Obstructive Sleep Apnea (OSA) Is responsible for 38,000 cardiovascular deaths yearly and costs 42 million dollars on related hospitalizations, according to estimates from the National Commission on Sleep Disorders Research. Untreated OSA leads to cardiovascular morbidity, automobile accidents, cognitive deficits, excessive daytime sleepiness and excess mortality. Fortunately, OSA treatment reduces risk for cardiovascular disease by 64%. Although OSA is a public health problem that disproportionately affects blacks, no systematic study has documented adherence to recommended OSA assessment and treatment at the community level. Preliminary evidence from a community-based study we conducted suggests that 43% of blacks screened with the ARES are at high OSA risk, but only 27% adhered to recommended OSA assessment. Evidence also suggests that blacks are less likely to adhere to OSA treatment. While few black patients adhered to physician's recommendations, evidence from our Sleep Disorders Center in Brooklyn, NY showed that 90% received a diagnosis. Effective behavioral interventions are needed to increase the number of blacks receiving OSA assessment and treatment. In a two-arm randomized controlled trial among 380 blacks at high OSA risk, we will evaluate effects of a culturally and linguistically tailored telephonedelivered behavioral intervention in increasing rates of OSA assessment and adherence to CPAP treatment. We will also evaluate Intervention effects on clinical outcomes (body mass index, lipid level, blood pressure, fasting plasma glucose/HbAIC, and C-reactive protein). Volunteers will be recruited from black-owned barbershops, beauty salons, churches, and community centers in Brooklyn, NY. The long-term goal is to apply this Intervention modality in community-based settings, thereby linking community health promotion to the healthcare system. Thus, our program could serve as an alternative, non-traditional model of disseminating this intervention for cardiovascular risk reduction among blacks nationwide. The potential for dissemination Is high, as there are over 18-thousand black barbershops and 13-thousand black churches in urban centers across the United States.

Public Health Relevance

This collaborative research project examines whether a culturally and linguistically tailored telephone Intervention will increase adherence to recommended sleep apnea assessment and treatment among blacks recruitedfrom community-based settings in Brooklyn, NY. The long-term goal is to link community health promotion to the healthcare system. Thus, our program could serve as an alternative, non-traditional model for nationwide dissemination of tailored Intervention of cardiovascular risk reduction through OSA treatment.

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Exploratory Grants (P20)
Project #
5P20MD006875-02
Application #
8489356
Study Section
Special Emphasis Panel (ZMD1-RN)
Project Start
Project End
Budget Start
2013-02-01
Budget End
2014-01-31
Support Year
2
Fiscal Year
2013
Total Cost
$88,089
Indirect Cost
$24,702
Name
Suny Downstate Medical Center
Department
Type
DUNS #
040796328
City
Brooklyn
State
NY
Country
United States
Zip Code
11203
Wilson, Tracey E; Fraser-White, Marilyn; Williams, Kim M et al. (2014) Barbershop Talk With Brothers: using community-based participatory research to develop and pilot test a program to reduce HIV risk among Black heterosexual men. AIDS Educ Prev 26:383-97
Donat, Margaret; Brown, Clinton; Williams, Natasha et al. (2013) Linking sleep duration and obesity among black and white US adults. Clin Pract (Lond) 10:
Adenekan, Bosede; Pandey, Abhishek; McKenzie, Sharon et al. (2013) Sleep in America: role of racial/ethnic differences. Sleep Med Rev 17:255-62