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Validation and confirmatory factor analysis of the pediatric Adherence Barriers to Continuous Positive Airway

Julia K Carmody1, Stacey L Simon2, Constance A Mara3

  • 1Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Sleep Medicine
|August 24, 2020
PubMed

Insights

The Adherence Barriers to Continuous Positive Airway Pressure Questionnaire (ABCQ) effectively measures barriers to positive airway pressure (PAP) treatment in pediatric patients with sleep disordered breathing (SDB). This tool aids in identifying adherence challenges for improved treatment outcomes.

Area of Science:

  • Pediatric Sleep Medicine
  • Respiratory Medicine
  • Psychometrics

Background:

  • Sleep disordered breathing (SDB) affects children and young adults, often requiring positive airway pressure (PAP) therapy.
  • Adherence to PAP therapy is crucial for treatment efficacy but can be challenging.
  • Existing tools for assessing adherence barriers may require refinement for pediatric populations.

Purpose of the Study:

  • To evaluate and refine the factor structure of the Adherence Barriers to Continuous Positive Airway Pressure Questionnaire (ABCQ).
  • To present psychometric data for the ABCQ in a large, diverse sample of pediatric patients with SDB.
  • To establish the validity and reliability of the ABCQ for measuring PAP adherence barriers.

Main Methods:

  • A sample of 181 patients (ages 8-21) and 234 caregivers completed the ABCQ.
  • Objective adherence data from PAP machines were collected via electronic download.
  • Confirmatory factor analysis was used to evaluate the proposed three-factor structure of the ABCQ.

Main Results:

  • A three-factor structure (Behavior, Beliefs, Environment; Emotional Barriers; Physical Barriers) demonstrated good model fit.
  • The ABCQ exhibited strong psychometric properties, including internal consistency and convergent validity with objective PAP adherence.
  • Receiver Operator Characteristic Curve analysis identified cut-off scores predicting nonadherence for both patient and caregiver reports.

Conclusions:

  • The refined three-factor ABCQ is a psychometrically sound instrument for assessing barriers to PAP treatment.
  • The ABCQ can be utilized by both patients and caregivers to identify challenges in pediatric SDB management.
  • This validated tool can inform interventions to improve PAP adherence in children and young adults.
Abstract

Keywords:
AdherenceAutomatic positive airway pressure treatment (AutoPAP)Bi-level positive airway pressure treatment (BiPAP)Continuous positive airway pressure (CPAP)PediatricSleep disordered breathing (SDB)

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