Development of a Novel Shared Care Intervention to Address Obstructive Sleep Apnea in Rural West Virginia

Area of Science:

• Implementation Science
• Community-Engaged Research
• Primary Care
• Health Disparities

Background:

• Significant unmet need for obstructive sleep apnea (OSA) diagnosis and treatment, particularly in rural areas.
• Existing health disparities in rural communities exacerbate the challenge of managing OSA.
• Need for sustainable interventions tailored to the realities of rural primary care settings.

Purpose of the Study:

• To address OSA care disparities in West Virginia (WV) using implementation science and community-engaged research.
• To design an intervention supporting primary care providers (PCPs) in rural WV for OSA management.
• To identify implementation determinants and select strategies for a novel OSA program.

Main Methods:

• Utilized the Veterans Affairs Quality and Enhancement and Research Initiative (QUERI) Implementation Roadmap.
• Mapped barriers and facilitators to the Consolidated Framework for Implementation Research (CFIR) domains.
• Derived Evidence-based Practice Implementation Strategies (ERIC) to guide intervention development.

Main Results:

• Facilitators included provider recognition of OSA importance, knowledge, and patient receptivity.
• Barriers included low PCP confidence in OSA management, workflow challenges, and lack of community resources.
• Key implementation strategies identified were 'Develop stakeholder interrelationships,' 'Provide interactive assistance,' and 'Support for clinicians.'

Conclusions:

• A community-engaged, implementation science-informed program was developed to support PCPs in OSA diagnosis and management.
• The West Virginia Obstructive Sleep Apnea Academic Mentoring Partnership is designed for rural primary care realities.
• The program is positioned to sustainably address OSA care disparities in rural communities.