POS0419-HPR WHAT CHALLENGES AND OPPORTUNITIES DO PHYSIOTHERAPISTS ENCOUNTER IN INTEGRATING INTERVENTIONS TO PROMOTE SLEEP FOR INDIVIDUALS WITH ARTHRITIS?

Background: The Canadian 24-hour Movement Guidelines provide people in Canada with a framework to support balancing time for physical activity, sedentary behaviour, and sleep in their 24-hour day. Achieving balance can be particularly challenging for individuals with chronic conditions like arthritis. Physiotherapists often recommend physical activity to patients, but their considerations for sleep remains unclear, and their roles and abilities in addressing sleep are undefined. Objectives: To investigate facilitators and barriers reported by physiotherapists and students in incorporating sleep interventions in practice. Methods: We conducted a nationwide survey using REDCap with physiotherapists and students in Canada. Participants were recruited via e-mail and social media. We developed a 28-item survey based on the Capability-Opportunity-Motivation-Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). Participants rated their agreement for each item (Figure 1) on a 7-point Likert scale (7=strongly agree). We report proportional scores (%) of means (95% confidence interval [CI]) relative to a sum score 1) overall, 2) by COM-B attribute and 3) by TDF domain. Higher scores indicated more positive attributes (i.e., facilitators). We also report means (95%CI) by individual items, and identified barriers (mean <4/7). Results: In January-November 2023, 216 responded to the invitation and 190 (88%) completed the questionnaire (148 physiotherapists; 42 students). Mean age was 35 (±11) years. Most practicing physiotherapists delivered in-person care (78%) and practiced in urban settings (80%). The overall proportional mean score was 66% (65%-68%). By COM-B attribute, motivation scored highest at 71% (69%-73%), followed by opportunity at 62% (60%-64%) and capability at 61% (58%-63%). The highest scoring TDF domain was social/professional role & identity at 86% (84%-88%), while the lowest was social influence at 54% (51%-57%). Figure 2 presents mean scores and 95%CI by COM-B attribute and TDF. Respondents identified facilitators including being aware sleep is important for managing arthritis, not being limited by caseload to discuss sleep, believing sleep education is within their scope of practice, and believing adequate sleep for patients with arthritis leads to better health outcomes (mean >5; Figure 2). They also planned to incorporate sleep education into their treatment protocols for arthritis and to learn more about the 24-hour guidelines. However, respondents also identified barriers including being unaware of where to find sleep resources (mean=3.63 [3.39-3.89]) and not having sufficient knowledge about sleep guidelines (mean=3.78 [3.46-4.10]). They also reported not regularly providing education for patients with arthritis about sleep (mean=3.52 [3.27-3.77]), nor felt their colleagues incorporated it as part of their routine practice (mean=3.60 [3.40-3.80]). Individuals also reported not feeling confident providing guidance about sleep for patients with arthritis (mean=3.38 [3.10-3.69]). Conclusion: Physiotherapists recognize the importance of sleep interventions in arthritis care and are motivated to incorporate them in practice. While there are perceived challenges for effective implementation related to capability and opportunity, the findings inform opportunities to develop theory-informed behaviour change interventions to engage physiotherapists in integrating sleep interventions in practice. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared. Figure 1 An overview of survey items organized by COM-B Model attribute and Theoretical Domains Framework (TDF). The response scale was reversed for five items, indicated by an asterisk (*), to ensure uniform polarity. Barriers, identified by a mean score <4/7, are highlighted in bold with a red background. Figure 2 Mean respondent scores (95% confidence intervals) for 28 items using a 7-point agreement scale. Items are organized under Capability [A], Opportunity [B], or Motivation [C] attributes of the COM-B Model, and subdivided by Theoretical Domains Framework. Item labels are further described in Figure 1. To ensure uniform polarity, responses to negatively framed items were reversed.