A Transdiagnostic Self-management Web-Based App for Sleep Disturbance in Adolescents and Young Adults: Feasibility and Acceptability Study

BackgroundSleep disturbance and its daytime sequelae, which comprise complex, transdiagnostic sleep problems, are pervasive problems in adolescents and young adults (AYAs) and are associated with negative outcomes. Effective interventions must be both evidence based and indiv...

Full description

Bibliographic Details
Main Authors: Nicole E Carmona, Aleksandra Usyatynsky, Samlau Kutana, Penny Corkum, Joanna Henderson, Kelly McShane, Colin Shapiro, Souraya Sidani, Jennifer Stinson, Colleen E Carney
Format: Article
Language:English
Published: JMIR Publications 2021-11-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2021/11/e25392
_version_ 1797735580987031552
author Nicole E Carmona
Aleksandra Usyatynsky
Samlau Kutana
Penny Corkum
Joanna Henderson
Kelly McShane
Colin Shapiro
Souraya Sidani
Jennifer Stinson
Colleen E Carney
author_facet Nicole E Carmona
Aleksandra Usyatynsky
Samlau Kutana
Penny Corkum
Joanna Henderson
Kelly McShane
Colin Shapiro
Souraya Sidani
Jennifer Stinson
Colleen E Carney
author_sort Nicole E Carmona
collection DOAJ
description BackgroundSleep disturbance and its daytime sequelae, which comprise complex, transdiagnostic sleep problems, are pervasive problems in adolescents and young adults (AYAs) and are associated with negative outcomes. Effective interventions must be both evidence based and individually tailored. Some AYAs prefer self-management and digital approaches. Leveraging these preferences is helpful, given the dearth of AYA treatment providers trained in behavioral sleep medicine. We involved AYAs in the co-design of a behavioral, self-management, transdiagnostic sleep app called DOZE (Delivering Online Zzz’s with Empirical Support). ObjectiveThis study tests the feasibility and acceptability of DOZE in a community AYA sample aged 15-24 years. The secondary objective is to evaluate sleep and related outcomes in this nonclinical sample. MethodsParticipants used DOZE for 4 weeks (2 periods of 2 weeks). They completed sleep diaries, received feedback on their sleep, set goals in identified target areas, and accessed tips to help them achieve their goals. Measures of acceptability and credibility were completed at baseline and end point. Google Analytics was used to understand the patterns of app use to assess feasibility. Participants completed questionnaires assessing fatigue, sleepiness, chronotype, depression, anxiety, and quality of life at baseline and end point. ResultsIn total, 83 participants created a DOZE account, and 51 completed the study. During the study, 2659 app sessions took place with an average duration of 3:02 minutes. AYAs tracked most days in period 1 (mean 10.52, SD 4.87) and period 2 (mean 9.81, SD 6.65), with a modal time of 9 AM (within 2 hours of waking). DOZE was appraised as highly acceptable (mode≥4) on the items “easy to use,” “easy to understand,” “time commitment,” and “overall satisfaction” and was rated as credible (mode≥4) at baseline and end point across all items (logic, confident it would work, confident recommending it to a friend, willingness to undergo, and perceived success in treating others). The most common goals set were decreasing schedule variability (34/83, 41% of participants), naps (17/83, 20%), and morning lingering in bed (16/83, 19%). AYAs accessed tips on difficulty winding down (24/83, 29% of participants), being a night owl (17/83, 20%), difficulty getting up (13/83, 16%), and fatigue (13/83, 16%). There were significant improvements in morning lingering in bed (P=.03); total wake time (P=.02); sleep efficiency (P=.002); total sleep time (P=.03); and self-reported insomnia severity (P=.001), anxiety (P=.002), depression (P=.004), and energy (P=.01). ConclusionsOur results support the feasibility, acceptability, credibility, and preliminary efficacy of DOZE. AYAs are able to set and achieve goals based on tailored feedback on their sleep habits, which is consistent with research suggesting that AYAs prefer autonomy in their health care choices and produce good results when given tools that support their autonomy. Trial RegistrationClinicalTrials.gov NCT03960294; https://clinicaltrials.gov/ct2/show/NCT03960294
first_indexed 2024-03-12T13:01:07Z
format Article
id doaj.art-1aaf941a74be41349677824d8c275ab4
institution Directory Open Access Journal
issn 2561-326X
language English
last_indexed 2024-03-12T13:01:07Z
publishDate 2021-11-01
publisher JMIR Publications
record_format Article
series JMIR Formative Research
spelling doaj.art-1aaf941a74be41349677824d8c275ab42023-08-28T19:42:56ZengJMIR PublicationsJMIR Formative Research2561-326X2021-11-01511e2539210.2196/25392A Transdiagnostic Self-management Web-Based App for Sleep Disturbance in Adolescents and Young Adults: Feasibility and Acceptability StudyNicole E Carmonahttps://orcid.org/0000-0003-3387-8234Aleksandra Usyatynskyhttps://orcid.org/0000-0002-3020-6646Samlau Kutanahttps://orcid.org/0000-0001-8126-3264Penny Corkumhttps://orcid.org/0000-0002-2552-4973Joanna Hendersonhttps://orcid.org/0000-0002-9387-5193Kelly McShanehttps://orcid.org/0000-0003-3597-2996Colin Shapirohttps://orcid.org/0000-0002-4523-2169Souraya Sidanihttps://orcid.org/0000-0002-9115-2389Jennifer Stinsonhttps://orcid.org/0000-0002-9969-8052Colleen E Carneyhttps://orcid.org/0000-0002-1942-2049 BackgroundSleep disturbance and its daytime sequelae, which comprise complex, transdiagnostic sleep problems, are pervasive problems in adolescents and young adults (AYAs) and are associated with negative outcomes. Effective interventions must be both evidence based and individually tailored. Some AYAs