ArticleSleep health2023
Racial disparities in treatment engagement and outcomes in digital cognitive behavioral therapy for insomnia among pregnant women.
Article in Sleep health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Evaluating the global prevalence of insomnia during pregnancy through standardized questionnaires and diagnostic criteria: a systematic review and meta-analysis.Frontiers in psychiatry · 2024Pooled it
- The role of racial discrimination in medical care: A secondary analysis of the effect of culturally tailored, internet-delivered CBT for insomnia in Black women.The British journal of clinical psychology · 2026Trial
- Black Women Benefit From Psychotherapies for Insomnia, but Experience Adherence Challenges: Results of a Comparative Effectiveness Trial in Women Veterans.Women's health issues : official publication of the Jacobs Institute of Women's HealthTrial
- Ethnocultural differences in symptom change, engagement, and adherence in internet-delivered cognitive behavioral therapy: A secondary analysis of a healthcare-embedded longitudinal study.Internet interventions · 2026Article
- Insomnia Symptoms are Common Among Community Dwelling African Americans Who Report Poor Sleep.Behavioral sleep medicine · 2026Article
- "Actionable" risk for preterm birth: patterns and prediction in California singleton births 2016-2020.BMC pregnancy and childbirth · 2026Article
- Gender Differences in Health Risk Factors for Co-Use of Gabapentin and Opioids among Black Americans.Addiction research & theory · 2026Article
- Self-rated pain and observed pain behavior in Black and White Americans with chronic low back pain.The journal of pain · 2025Article
- Determinants of treatment response to cognitive behavioral therapy in veterans presenting with comorbid insomnia and sleep apnea.Sleep & breathing = Schlaf & Atmung · 2025Article
- Gaps in psychiatric care before and after the COVID-19 pandemic among patients with depression using electronic health records.Psychiatry research · 2025Article
- Identifying predictors of the amount of veteran participation in cognitive behavioral therapy for insomnia in the Veterans Affairs health care system.Psychological services · 2024Article
- Disparities in sleep care and cardiovascular outcomes: defining the problem and implementing solutions.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Developing a culturally tailored digital health intervention for insomnia in Black women.Translational behavioral medicine · 2024Article
- Article
- Article
- App-Supported Sleep Coaching: Implications for Sleep Duration and Sleep Quality.Frontiers in sleep · 2023Article
- Examining the barriers and recommendations for integrating more equitable insomnia treatment options in primary care.Frontiers in sleep · 2023Article
- Effects of Recruitment Messaging on Ethnic/Racial Minority Screening in a RCT for Prenatal Insomnia: An Experimental Approach.Behavioral sleep medicineArticle
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesIn the United States, Black women are disproportionately afflicted with prenatal insomnia. Although cognitive-behavioral therapy for insomnia (CBTI) may represent a strategy to reduce disparities in insomnia, racial minorities attend fewer healthcare appointments and have poorer outcomes from prenatal care and mental health treatment relative to white patients. The present study examined differences in treatment engagement and patient-reported outcomes in non-Hispanic Black and white pregnant women receiving digital CBTI.
methodsSecondary analysis of 39 pregnant women with clinical insomnia who received digital CBTI. Treatment engagement was operationalized as the number of sessions completed (≥4 considered an adequate dose). Treatment outcomes were assessed using the Insomnia Severity Index (ISI; insomnia) and Pittsburgh Sleep Quality Index (PSQI; global sleep disturbance).
resultsBlack women were 4 times more likely than white women to discontinue CBTI before receiving an adequate dose (8.3% vs. 33.3%). Regarding treatment outcomes, white women reported a mean reduction of 5.75 points on the ISI and a reduction of 3.33 points on the PSQI (Cohen's dz = 1.10-1.19). By comparison, Black women reported reductions of 2.13 points on the ISI and 1.53 points on the PSQI, which were statistically non-significant. Differences in treatment engagement did not account for the disparities in patient-reported outcomes.
conclusionsDuring pregnancy, Black women completed fewer CBTI sessions and experienced poorer treatment outcomes in response to digital CBTI relative to white women. Enhancements to insomnia therapy and its digital delivery may improve adherence and outcomes in Black pregnant women.
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