0266 An mHealth intervention to deliver personalized messages to increase adherence to OSA care among transportation workers

Abstract

Abstract Introduction Transportation workers are at risk for obstructive sleep apnea (OSA), yet OSA is commonly undiagnosed in this population. In a two-phase study, we design and evaluate a tailored, mobile health (mHealth) intervention aimed at achieving OSA awareness, including changes in OSA beliefs, among operators of large highway maintenance vehicles. Methods In Phase 1, we recruited highway maintenance vehicle operators employed at worksites in the US northeast for focus groups to examine OSA beliefs and barriers. Results of the Phase 1 focus groups were used to inform the tailored intervention. In Phase 2, we evaluated the tailored approach, “Sleep Strong, Live Long,” in a mini-RCT. Worksites were randomized to intervention (Sleep Strong, Live Long) or control. Employees at both worksites completed baseline questionnaires and follow-up questionnaires 2-months post-baseline. Employees at the intervention worksite received a 30 minute in-person education session, access to an interactive website including video success stories, then follow-up text messages over 2 months as part of the Sleep Strong, Live Long program. The control condition received the intervention after completing follow-up surveys. We compared responses on the follow-up surveys between intervention and control conditions using linear regression with baseline responses as covariates. Results Phase 1 themes included common sleep complaints, inconsistent work schedules, and misconceptions about OSA (n=45). 75% of Phase 1 participants reported resistance to OSA behavior change. Phase 2 mini-RCT participants (n= 38) were on average 43.4 (sd=12.1) years old. Participants were 86.8% male and 67.6% reported an annual household income of $50,000 or more. Exposure to the intervention was associated with an improvement in OSA literacy (b=0.14, p=0.037), but not OSA self-efficacy (b=0.12, p=0.330) or OSA readiness to change (b=0.76, p=0.336). Conclusion We provide preliminary support for improving OSA literacy among a sample of transportation workers. Future research may evaluate the tailored program in a larger sample of workers and with a longer follow-up period to consider whether OSA literacy and self-efficacy mediate actual OSA behaviors, such as changes in OSA evaluation and treatment. Support (if any) This work was supported by the National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health (NIH, Grant # K01HL150339).