prefer self-management and digital approaches. Leveraging these preferences is helpful, given the dearth of AYA treatment providers trained in behavioral sleep medicine. We involved AYAs in the co-design of a behavioral, self-management, transdiagnostic sleep app called DOZE (Delivering Online Zzz’s with Empirical Support). ObjectiveThis study tests the feasibility and acceptability of DOZE in a community AYA sample aged 15-24 years. The secondary objective is to evaluate sleep and related outcomes in this nonclinical sample. MethodsParticipants used DOZE for 4 weeks (2 periods of 2 weeks). They completed sleep diaries, received feedback on their sleep, set goals in identified target areas, and accessed tips to help them achieve their goals. Measures of acceptability and credibility were completed at baseline and end point. Google Analytics was used to understand the patterns of app use to assess feasibility. Participants completed questionnaires assessing fatigue, sleepiness, chronotype, depression, anxiety, and quality of life at baseline and end point. ResultsIn total, 83 participants created a DOZE account, and 51 completed the study. During the study, 2659 app sessions took place with an average duration of 3:02 minutes. AYAs tracked most days in period 1 (mean 10.52, SD 4.87) and period 2 (mean 9.81, SD 6.65), with a modal time of 9 AM (within 2 hours of waking). DOZE was appraised as highly acceptable (mode≥4) on the items “easy to use,” “easy to understand,” “time commitment,” and “overall satisfaction” and was rated as credible (mode≥4) at baseline and end point across all items (logic, confident it would work, confident recommending it to a friend, willingness to undergo, and perceived success in treating others). The most common goals set were decreasing schedule variability (34/83, 41% of participants), naps (17/83, 20%), and morning lingering in bed (16/83, 19%). AYAs accessed tips on difficulty winding down (24/83, 29% of participants), being a night owl (17/83, 20%), difficulty getting up (13/83, 16%), and fatigue (13/83, 16%). There were significant improvements in morning lingering in bed (P=.03); total wake time (P=.02); sleep efficiency (P=.002); total sleep time (P=.03); and self-reported insomnia severity (P=.001), anxiety (P=.002), depression (P=.004), and energy (P=.01). ConclusionsOur results support the feasibility, acceptability, credibility, and preliminary efficacy of DOZE. AYAs are able to set and achieve goals based on tailored feedback on their sleep habits, which is consistent with research suggesting that AYAs prefer autonomy in their health care choices and produce good results when given tools that support their autonomy. Trial RegistrationClinicalTrials.gov NCT03960294; https://clinicaltrials.gov/ct2/show/NCT03960294https://formative.jmir.org/2021/11/e25392
spellingShingle Nicole E Carmona
Aleksandra Usyatynsky
Samlau Kutana
Penny Corkum
Joanna Henderson
Kelly McShane
Colin Shapiro
Souraya Sidani
Jennifer Stinson
Colleen E Carney
A Transdiagnostic Self-management Web-Based App for Sleep Disturbance in Adolescents and Young Adults: Feasibility and Acceptability Study
JMIR Formative Research
title A Transdiagnostic Self-management Web-Based App for Sleep Disturbance in Adolescents and Young Adults: Feasibility and Acceptability Study
title_full A Transdiagnostic Self-management Web-Based App for Sleep Disturbance in Adolescents and Young Adults: Feasibility and Acceptability Study
title_fullStr A Transdiagnostic Self-management Web-Based App for Sleep Disturbance in Adolescents and Young Adults: Feasibility and Acceptability Study
title_full_unstemmed A Transdiagnostic Self-management Web-Based App for Sleep Disturbance in Adolescents and Young Adults: Feasibility and Acceptability Study
title_short A Transdiagnostic Self-management Web-Based App for Sleep Disturbance in Adolescents and Young Adults: Feasibility and Acceptability Study
title_sort transdiagnostic self management web based app for sleep disturbance in adolescents and young adults feasibility and acceptability study
url https://formative.jmir.org/2021/11/e25392
work_keys_str_mv AT nicoleecarmona atransdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT aleksandrausyatynsky atransdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT samlaukutana atransdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT pennycorkum atransdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT joannahenderson atransdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT kellymcshane atransdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT colinshapiro atransdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT sourayasidani atransdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT jenniferstinson atransdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT colleenecarney atransdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT nicoleecarmona transdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT aleksandrausyatynsky transdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT samlaukutana transdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT pennycorkum transdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT joannahenderson transdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT kellymcshane transdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT colinshapiro transdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT sourayasidani transdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT jenniferstinson transdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy
AT colleenecarney transdiagnosticselfmanagementwebbasedappforsleepdisturbanceinadolescentsandyoungadultsfeasibilityandacceptabilitystudy