Virtual first: implementation of a novel sleep telehealth platform in the United States military
BackgroundThere is a gross shortage of sleep specialist providers within the military health system. Telehealth and mobile health represent promising approaches to increase access to high quality, cost-effective care in the U.S military.ObjectivesThis paper reports findings from a mixed-methods clin...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Sleep |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/frsle.2024.1304743/full |
| _version_ | 1797278489222578176 |
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| author | Emerson M. Wickwire Emerson M. Wickwire Jacob Collen Jacob Collen Vincent F. Capaldi Vincent F. Capaldi Samson Z. Assefa Rachell Jones Scott G. Williams Connie L. Thomas Daniel C. Williams Jennifer S. Albrecht |
| author_facet | Emerson M. Wickwire Emerson M. Wickwire Jacob Collen Jacob Collen Vincent F. Capaldi Vincent F. Capaldi Samson Z. Assefa Rachell Jones Scott G. Williams Connie L. Thomas Daniel C. Williams Jennifer S. Albrecht |
| author_sort | Emerson M. Wickwire |
| collection | DOAJ |
| description | BackgroundThere is a gross shortage of sleep specialist providers within the military health system. Telehealth and mobile health represent promising approaches to increase access to high quality, cost-effective care in the U.S military.ObjectivesThis paper reports findings from a mixed-methods clinical implementation study of a novel sleep telehealth platform at two military treatment facilities in the National Capitol Region. The platform includes a mobile app and integrated wearable sensors (i.e., a commercial off-the-shelf sleep tracker [Fitbit]). The primary purpose was to evaluate the implementation of a 10-day remote monitoring assessment and provision of evidence-based sleep treatment recommendations to patients and providers. In addition, we sought to observe, in an exploratory manner, subsequent engagement with the app during 5 days of personalized sleep education and training.MethodsPatients with sleep problems completed an intensive 10-day remote monitoring assessment that included a baseline intake questionnaire, daily sleep diaries, twice daily symptom surveys, and Fitbit. Based on this assessment, patients received personalized assessment results. Concurrently, a provider report was generated that included provisional diagnoses and evidence-based treatment recommendations. Next, participants gained access to personalized sleep education and trainings within the mobile app. Within an established implementation science framework, outcomes were assessed via behavioral adherence (engagement with the app) and separate questionnaires for patients and providers. Last, we conducted four focus groups with patients and 12 key informant interviews with primary care managers (PCMs) and economic stakeholders to seek feedback and recommendations for future directions.ResultsTwo hundred and seventy patients participated in the study. Using validated research questionnaires, participants reported high-risk for obstructive sleep apnea (65.6%), moderate to severe insomnia (38.2%), and moderate to severe daytime sleepiness (38.5%), and moderate to severe anxiety (14.1%) and depressive (20.4%) symptoms. Total sleep time was 6.6 (SD = 1.8) h based on sleep diaries and 6.1 (SD = 1.8) h based on Fitbit. Regarding implementation, reach, effectiveness, adoption, implementation, and maintenance were all notably high, based on quantitative and qualitative data from participants and PCMs.ConclusionsSleep telehealth and mobile health represent promising approaches to increase access to cost-effective, evidence-based care for sleep disorders in the U.S. military. |
| first_indexed | 2024-03-07T16:09:04Z |
| format | Article |
| id | doaj.art-5c01b8fa584b4c12982a62f5c4702bfc |
| institution | Directory Open Access Journal |
| issn | 2813-2890 |
| language | English |
| last_indexed | 2024-03-07T16:09:04Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Sleep |
