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

Objective This paper reports the effect 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 3rd, 6th or 8th 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 7th grade. Health literacy, socioeconomic status, number of health conditions, and the intervention’s effect were related to the PSQI. The PSQI score significantly 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.

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.