Provider Perspectives on Sleep Apnea from Appalachia: A Mixed Methods Study.

Area of Science:

• Public Health
• Health Disparities
• Rural Health

Background:

• West Virginia (WV) exhibits the highest U.S. rates of obesity and cardiopulmonary disease.
• A significant care gap for obstructive sleep apnea (OSA) has been identified in WV.
• This OSA care gap exacerbates health issues in a region with high rates of obesity and cardiopulmonary disease.

Purpose of the Study:

• To identify barriers contributing to the rural OSA care disparity in WV.
• To evaluate barriers and facilitators to OSA management in Federally Qualified Health Centers in southern WV.

Main Methods:

• Mixed-methods study including focus groups with healthcare providers in Appalachian communities.
• Administration of the Obstructive Sleep Apnea Knowledge and Attitudes (OSAKA) questionnaire.
• Electronic Medical Record (EMR) analysis using diagnostic codes to assess OSA prevalence.

Main Results:

• Focus groups revealed themes related to barriers, facilitators, and community needs for OSA care delivery.
• Providers acknowledged OSA's importance but lacked confidence in diagnosis and treatment.
• EMR analysis indicated a larger OSA care gap in rural communities than previously reported.

Conclusions:

• A lack of provider confidence and specific limiting themes hinder effective OSA diagnosis and management in rural WV.
• Targeted training on knowledge gaps and new technologies can empower rural primary care providers.
• An integrated care model with primary care, specialists, and technology is essential to address OSA disparities.