Olugbenga Ogedegbe
Olugbenga Ogedegbe
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Professor of Social and Behavioral Sciences
Professor for the Department of Population Health at NYU Grossman School of Medicine
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Professional overview
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Gbenga Ogedegbe, a physician, is Professor of Population Health & Medicine, Chief Division of Health & Behavior and Director Center for Healthful Behavior Change in the Department of Population Health at the School of Medicine. Gbenga is a leading expert on health disparities research; his work focuses on the implementation of evidence-based interventions for cardiovascular risk reduction in minority populations. He is Principal Investigator on numerous NIH projects, and has expanded his work globally to Sub-Saharan Africa where he is funded by the NIH to strengthen research capacity and reduce the burden of noncommunicable diseases. He has co-authored over 250 publications and his work has been recognized by receipt of several research and mentoring awards including the prestigious John M. Eisenberg Excellence in Mentorship Award from the Agency for Healthcare Research and Quality, and the Daniel Savage Science Award. He has served on numerous scientific panels including the NIH, CDC, World Health Organization, and the European Union Research Council. Prior to joining NYU, he was faculty at Cornell Weill Medical School and Columbia University College of Physicians and Surgeons.
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Education
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MPH from Columbia University, 1999Residency, Montefiore Medical Center, Internal Medicine, 1998MD from Donetsk University, 1988
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Areas of research and study
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Access to HealthcareGlobal HealthHealth of Marginalized PopulationImplementation and Impact of Public Health RegulationsImplementation scienceStroke and Cardiovascular Disease
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Publications
Publications
Effect of a congregation-based intervention on uptake of HIV testing and linkage to care in pregnant women in Nigeria (Baby Shower): A cluster randomised trial
AbstractEzeanolue, E. E., Obiefune, M. C., Ezeanolue, C. O., Ehiri, J. E., Osuji, A., Ogidi, A. G., Hunt, A. T., Patel, D., Yang, W., Pharr, J., & Ogedegbe, G. (n.d.).Publication year
2015Journal title
The Lancet Global HealthVolume
3Issue
11Page(s)
e692-e700AbstractBackground: Few effective community-based interventions exist to increase HIV testing and uptake of antiretroviral therapy (ART) in pregnant women in hard-to-reach resource-limited settings. We assessed whether delivery of an intervention through churches, the Healthy Beginning Initiative, would increase uptake of HIV testing in pregnant women compared with standard health facility referral. Methods: In this cluster randomised trial, we enrolled self-identified pregnant women aged 18 years and older who attended churches in southeast Nigeria. We randomised churches (clusters) to intervention or control groups, stratified by mean annual number of infant baptisms (<80 vs ≥80). The Healthy Beginning Initiative intervention included health education and on-site laboratory testing implemented during baby showers in intervention group churches, whereas participants in control group churches were referred to health facilities as standard. Participants and investigators were aware of church allocation. The primary outcome was confirmed HIV testing. This trial is registered with ClinicalTrials.gov, identifier number NCT 01795261. Findings: Between Jan 20, 2013, and Aug 31, 2014, we enrolled 3002 participants at 40 churches (20 per group). 1309 (79%) of 1647 women attended antenatal care in the intervention group compared with 1080 (80%) of 1355 in the control group. 1514 women (92%) in the intervention group had an HIV test compared with 740 (55%) controls (adjusted odds ratio 11·2, 95% CI 8·77-14·25; p<0·0001). Interpretation: Culturally adapted, community-based programmes such as the Healthy Beginning Initiative can be effective in increasing HIV screening in pregnant women in resource-limited settings. Funding: US National Institutes of Health and US President's Emergency Plan for AIDS Relief.Ethical oversight in quality improvement and quality improvement research: New approaches to promote a learning health care system Ethics in Biomedical Research
