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: 8608948
• 负责人: Ruth C Browne
• 金额: $ 17.51万
• 依托单位: SUNY DOWNSTATE MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-02-01 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8608948
• 关键词: Adherence; Advocate; Affect; Attention; Beauty; Behavior Therapy; Behavioral; Blood Pressure; Body mass index; C-reactive protein; Cardiovascular system; Caring; Cessation of life; Church; Clinical; Cognitive deficits; Communities; Community Health; Continuous Positive Airway Pressure; Control Groups; Data; Diagnosis; Excess Mortality; Excessive Daytime Sleepiness; Exposure to; Faculty; Goals; Health Educators; Health Promotion; Healthcare Systems; Hospitalization; Individual; Instruction; Intervention; Knowledge; Laboratories; Link; Lipids; Logistic Models; Measures; Mediating; Metabolic; Minority; Modality; Modeling; Morbidity - disease rate; Obstructive Sleep Apnea; Outcome; Outcome Measure; Outcome Study; Participant; Patients; Physicians; Polysomnography; Positioning Attribute; Protocols documentation; Public Health; Quality Control; Randomized; Randomized Controlled Trials; Readiness; Recommendation; Recruitment Activity; Research; Research Personnel; Research Project Grants; Risk; Risk Reduction; Self Efficacy; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Specialist; Telephone; Training; Trust; United States; Work; arm; automobile accident; base; cardiovascular disorder risk; cardiovascular risk factor; cost; experience; fasting plasma glucose; follow-up; health disparity; high risk; improved; intervention effect; post intervention; pressure; 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 telephone delivered 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3.8万人死于心血管疾病，花费4200万美元