0376 Evaluation of healthcare delivery disparities among the Native American population: Knowledge and Attitudes of obstructive sleep apnea among the Indian Health Services primary care physicians

Abstract Introduction The burden of racial disparities in diagnosis and treatment of Obstructive sleep apnea (OSA) remains underrecognized among the Native American population. This study intends to assess the knowledge and attitudes towards diagnosis and management of obstructive sleep apnea among the primary care physicians caring for the Native American population. Methods A cross-sectional survey was conducted at an Indian Health Services (IHS) primary care clinic. A validated OSA Knowledge (18 questions) and Attitudes (5 questions) (OSAKA) questionnaire was used, in addition to one question to address referrals to a sleep specialist. Results A total of 20 primary care providers were invited to participate in the survey with a response rate of 45% (9 participants, 2 males and 7 females). The median (IQR) knowledge score was 14 (13-16). The mean (±SD) percentage of correct response (proportion of correctly answered questions) was 79% (±9.5), which was similar to previously reported scores among primary care physicians in other studies. There was no significant knowledge difference between males and females and no difference based on age. All participants felt it was very or extremely important to identify patients with OSA and that OSA is important as a clinical disorder. There was a significant positive correlation between knowledge and recognizing the importance of OSA as clinical disorder, and between knowledge and confidence in identification of OSA. There was a negative correlation between confidence in OSA identification and referral to a sleep specialist but was not statistically significant. Only one participant (11%) felt comfortable managing patients on CPAP therapy, but there was no significant correlation with referrals to a sleep specialist. Conclusion Obstructive sleep apnea knowledge in IHS primary care providers is comparable to their peers. However, the lack of comfort in managing patients with OSA on CPAP did not increase referrals to a sleep specialist. This highlights a possible disparity and resource gap in treating Native Americans within the IHS health system with sleep apnea and further studies are needed. Support (If Any)