AbstractFiscella, K., Tobin, J. N., Carroll, J. K., He, H., & Ogedegbe, G. (n.d.).Publication year
2015Journal title
BMC Medical EthicsVolume
16Issue
1AbstractBackground: Institutional review boards (IRBs) distinguish health care quality improvement (QI) and health care quality improvement research (QIR) based primarily on the rigor of the methods used and the purported generalizability of the knowledge gained. Neither of these criteria holds up upon scrutiny. Rather, this apparently false dichotomy may foster under-protection of participants in QI projects and over-protection of participants within QIR. Discussion: Minimal risk projects should entail minimal oversight including waivers for informed consent for both QI and QIR projects. Minimizing the burdens of conducting QIR, while ensuring minimal safeguards for QI projects, is needed to restore this imbalance in oversight. Potentially, such ethical oversight could be provided by the integration of Institutional Review Boards and Clinical Ethical Committees, using a more integrated and streamlined approach such as a two-step process involving a screening review, followed by a review by committee trained in QIR. Standards for such ethical review and training in these standards, coupled with rapid review cycles, could facilitate an appropriate level of oversight within the context of creating and sustaining learning health care systems. Summary: We argue that QI and QIR are not reliably distinguishable. We advocate for approaches that improve protections for QI participants while minimizing over-protection for participants in QIR through reasonable ethical oversight that aligns risk to participants in both QI and QIR with the needs of a learning health care system.Excess Metabolic Syndrome Risks Among Women Health Workers Compared With Men
AbstractAdeoye, A. M., Adewoye, I. A., Dairo, D. M., Adebiyi, A., Lackland, D. T., Ogedegbe, G., & Tayo, B. O. (n.d.).Publication year
2015Journal title
Journal of Clinical HypertensionVolume
17Issue
11Page(s)
880-884AbstractMetabolic syndrome is associated with higher rates of cardiovascular morbidity and mortality. Although significant disparities in the risks of metabolic syndrome by occupation type and sex are well documented, the factors associated with metabolic syndrome in low- to middle-income countries remain unclear. These gaps in evidence identify the need for patterns of metabolic syndrome among hospital personnel of both sexes in Nigeria. A total of 256 hospital workers comprising 32.8% men were studied. The mean age of the participants was 42.03±9.4 years. Using International Diabetic Federation criteria, the prevalence of metabolic syndrome was 24.2%. Women were substantially and significantly more likely to be identified with metabolic syndrome compared with men (34.9% vs 2.4%, respectively; P=.0001). This study identified metabolic syndrome among health workers with over one third of women with metabolic syndrome compared with <10% of men. These results support the implementation of lifestyle modification programs for management of metabolic syndrome in the health care workplace.Explanatory models of diabetes in urban poor communities in Accra, Ghana
AbstractDe-Graft Aikins, A., Awuah, R. B., Pera, T. A., Mendez, M., & Ogedegbe, G. (n.d.).Publication year
2015Journal title
Ethnicity and HealthVolume
20Issue
4Page(s)
391-408AbstractObjectives. The objective of the study was to examine explanatory models of diabetes and diabetes complications among urban poor Ghanaians living with diabetes and implications for developing secondary prevention strategies.Design. Twenty adults with type 2 diabetes were recruited from three poor communities in Accra. Qualitative data were obtained using interviews that run between 40 and 90 minutes. The interviews were audio-taped, transcribed and analysed thematically, informed by the explanatory model of disease concept.Results. Respondents associated diabetes and its complications with diet, family history, lifestyle factors (smoking, excessive alcohol consumption and physical inactivity), psychological stress and supernatural factors (witchcraft and sorcery). These associations were informed by biomedical and cultural models of diabetes and disease. Subjective experience, through a process of body-listening, constituted