0599 Cultural Adaptation of a Dyadic Digital Health Treatment to Improve Positive Airway Pressure Adherence and Sleep Health Among Hispanic Couples

Abstract Introduction While the gold-standard treatment for OSA is positive airway pressure (PAP), most patients are non-adherent. Current PAP adherence treatments were designed with a focus on the individual and on non-Hispanic White populations, overlooking the role of the bedpartner in treatment, and salient sociocultural factors that may shape treatment adherence in marginalized groups. Our aim was to describe the rigorous cultural adaptation process we used to develop “Nuestro Sueño,” a culturally adapted, evidence-based, 3 session dyadic digital health treatment to improve PAP adherence and sleep health among Hispanic patients and their bedpartners. Methods We used an integrated four-stage model of cultural adaptation to guide our process. A bilingual (Spanish/English) community advisory board provided critical input. In stages 1-3, six focus groups with 15 couples, and 6 dyadic interviews were conducted to obtain feedback. In stage 4, a pilot study was conducted with 4 couples. To organize and report our findings, we used the cultural adaptation taxonomy of common elements. Results Participants were 54 adults (Mage=51.4 SD=11.3, 52% female, 74% Spanish-language preference, 33% Mexican, 30% Peruvian, 17% US-born, 20% Other). Relationship duration was 22.3 years (SD=14.22). Average PAP use was 3.85 years (SD=3.4). Cultural adaptations to the original intervention were made in each of the taxonomy components (81 total). Deep-level adaptations (52% of the changes based on sociocultural values) included integration of cultural values of familismo and marianismo into treatment, inclusion of Spanish language proverbs, and language tailoring to address health literacy concerns. Surface-level adaptations (48% of the changes based on observable characteristics) included structural changes to the treatment such as use of ethnicity-matched community health workers as interventionists, Spanish-language translation, use of culturally and age-appropriate images, and integrating health information relevant to the target population. Conclusion We used a rigorous cultural adaptation process to develop an innovative, culturally acceptable dyadic digital health treatment that leverages the central role of family in health promotion. Future research should evaluate the effectiveness of Nuestro Sueño in improving PAP adherence and sleep health among Hispanic couples. Support (if any) R61AG084477