A mobile app providing individually-tailored psychoeducation about sleep for older adults with chronic health conditions and low health literacy

Abstract

Objective: This paper reports on a study of a mobile app that provides tailored information about sleep to individuals aged 40 and older who have chronic health conditions and low health literacy.

Methods: The sleep module was a part of a multitopic app focused on chronic disease self-management. Participants were randomly assigned to receive sleep psychoeducation at reading levels equivalent to 3^rd, 6^th or 8^th grade. The primary outcome measure was the Pittsburgh Sleep Quality Index (PSQI), which was completed at baseline, after the intervention, and again three months later. Outcomes were assessed using repeated measures mixed effects models.

Results: Most participants were Black, Indigenous, or Other Persons of Color (BIPOC; 87%); they had average reading level at the 7^th grade. Health literacy, socioeconomic status, and number of health conditions were related to the PSQI. The PSQI score decreased over the course of the three study visits for all groups, consistent with a small to medium effect size (d = 0.40). No effect of treatment group was observed. Participants were positive about the usefulness and helpfulness of the app.

Conclusion: Results suggest that a brief tailored information intervention may be beneficial for individuals aged 40 and older who have low health literacy and chronic health conditions. Further development of the intervention may enhance its clinical effectiveness.

Figure 1.

Pittsburgh Sleep Quality Index at Each Visit for Treatment Groups. PSQI = Pittsburgh Sleep Quality Index; Evaluations = Study Visit ( 0 = Baseline; 1= First Follow-Up; 2 = Second Follow-Up; Colors represent model-corrected mean values for each treatment group (3^rd, 6^th, and 8^th grade reading difficulty of intervention materials).