Symposia
Sleep / Wake Disorders
Kristi Pruiksma, Ph.D.
Associate Professor
University of Texas Health Science Center at San Antonio
San Antonio, Texas
Background: Insomnia and nightmares are common and debilitating sleep disorders that increase risk for physical and mental health morbidities. Cognitive behavioral therapy for insomnia (CBT-I) and Cognitive Behavioral Therapy for Nightmares (CBT-N) have been shown to improve sleep and daytime functioning. However, there is a critical lack of CBT-I providers and CBT-N providers likely due to lack of training opportunities and costs. A recently completed project addressed this gap for CBT-I by developing an online CBT-I training platform to deliver knowledge in a convenient and low-to-no cost manner to providers: CBTiweb.org. In 2021, the DoD also awarded funding to develop a similar training for treating chronic nightmares: CBTnightmares.org. The purpose of this presentation is to outline the methods used to build, refine, evaluate, and implement CBTiweb and planned methods to develop CBTnightmares.org.
Methods: For CBTiweb.org, subject matter experts developed CBT-I content and consulted with web-developers to build the website. The website was iteratively improved based on feedback received through alpha-testing (n = 24 trainees), beta-testing (n = 41 licensed providers and trainees), and a final study comparing the web-based training (n = 21 licensed providers) to an in-person workshop (n = 23 licensed providers). The website launched on 1 April 2021. For CBTnightmares.org, a consensus manual for CBT-N will first be developed and then a similar process will be used to develop CBTnightmares.org.
Results: For CBTiweb.org, the vast majority of providers positively rated the website navigation, content, and aesthetics and reported better understanding of all core CBT-I skills. In the pilot comparison study, linear fixed-effects modeling on the pre/post-questionnaires revealed a significant main effect for time, indicating a significant increase in knowledge acquisition (baseline = 69% correct, post-training = 92% correct) collapsed across groups (in-person workshop and CBTIweb.org). The interaction effect (Time x Condition) was non-significant, indicating similar gains in knowledge across both groups.
Discussion: Results of development demonstrated CBTIweb.org is an acceptable and effective platform to train health professionals to be minimally proficient in the CBT-I. CBTiweb.org and CBTnighmtares.org are innovative solutions to address the lack of CBT-I and CBT-N providers. Future comparison studies are needed to compare web-based trainings to live trainings.