Abstract Introduction Perspectives on obstructive sleep apnea (OSA) and its symptoms vary across communities, and understanding these differences can improve the cultural proficiency of research and care with Hispanic/Latine patients. In these communities, treatment seeking, adherence, and stigma are shaped by medical mistrust, cultural values, and community-level communication, yet few studies have examined how these factors shape understandings of OSA and decisions about care. This study examined Hispanic/Latine immigrant patients’ experiences with OSA, focusing on cultural mechanisms that frame motivation to address sleep problems within couples. Methods immigrant patients with OSA and their partners (N = 18; 9 men, 9 women; 9 patients with OSA, 9 partners; Mage = 54.3 years). A guide, developed from literature and refined with a Community Advisory Board, was used by bilingual community health workers to explore couples’ sleep practices, strategies for managing OSA, and barriers and facilitators to PAP use. FGDs were audio-recorded, transcribed, and analyzed in Spanish using Braun and Clarke’s thematic content analysis. Results Participants described boca a boca (word-of-mouth) as a key cultural mechanism through which communities disseminated information and circumvented traditional, yet mistrusted medical sources. Discussions of boca a boca were frequently paired with accounts of rushed appointments, dismissed concerns, and unclear explanations from healthcare providers. In the absence of such community-level communication, many participants were unsure whether OSA symptoms signaled a serious disease or something “normal,” which lowered their perceived need for evaluation and treatment. Motivation to seek diagnosis and use PAP typically arose when friends, family, or other community members shared personal experiences, highlighted risks, and framed OSA as worthy of concern. Participants described delaying or avoiding diagnosis and treatment, sometimes for more than a decade, when these messages were lacking. Conclusion Findings suggest that community-wide approaches to communication, alongside community health workers bridging clinical care and community networks, may prove crucial for reducing underdiagnosis of OSA in Hispanic/Latine communities. Culturally-grounded approaches to OSA screening and treatment may consider centering cultural mechanisms like boca a boca to improve engagement and advance sleep health equity. Support (if any)
Escorcia et al. (Fri,) studied this question.