Tailored approach to sleep health education (TASHE): study protocol for a web-based randomized controlled trial

Trials, Dec 2016

Background Obstructive sleep apnea (OSA) is a sleep disorder that disproportionately affects African Americans (hereafter referred to as blacks). Moreover, blacks may underutilize sleep services including overnight polysomnography. Thus, OSA among blacks may go undiagnosed and untreated, which has significant health consequences, including hypertension, diabetes, cognitive impairment, and daytime sleepiness. Design and Methods This two-arm randomized controlled trial will assign 200 participants to a culturally and linguistically tailored web-based sleep educational platform. The website will be developed to ensure that the content is user friendly and that it is readable and acceptable by the target community. Participants will receive login information to a password-protected website and will have access to the website for 2 months. Study assessments will be collected at baseline, 2 months (post-enrollment) and at 6 months (follow-up). We will use qualitative and quantitative methods to develop tailored materials and to ascertain whether tailored materials will increase OSA knowledge and OSA health literacy by comparing blacks exposed to tailored materials versus those exposed to standard sleep health literature. We hypothesize that exposure to tailored OSA information will improve OSA health literacy. Discussion Few studies have investigated the racial/ethnic disparities in relation to OSA screening and treatment comparing blacks and whites. Moreover, we know of no interventions designed to increase OSA knowledge and health literacy among blacks. Use of the Internet to disseminate health information is growing in this population. Thus, the Internet may be an effective means to increase OSA health literacy, thereby potentially increasing utilization of sleep-related services in this population. Trial registration The study is registered at clinicaltrials.gov, reference number NCT02507089. Registered on 21 July 2015.

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Tailored approach to sleep health education (TASHE): study protocol for a web-based randomized controlled trial

Williams et al. Trials Tailored approach to sleep health education (TASHE): study protocol for a web-based randomized controlled trial Natasha J. Williams 0 Rebecca Robbins 0 David Rapoport John P. Allegrante Alwyn Cohall Gbenga Ogedgebe 0 Girardin Jean-Louis 0 0 Department of Population Health, Division of Health and Behavior, Center for Healthful Behavior Change, NYU Medical Center , New York, NY 10016 , USA Background: Obstructive sleep apnea (OSA) is a sleep disorder that disproportionately affects African Americans (hereafter referred to as blacks). Moreover, blacks may underutilize sleep services including overnight polysomnography. Thus, OSA among blacks may go undiagnosed and untreated, which has significant health consequences, including hypertension, diabetes, cognitive impairment, and daytime sleepiness. Design and Methods: This two-arm randomized controlled trial will assign 200 participants to a culturally and linguistically tailored web-based sleep educational platform. The website will be developed to ensure that the content is user friendly and that it is readable and acceptable by the target community. Participants will receive login information to a password-protected website and will have access to the website for 2 months. Study assessments will be collected at baseline, 2 months (post-enrollment) and at 6 months (follow-up). We will use qualitative and quantitative methods to develop tailored materials and to ascertain whether tailored materials will increase OSA knowledge and OSA health literacy by comparing blacks exposed to tailored materials versus those exposed to standard sleep health literature. We hypothesize that exposure to tailored OSA information will improve OSA health literacy. Discussion: Few studies have investigated the racial/ethnic disparities in relation to OSA screening and treatment comparing blacks and whites. Moreover, we know of no interventions designed to increase OSA knowledge and health literacy among blacks. Use of the Internet to disseminate health information is growing in this population. Thus, the Internet may be an effective means to increase OSA health literacy, thereby potentially increasing utilization of sleep-related services in this population. Adherence; Sleep health; Blacks; Continuous positive airway pressure; Health education; Health literacy; Internet; Obstructive sleep apnea - Background Increasingly, researchers and practitioners recognize that obstructive sleep apnea (OSA) - one of the most commonly diagnosed sleep disorders - disproportionately affects blacks. One of the earliest studies documenting racial/ethnic differences in the rate of OSA compared 225 black and 622 white volunteers, ages 2–86 years, and found that 31% of blacks versus 10% of whites had OSA [1]. More recent studies have also reported similar disparities including adherence to OSA treatment, with blacks using positive airway pressure (PAP) far less than their white counterparts [2–4]. The underlying mechanisms of these disparities are not clear. However, research suggests that the disparities in OSA prevalence may be explained by genetic factors and obesity [5], while disparities in treatment adherence may be partially explained by socioeconomic status [3] and sleep duration [2]. © The Author(s). 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. The Institute of Medicine and the National Institutes of Health (NIH) recognize OSA as a chronic disease that requires novel adherence strategies to promote enhanced quality of life and diminish social and economic costs [6]. Yet, our pilot data suggests that blacks tend to underutilize sleep services. This is unfortunate given that there may be a high prevalence of OSA in this community, and that treatment is effective in improving cardiovascular disease (CVD) risk factors, especially blood pressure [7], which disproportionately burden blacks. Insufficient sleep and sleep disorders A recent analysis of data from 12 states conducted by the Centers for Disease Control and Prevention (CDC) illustrated that 35.3% of United States (US) adults reported insufficient sleep and 37.9% reported unintentionally falling asleep during the day [8]. It also appears that there is increased awareness about sleep in the general population. For example, using the National Ambulatory Medical Care Survey, Ford et al. [9] found a 13% increase in the number of physician office visits for sleep complaints and (...truncated)


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Natasha Williams, Rebecca Robbins, David Rapoport, John Allegrante, Alwyn Cohall, Gbenga Ogedgebe, Girardin Jean-Louis. Tailored approach to sleep health education (TASHE): study protocol for a web-based randomized controlled trial, Trials, 2016, pp. 585, 17, DOI: 10.1186/s13063-016-1701-x