| spelling | doaj.art-5c01b8fa584b4c12982a62f5c4702bfc2024-03-04T17:01:04ZengFrontiers Media S.A.Frontiers in Sleep2813-28902024-02-01310.3389/frsle.2024.13047431304743Virtual first: implementation of a novel sleep telehealth platform in the United States militaryEmerson M. Wickwire0Emerson M. Wickwire1Jacob Collen2Jacob Collen3Vincent F. Capaldi4Vincent F. Capaldi5Samson Z. Assefa6Rachell Jones7Scott G. Williams8Connie L. Thomas9Daniel C. Williams10Jennifer S. Albrecht11Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United StatesSleep Disorders Center, Walter Reed National Military Medical Center, Bethesda, MD, United StatesDepartment of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United StatesSleep Disorders Center, Walter Reed National Military Medical Center, Bethesda, MD, United StatesDepartment of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, United StatesSleep Disorders Center, Alexander T. Augusta Military Medical Center, Fort Belvoir, VA, United StatesBehavioral Biology Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, United StatesCenter for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, United StatesBehavioral Biology Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, United StatesDepartment of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM, United States0Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United StatesBackgroundThere is a gross shortage of sleep specialist providers within the military health system. Telehealth and mobile health represent promising approaches to increase access to high quality, cost-effective care in the U.S military.ObjectivesThis paper reports findings from a mixed-methods clinical implementation study of a novel sleep telehealth platform at two military treatment facilities in the National Capitol Region. The platform includes a mobile app and integrated wearable sensors (i.e., a commercial off-the-shelf sleep tracker [Fitbit]). The primary purpose was to evaluate the implementation of a 10-day remote monitoring assessment and provision of evidence-based sleep treatment recommendations to patients and providers. In addition, we sought to observe, in an exploratory manner, subsequent engagement with the app during 5 days of personalized sleep education and training.MethodsPatients with sleep problems completed an intensive 10-day remote monitoring assessment that included a baseline intake questionnaire, daily sleep diaries, twice daily symptom surveys, and Fitbit. Based on this assessment, patients received personalized assessment results. Concurrently, a provider report was generated that included provisional diagnoses and evidence-based treatment recommendations. Next, participants gained access to personalized sleep education and trainings within the mobile app. Within an established implementation science framework, outcomes were assessed via behavioral adherence (engagement with the app) and separate questionnaires for patients and providers. Last, we conducted four focus groups with patients and 12 key informant interviews with primary care managers (PCMs) and economic stakeholders to seek feedback and recommendations for future directions.ResultsTwo hundred and seventy patients participated in the study. Using validated research questionnaires, participants reported high-risk for obstructive sleep apnea (65.6%), moderate to severe insomnia (38.2%), and moderate to severe daytime sleepiness (38.5%), and moderate to severe anxiety (14.1%) and depressive (20.4%) symptoms. Total sleep time was 6.6 (SD = 1.8) h based on sleep diaries and 6.1 (SD = 1.8) h based on Fitbit. Regarding implementation, reach, effectiveness, adoption, implementation, and maintenance were all notably high, based on quantitative and qualitative data from participants and PCMs.ConclusionsSleep telehealth and mobile health represent promising approaches to increase access to cost-effective, evidence-based care for sleep disorders in the U.S. military.https://www.frontiersin.org/articles/10.3389/frsle.2024.1304743/fullsleeptelehealthimplementationinsomniasleep apneamilitary |
| spellingShingle | Emerson M. Wickwire Emerson M. Wickwire Jacob Collen Jacob Collen Vincent F. Capaldi Vincent F. Capaldi Samson Z. Assefa Rachell Jones Scott G. Williams Connie L. Thomas Daniel C. Williams Jennifer S. Albrecht Virtual first: implementation of a novel sleep telehealth platform in the United States military Frontiers in Sleep sleep telehealth implementation insomnia sleep apnea military |
| title | Virtual first: implementation of a novel sleep telehealth platform in the United States military |
| title_full | Virtual first: implementation of a novel sleep telehealth platform in the United States military |
| title_fullStr | Virtual first: implementation of a novel sleep telehealth platform in the United States military |
| title_full_unstemmed | Virtual first: implementation of a novel sleep telehealth platform in the United States military |
| title_short | Virtual first: implementation of a novel sleep telehealth platform in the United States military |
| title_sort | virtual first implementation of a novel sleep telehealth platform in the united states military |
| topic | sleep telehealth implementation insomnia sleep apnea military |
| url | https://www.frontiersin.org/articles/10.3389/frsle.2024.1304743/full |
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