Maximizing Sleep Apnea Treatment at the Community Level to Reduce CVD Risks

在社区层面最大限度地进行睡眠呼吸暂停治疗以降低心血管疾病风险

• 批准号: 8343614
• 负责人: Ruth C Browne
• 金额: $ 18.93万
• 依托单位: SUNY DOWNSTATE MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-06-14 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8343614
• 关键词: Adherence; Affect; Beauty; Behavior Therapy; Blood Pressure; Body mass index; C-reactive protein; Cardiovascular system; Cessation of life; Church; Clinical; Cognitive deficits; Communities; Community Health; Continuous Positive Airway Pressure; Diagnosis; Excess Mortality; Excessive Daytime Sleepiness; Goals; Health Promotion; Healthcare Systems; Hospitalization; Instruction; Intervention; Link; Lipids; Modality; Modeling; Morbidity - disease rate; Obstructive Sleep Apnea; Outcome; Patients; Physicians; Public Health; Randomized Controlled Trials; Recommendation; Recruitment Activity; Research; Research Project Grants; Risk; Risk Reduction; Sleep Apnea Syndromes; Sleep Disorders; Telephone; United States; arm; automobile accident; base; cardiovascular disorder risk; cardiovascular risk factor; cost; fasting plasma glucose; health disparity; intervention effect; programs; volunteer

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.

阻塞性睡眠呼吸暂停(OSA)每年导致3.8万人心血管死亡，造成4200万人死亡 根据国家睡眠障碍委员会的估计，相关的住院费用 研究。未经治疗的阻塞性睡眠呼吸暂停综合症会导致心血管疾病、车祸、认知障碍、 白天过度嗜睡，死亡率过高。幸运的是，阻塞性睡眠呼吸暂停综合症的治疗降低了 心血管疾病，%。尽管阻塞性睡眠呼吸暂停综合症是一个公共卫生问题，对 黑人，没有系统的研究证明遵守建议的OSA评估和治疗 在社区层面。我们进行的一项基于社区的研究的初步证据表明 43%的接受ARES筛查的黑人OSA风险很高，但只有27%的人坚持推荐的OSA 评估。证据还表明，黑人不太可能坚持OSA治疗。虽然黑人很少 患者遵循医生的建议，布鲁克林睡眠障碍中心的证据， 纽约显示，90%的人得到了诊断。需要有效的行为干预来增加 接受OSA评估和治疗的黑人人数。在一项双臂随机对照试验中 380名患有阻塞性睡眠呼吸暂停综合症的黑人，我们将评估一种在文化和语言上量身定做的电话传授的影响 行为干预对提高OSA评估率和坚持CPAP治疗的作用。 我们还将评估对临床结果的干预效果(体重指数、血脂水平、血压、 空腹血糖/糖化血红蛋白和C反应蛋白)。志愿者将从黑人拥有的人中招募 纽约布鲁克林的理发店、美容院、教堂和社区中心。长期目标是 在社区环境中应用这一干预模式，从而将社区健康促进与 医疗保健系统。因此，我们的程序可以作为一种替代的、非传统的 在全国黑人中传播这项降低心血管风险的干预措施。潜在的 传播率很高，因为在美国有超过1.8万家黑人理发店和1.3万家黑人教堂 全美的城市中心。