This research study aims to find out the effect of REPOSE, a patient navigation intervention, on the receipt of equitable care among children with a broad range of socioeconomic and rural/urban status with Sleep Disordered Breathing (SDB).
In the REPOSE intervention, a centralized patient navigator a) identifies and addresses dynamic individual barriers, b) provides resources and social support for parent-child dyads, and c) facilitates bidirectional SDB care coordination between clinical teams and parents to achieve evidence-based care.
This study will evaluate the effects of the REPOSE intervention on SDB care delivery and clinical process outcomes for children with a broad range of socioeconomic and rural/urban status by reducing barriers and increasing self-efficacy among parents.
Parents or caregivers (18 and older) of children who were referred by any primary care for SDB evaluation with sleep medicine or pediatric otolaryngology
Patients 2.00 to 11.99 years old
Parents with a working phone who are willing to participate in the study for a 12-month period after enrollment
Patients already established with sleep medicine or otolaryngology which would bias ease of completing specialty evaluation
Parallel
Reach for Equity in Pediatric Obstructive Sleep Evaluation (REPOSE)
Other interventionThe REPOSE intervention consists of a centralized patient navigator who (1) identifies and addresses dynamic individual barriers, (2) provides support for parent-child dyads, and (3) facilitates bidirectional SDB care coordination between clinical teams and parents to achieve evidence-based care. The goals of the REPOSE intervention are to systematically address barriers to care, develop parental self-efficacy to enhance healthcare utilization (e.g., receipt of recommended care and adherence to evidence-based care), and to improve symptom severity and quality of life.
Usual Care
Other interventionUsual care is defined by standard clinical care delivered without a protocolized intervention (e.g., the ordinary course of care).
Completion of specialist evaluation
Binary, evaluation of SDB by completion of specialist consultation (e.g., sleep medicine, otolaryngologist) per AAP guidelines.
Time from referral to specialist consultation
Time in days from referral order to specialist evaluation (sleep medicine or otolaryngology).
Completion of PSG
Binary, PSG (if ordered) was completed within 90 days of the order.
Time to PSG
Time in days from PSG order to completion.
Receipt of treatment
Binary, treatment completion within 60 days.
Sociodemographic factors
Sex, age, race, ethnicity, SES, education, employment, income, distance to medical facility, rural/urban residence, and insurance status.
Clinical characteristics
Comorbidities, body mass index (percentile), and PSG parameters.
Social Support
The Interpersonal Support Evaluation List (ISEL-12) is a 12-item measure of perceptions of social support with three subscale scores representing appraisal, belonging, and tangible social support.
REPOSE Accrual Rate
REPOSE Accrual Rate is the proportion of eligible patients who enroll in REPOSE.
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Medical University of South Carolina
Lead sponsor
National Heart, Lung, and Blood Institute (NHLBI)
Collaborator
