碍的一部分。二进 一种让患者和伴侣都参与进来以促进CPAP依从性的方法仍然是一种尚未开发的方法。 机会我们的跨学科团队开发了一个OurSleepKit的原型，这是一个创新的 以夫妇为中心的移动健康工具，以促进CPAP的遵守。以伙伴关系概念框架为指导 参与CPAP依从性，OurSleepKit的目标是指导相互参与并建立积极的模型 合作伙伴参与CPAP治疗，从而激励更大的CPAP依从性。回应PA-18- 722，该R01项目的目标是完善和测试OurSleepKit，以支持CPAP治疗的依从性。我们 我们将在一个安全的移动健康平台NUCoach上完善和部署OurSleepKit。让用户 参与移动医疗干预措施对其成功至关重要，而用户参与现有移动医疗的程度较低 工具仍然是一个大问题。为了解决这个问题，我们将使用参与式方法来完善OurSleepKit 并综合评价其对CPAP依从性和用户参与度的影响。具体来说，我们将 1)在标准化的迭代参与式方法中使用定性方法优化OurSleepKit， 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 诊断的OSA患者及其伴侣）;以及3）通过以下方式评估干预组中的用户参与度： 跟踪客观的OurSleepKit使用情况并了解主观的用户体验。本项目的成果 将支持开发一个有效的、吸引人的移动健康工具，该工具可以随时被OSA采用 患者及其伴侣支持持续气道正压通气治疗的依从性。考虑到地震的频率和深度 大多数患者与其伴侣之间的互动，OurSleepKit很可能会成功并产生可持续的效果 持续气道正压通气的坚持，导致显着的健康益处。如果被证明是成功的，OurSleepKit可以很容易 与其他干预措施和现有技术相结合，以更好地促进CPAP的使用。新的mHealth 干预有助于改变目前的治疗OSA从反应性疾病为重点的模式， 积极主动的自我管理模式。超越OSA，OurSleepKit可以成为使用mHealth的典范 技术，以优化治疗依从性和涉及家庭护理伙伴的自我管理。

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.