title: Development and usability testing of a self-management intervention to support individuals with obstructive sleep apnea in accommodating to CPAP treatment.
abstract: OBJECTIVE
  Development and usability testing of a self-management intervention to promote CPAP adherence.
  
  
  BACKGROUND
  While CPAP is an effective treatment for OSA, patient adherence is sub-optimal. Qualitative interviews and evidence based approaches were used in development.
  
  
  METHODS
  The initial steps in the Campbell (2000) Framework for complex intervention guided development of the intervention in book format. After sleep expert review and modification, CPAP users reviewed the format and content of the intervention and were interviewed by telephone using a "talk-out-loud technique" to determine usability. The interviews transcripts were analyzed thematically.
  
  
  RESULTS
  Ten participants with varying ages, race, education, and CPAP usage, found the intervention contained useful information to understand their diagnosis, to problem-solve, and monitor their progress. Suggestions included minor format changes and the wish that they had access to the intervention when first diagnosed.
  
  
  CONCLUSIONS
  This intervention provides a multimodal approach including education, self-management tools, cognitive restructuring, provider communication guides, and peer stories of success that may be helpful in initiating active problem solving to improve self-efficacy to adhere to CPAP. Future research plans include clinical testing in a RCT with new CPAP users.
authors.affiliation: University at Buffalo, School of Nursing, 105 Wende Hall, 3435 Main Street, Buffalo, NY, USA. sdickers@buffalo.edu
authors.forename: Suzanne S
authors.initials: SS
authors.lastname: Dickerson
authors.forename: Rana
authors.initials: R
authors.lastname: Obeidat
authors.forename: Grace
authors.initials: G
authors.lastname: Dean
authors.forename: Alan
authors.initials: A
authors.lastname: Aquilina
authors.forename: Eric Ten
authors.initials: ET
authors.lastname: Brock
authors.forename: Patricia
authors.initials: P
authors.lastname: Smith
authors.forename: Carla
authors.initials: C
authors.lastname: Jungquist
mesh_terms: D015928:Cognitive Behavioral Therapy; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D036301:Qualitative Research; D012107:Research Design; D012648:Self Care; D020377:Self Efficacy; D020181:Sleep Apnea, Obstructive / Q000523:psychology / Q000628:therapy*
keywords: CBT; CPAP adherence; Complex intervention; OSA; Usability testing