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Abstract Introduction Health literacy of sleep apnea (SA) and access to behavioral strategies to promote positive airway pression (PAP) adherence remain challenges in clinical settings. Understanding what factors hinder or support PAP use is critical to increasing adherence and optimizing patient outcomes. We developed and implemented a brief PAP education and behavioral intervention program (1-hour 1:1 telehealth session prior to initiating PAP and 1-week follow-up call) in a VA sleep medicine clinic to increase SA knowledge and PAP use. To evaluate the program, we collected qualitative feedback from participants. Methods The PAP program was offered to Veterans newly diagnosed with SA. Among 43 veterans who participated in the program, 10 completed the Self-Efficacy Measure for Sleep Apnea (SEMSA) prior to program initiation and provided retrospective qualitative feedback within 6 months of initiating PAP. Three raters independently coded qualitative responses and reached consensus on domains and subcategories that emerged. Results Veterans (M=56 years) were categorized as “low” (n=5) or “high (n=5)” based on mean SEMSA perceived risk subscale score. Qualitative analysis revealed 3 domains (pre-program SA knowledge, pre-program PAP knowledge, and post-program SA/PAP knowledge) and categories of barriers or facilitators emerged. Four out of the 5 participants in both groups reported a perceived lack of knowledge of SA before the PAP program (unaware of SA-associated health risks). Despite this perception, the high group reported more pre-program basic knowledge about PAP vs. the low group, and knowing a family/friend with a neutral/positive PAP experience. Two participants in the low group expressed negative PAP-related expectations/cognitions vs. no participants in the high group. Participants in both groups reported having increased knowledge about SA/PAP post-PAP program; however, only participants in the low group recalled specific skills/strategies to facilitate PAP use. Conclusion Qualitative feedback revealed a general lack of knowledge about SA pre-PAP education program. A PAP education program may help those newly diagnosed with SA increase their health literacy and learn skills/strategies to facilitate PAP use, particularly for those who have a lower risk perception of SA. Future research should explore the impact of negative SA/PAP-related perceptions on PAP adherence. Support (if any) AASM Foundation#211-FP-19, VAGLAHS GRECC/CSHIIP, VA-HSR&D-CDA-20-227
Gomez et al. (Sat,) studied this question.