Exploring health literacy, perceived needs, information preferences and acceptability of smartphone-based messaging interventions among individuals with obstructive sleep apnoea in Hong Kong: a mixed-method approach

Background: The role of technology in disease management has gained significant attention, mobile health technology for obstructive sleep apnea (OSA) remains underdeveloped, with limited research exploring its applications. This study explored OSA individuals' health literacy, perceived needs for improvement, information preferences, and acceptance of smartphone-based messaging interventions. Methods: The study comprised two parts. Part 1 was a cross-sectional, self-administered online survey using non-probability convenience sampling conducted in the inpatient ward and outpatient clinic of Queen Mary Hospital, Hong Kong, from May to July 2020. The questionnaire assessed health literacy, perceived needs, and views on smartphone-based messaging interventions to enhance self-management of OSA. Written consent was obtained, and the survey took approximately 10 minutes to complete. Part 2 involved a focus group interview in August 2020 with nine randomly selected participants from Part 1, exploring their views on perceived needs and smartphone-based messaging interventions. Results: A total of 108 participants (82% men; 40.7% aged ≥60 years) were included. Participants self-reported their OSA severity as mild (21.3%), moderate (17.6%), and severe (23.1%), while 38% were unaware of their severity. The results showed low OSA-related health literacy among participants, with no significant differences by age or years since diagnosis. Most participants (76.8%) expressed a strong desire to improve their health. High demand for OSA-related information was reported, including sleep quality (83.3%), OSA-related knowledge (82.4%), weight control (81.5%), habit improvement (78.7%), and emotional management (66.7%). The messaging intervention was well accepted, with high feasibility (82.4%) and usability (72.2%). Conclusions: This study highlights low OSA-related health literacy and a strong demand for authoritative health information. Most found that the messaging intervention was feasible and useful in improving health-related habits and OSA management. The study underscores the need for tailored health education, personalized interventions targeting perceived needs, and innovative messaging solutions to enhance treatment adherence and self-management in OSA individuals.