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. Author manuscript; available in PMC: 2020 Jan 1.
Published in final edited form as: Behav Sleep Med. 2017 Jan 27;17(1):49–69. doi: 10.1080/15402002.2016.1276018

Table 1.

Social Cognitive Intervention to Promote PAP Adherence: SCIP-PA Description

Critical
Intervention
Period
Critical
Indicator
(SEMSA*)
Measurement
Tailored
Intervention
Phase
(Activity
Participants)
Tailored Intervention Description
(Critical Indicator Domain Target*)
Pre-
diagnosis
1 Phase I
(Participant)
  • “What is Sleep Apnea” DVD provided by American Sleep Apnea Association (RP, OE, SE)

  • Identify 2-5 proximate social support resources (F, B)

  • Identify reasons participant initiated sleep diagnostics (RP, OE, G)

  • Identify participant goals for diagnosis and treatment (OE, G)

Post-
diagnostic
PSG
2 Phase II
(Participant;
1 social
support
resource)
  • Diagnostic PSG hypnogram and selected epoch by epoch review(RP, OE)

  • Baseline ESS review (RP, OE)

  • Baseline FOSQ review (RP, OE)

  • Comorbidity and health risk review (RP, OE)

  • Social & interpersonal relationship limitation discussion

  • Review & revise participant goals for diagnosis and treatment

  • PAP equipment introduction and practice (SE)

  • Mask-fitting (SE)

  • Mask/headgear application demonstration/return demonstration(SE)

  • Mask/headgear/tubing practice instructions: 5 consecutive days prior to titration PSG (SE)

Post-titration
PSG
3 Phase III
(Participant)
  • Diagnostic PSG hypnogram and selected epoch by epoch comparative review with titration PSG hypnogram and epochs(RP, OE)

  • Review bedtime routine and incorporation of PAP (F, B, SE)

  • Discuss participant-identified barriers and facilitators of PAP use and plans to address (F,B, SE)

  • Review participant risks of untreated OSA (from baseline assessment)(RP, OE)

  • Review and revise participant goals for treatment (OE, G)

  • Reassess mask/headgear application; repeat demonstration as needed (SE)

  • PAP equipment review (SE)

Day 1, Day
2, Day 5
Home CPAP
Treatment
Phone
Follow Up &
Day 8 Home
Visit
4 (Day 2) Phase IV
(Participant;
social
support
resources)
  • Phone contact Day 1 (participant only)
    • Discuss questions, concerns, difficulties, & facilitators night 1 PAP experience (F, B)
  • Phone contact Day 2 (participant only)
    • Administer SEMSA
    • Discuss questions, concerns, difficulties, & facilitators night 2 PAP experience (F,B)
    • Review bedtime routine and incorporation of PAP (F, B, SE)
    • Discuss participant-identified barriers and facilitators of PAP use and plans to address (F,B, SE)
    • Review participant risks of untreated OSA (from baseline assessment)(RP, OE)
    • Review and revise participant goals for treatment (OE, G)
    • Discuss participant perceived response to PAP (RP, OE, G, SE)
    • Instructions for discussing participant response to PAP with identified proximate social support resources (F)
  • Phone Contact Day 5 (participant only)
    • Discuss questions, concerns, difficulties, & facilitators night 3-5 PAP experience (F,B)
    • Review bedtime routine and incorporation of PAP (F, B, SE)
    • Discuss participant-identified barriers and facilitators of PAP use and plans to address (F,B, SE)
    • Review participant risks of untreated OSA (from baseline assessment)(RP, OE)
    • Review and revise participant goals for treatment (OE, G)
    • Discuss participant perceived response to PAP (RP, OE, G, SE)
    • Discuss participant’s feedback from 2-5 proximate social support resources re: observed response to PAP (F)
  • Day 8 Research Visit (participant; 1 social support resource if available)
    • PAP Smartcard download
    • Review downloaded PAP usage data (OE, G, F, B, SE)
    • Review and revise participant goals for treatment (OE, G)
    • Discuss participant perceived response to PAP (RP, OE, G, SE)
    • Address any concerns, questions, difficulties & facilitators from Night 1-7 (F, B)
*

Notes. Theory Derived Intervention Components: RP – Risk Perception; OE – Outcome Expectations; SE – Self Efficacy; F – Facilitators; B – Barriers; G – Goals

Abbreviations: PSG, polysomnogram; SEMSA, Self Efficacy Measure in Sleep Apnea; ESS, Epworth Sleepiness Scale; FOSQ, Functional Outcomes of Sleep Questionnaire; PAP, Positive Airway Pressure