Abstract
Objectives: The goals of this study are to assess primary care
provider (PCP) knowledge of and attitudes toward pediatric obstructive
sleep apnea (OSA), and to identify variations in practice patterns.
Design: A cross-sectional survey including the Obstructive
Sleep Apnea Knowledge and Attitudes in Children (OSAKA-KIDS)
questionnaire was administered to PCPs from August to December 2021.
Univariable analyses and multivariable linear regressions were performed
to analyze associations between demographics and knowledge, attitudes,
and screening frequency. Results: There were 82 PCPs who
completed the survey (age 43.4 ±9.6 years, 69.6% female, 90.2%
non-Hispanic White). Specialties included Pediatrics (65.9%) and Family
Medicine (32.9%). Respondents answered a mean 84.9 ±10.7% questions
correctly on the knowledge portion. Years in practice, provider training
background, and academic affiliation were not associated with knowledge
scores. Less than half (45.1%) of respondents screened for OSA ‘most of
the time’ (32.9%) or ‘always’ (12.2%). Higher screening frequency was
associated with clinics with higher Medicaid beneficiaries (P=0.002) and
a lower proportion of Black patients (P=0.033). Providers who felt more
confident in managing OSA were more likely to screen ‘most of the time’
(B=0.532, 95%CI [0.120 – 0.926], P=0.012), or ‘always’ (B=0.708,
95%CI [0.129 – 1.29], P=0.017). Conclusion: These results
suggest guideline-recommended screening for OSA is low among PCPs
despite high knowledge scores. Higher confidence in OSA management was
associated with higher screening rates for obstructive sleep-disordered
breathing. Further studies on interventions aimed to increase screening
and confidence may improve equitable care.