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）每年造成38,000次心血管死亡，成本为4200万 根据国家睡眠障碍委员会的估计，相关住院的美元 研究。未经治疗的OSA导致心血管发病率，汽车事故，认知缺陷， 白天嗜睡过多和死亡率过多。幸运的是，OSA治疗降低了 心血管疾病增加了64％。尽管OSA是一个公共卫生问题，对 黑人，没有系统的研究记录了推荐OSA评估和治疗的依从性 在社区层面。我们进行的基于社区研究的初步证据表明 43％的黑人用ARES筛选为高OSA风险，但只有27％的人遵守推荐的OSA 评估。证据还表明，黑人不太可能遵守OSA治疗。虽然黑色 遵守医师建议的患者，来自布鲁克林睡眠障碍中心的证据， 纽约州表明90％的人接受了诊断。需要有效的行为干预以增加 接受OSA评估和治疗的黑人数量。在两臂随机对照试验中 380个黑人风险高的黑人，我们将评估交付的文化和语言量身定制的电话的影响 在OSA评估率提高和遵守CPAP治疗的情况下，行为干预。 我们还将评估干预对临床结果的影响（体重指数，脂质水平，血压，血压， 禁食等离子体葡萄糖/HBAIC和C反应蛋白）。志愿者将从黑人拥有 理发店，美容院，教堂和社区中心位于纽约州布鲁克林。长期目标是 将这种干预方式应用于基于社区的环境，从而将社区健康促进链接到 医疗保健系统。因此，我们的计划可以作为替代性的非传统模型 在全国黑人中散布这种干预措施，以减少心血管风险。潜力 传播很高，因为有超过18000个黑人理发店和13000个黑人教堂 城市中心在美国。