Increasing Provider Awareness of Evidence-Based Screening Tools to Identify Insomnia

Abstract

Background: Insomnia (poor sleep) is a highly prevalent patient-reported symptom that impactsnearly every health-related metric. In its persistent forms, patients may have symptoms meeting DSM-5-TR criteria for a sleep-wake disorder. As a symptom, it is often under-assessed, under-diagnosed, and under-treated, predisposing individuals to have persistent and worsening manifestations and subsequently develop physical health illnesses and mental health disorders. Standardized screening across diverse health conditions, such as insomnia, has been shown to improve recognition, diagnostic accuracy, tailored treatment planning, and patient outcomes. As the basis for standardized screening and the ISE intervention for this project, the ISI, a validated self-report questionnaire designed to assess the severity of insomnia symptoms in clinical practice, was implemented. Purpose: The aim of this quality improvement (QI) project was to evaluate an educationalintervention to motivate clinician use of a validated, evidence-based screening tool, the Insomnia Severity Index (ISI). The overall goal was to improve the identification of insomnia among clinic patients. The Insomnia Severity Education (ISE) intervention was designed to enhance healthcare provider outcomes of 1) insomnia screening knowledge, 2) confidence in using the ISI, and 3) intention to incorporate insomnia screening, specifically the ISI, into routine clinical practice. Methods: An evaluative design utilizing pre- and post-intervention measures was employed toassess the effectiveness of the ISE intervention in enhancing provider knowledge of insomnia screening, confidence in using the ISI, and intention to incorporate insomnia screening, specifically the ISI, into clinical practice. Healthcare providers from a community health center in southern Arizona were invited to participate voluntarily, with three providers completing all components of the intervention. The link to the ISE intervention was distributed through the organization’s internal email system. Descriptive statistics were used to evaluate and interpret the survey data. Results: Post-intervention survey responses indicated increases in healthcare providers'knowledge of insomnia screening, confidence in using the ISI, and intent to implement the ISI in clinical practice. Descriptive statistics revealed positive shifts in all three domains, with providers reporting increased familiarity with the ISI and its clinical applications. The anonymous, self-matched pre- and post-surveys demonstrated that a brief, asynchronous educational intervention was effective in promoting awareness and readiness for practice change. Conclusions: The findings suggest that brief, asynchronous education can be an effectivestrategy for enhancing provider knowledge and confidence in screening for insomnia. The increase in intention to incorporate the ISI into clinical assessments highlights the potential of targeted educational interventions to support the adoption of evidence-based tools in everyday practice. These results support the feasibility and value of integrating insomnia screening into routine care through provider-focused education.