Abstract
Abstract
Introduction
The Transtheoretical Model (TTM) is often used in public health to understand outcomes associated with behavioral intervention. This theory argues that effective interventions guide individuals along a spectrum of ‘readiness’ to change. We utilized this theory to examine the efficacy of exposure to a tailored approach to sleep health education (TASHE) in advancing individuals toward a later stage of readiness to adopt recommended sleep hygiene practices.
Methods
We utilized data from an NIH-funded randomized controlled trial testing the efficacy of TASHE, a website providing culturally and linguistically tailored content aimed at blacks at risk for Obstructive Sleep Apnea (OSA) compared to exposure to generic OSA information (National Sleep Foundation). This intervention aimed to advance participants through TTM stages. In this trial, we recruited community-dwelling individuals who self-identified as black. We provided several questionnaires at baseline, 2-months, and 6-month follow-up. Readiness to change was evaluated using the University of Rhode Island Change Assessment scale. Mixed-model regression was used to examine improvement in readiness to change between baseline and follow-up between the TASHE and control participants.
Results
Of the 184 participants, 49% were male and the average age was 47 ± 12.9 years. Among control participants, mean readiness to change decreased from baseline (mean=8.9 ± 1.8) to 6 months (mean=8.6 ± 2.2,p=.702). Among intervention participants, mean readiness increased from baseline (mean=8.5 ± 2.2) to 6 months (mean=9.2 ± 1.9,p=.296). Regression results revealed no significant improvement in readiness by intervention exposure (b=-0.34,p=.215) or time alone (b=-0.05,p=.436), but there was a marginally significant increase in readiness in the intervention group over time compared with the control group (b=0.16,p=.093).
Conclusion
Behavioral interventions ideally advance individuals toward a higher level of readiness to change to adopt evidence-based recommendations. Our findings suggest a tailored intervention may be slightly more efficacious in preparing individuals to change behaviors and engage in recommended sleep hygiene and diagnostic procedures for OSA.
Support (If Any)
Supported by grants RO1MD007716, R25HL116378 and K07AG052685.
