Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Carole A. Pepa


Obstructive sleep apnea (OSA) affects 24% of the US population (DiNapoli, 2014). Untreated OSA causes many diseases, affects one’s quality of life, and increases mortality (Pengo et al., 2018). Continuous positive airway pressure (CPAP) is the lifelong treatment for OSA; yet 30%-80% of OSA patients are CPAP noncompliant within one year. The purpose of this EBP project was to determine if implementing a positive frame message intervention would improve CPAP compliance for newly diagnosed OSA patients. Based on the evidence, implementation of behavioral interventions, such as a positive framed message, was effective in improving CPAP compliance (Pengo et al., 2018). The Iowa Model (Titler et al., 2001) was used as the framework to guide the project that was undertaken at a pulmonary and sleep clinic in Northwest Indiana. Nineteen (N = 19) newly diagnosed OSA participants were recruited for the EBP project using a rolling enrollment; each participant was followed over a 13-week period. The participants ranged in age from 31 to 76 years with the majority (52%) in the 50-60 age range. CPAP compliance data were recorded on a SD card located in the participants’ CPAP devices. The compliance data were retrieved weekly and compared before and after initiating a positive framed message intervention at four-week, nine-week, and 13-week intervals. A one-way repeated-measures ANOVA was calculated comparing the CPAP compliance rates of the participants at the three different intervals. No statistically significant effect was found (F (2, 36) = .984, p > .05). Although the results of the ANOVA were not statistically significant, mean CPAP compliance scores increased from the four-week pre-intervention score (M = 69.65, SD = 25.76) to the nine-week post-intervention score (M = 71.22, SD 25.89). Once the participants no longer received phone calls, the 13-week mean CPAP compliance scores decreased (M = 66.62, SD 26.92). Further projects investigating message framing to improve CPAP compliance are warranted.

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Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

F. Clark DNP poster.pdf (245 kB)