a third model on which respondents drew to theorise diabetes complications. Poverty was an important mediator of poor self-care practices, including treatment non-adherence.Conclusions. The biomedical model of diabetes was a major source of legitimate information for self-care practices. However, this was understood and applied through a complex framework of cultural theories of chronic disease, the biopsychological impact of everyday illness experience and the disempowering effects of poverty. An integrated biopsychosocial approach is proposed for diabetes intervention in this research community.Factors Associated with Medication Nonadherence among Hypertensives in Ghana and Nigeria
AbstractBoima, V., Ademola, A. D., Odusola, A. O., Agyekum, F., Nwafor, C. E., Cole, H., Salako, B. L., Ogedegbe, G., & Tayo, B. O. (n.d.).Publication year
2015Journal title
International Journal of HypertensionVolume
2015AbstractBackground. Blood pressure (BP) control is poor among hypertensives in many parts of sub-Saharan Africa. A potentially modifiable factor for control of BP is medication nonadherence (MNA); our study therefore aimed to determine factors associated with MNA among hypertensives in Ghana and Nigeria. Methodology. We conducted a multicenter cross-sectional study. Patients were recruited from Korle-Bu Hospital (n=120), Ghana; and University of Port Harcourt Teaching Hospital, (n=73) Apapa General Hospital Lagos (n=79) and University College Hospital Ibadan (n=85), Nigeria. Results. 357 hypertensive patients (42.6% males) participated. MNA was found in 66.7%. Adherence showed correlation with depression (r=-0.208, P<0.001), concern about medications (r=-0.0347, P=0.002), and knowledge of hypertension (r=0.14, P=0.006). MNA was associated with formal education (P=0.001) and use of herbal preparation (P=0.014). MNA was found in 61.7% of uninsured participants versus 73.1% of insured participants (P=0.032). Poor BP control was observed in 69.7% and there was significant association between MNA and poor BP control (P=0.006). Conclusion. MNA is high among hypertensives in Ghana and Nigeria and is associated with depression, concern about hypertensive medications, formal education, and use of herbal preparations. The negative association between health insurance and MNA suggests interplay of other factors and needs further investigation.Factors associated with referrals for obstructive sleep apnea evaluation among community physicians
AbstractWilliams, N. J., Nunes, J. V., Zizi, F., Okuyemi, K., Airhihenbuwa, C. O., Ogedegbe, G., & Jean-Louis, G. (n.d.).Publication year
2015Journal title
Journal of Clinical Sleep MedicineVolume
11Issue
1Page(s)
23-26AbstractStudy Objectives: This study assessed knowledge and attitudes toward obstructive sleep apnea (OSA) among community physicians and explored factors that are associated with referrals for OSA evaluation. Methods: Medical students and residents collected data from a convenience sample of 105 physicians practicing at communitybased clinics in a large metropolitan area. Average age was 48 ± 14 years; 68% were male, 70% black, 24% white, and 6% identified as "other." Physicians completed the Obstructive Sleep Apnea Knowledge and Attitudes questionnaire. Results: The average year in physician practice was 18 ± 19 years. Of the sample, 90% reported providing care to black patients. The overall OSA referral rate made by physicians was 75%. OSA knowledge and attitudes scores ranged from 5 to 18 (mean = 14 ± 2) and from 7 to 20 (mean = 13 ± 3), respectively. OSA knowledge was associated with white race/ethnicity (rp = 0.26, p < 0.05), fewer years in practice (rp = -0.38, p < 0.01), patients inquiring about OSA (rp = 0.31, p < 0.01), and number of OSA referrals made for OSA evaluation (rp = 0.30, p < 0.01). Positive attitude toward OSA was associated with patients inquiring about OSA (rp = 0.20, p < 0.05). Adjusting for OSA knowledge and attitudes showed that physicians whose patients inquired about OSA were nearly 10 times as likely to make a referral for OSA evaluation (OR = 9.38, 95% CI: 2.32-38.01, p < 0.01). Conclusion: Independent of physicians' knowledge and attitudes toward obstructive sleep apnea, the likelihood of making a referral for obstructive sleep apnea evaluation was influenced by whether patients inquired about the condition.Food insecurity and effectiveness of behavioral interventions to reduce blood pressure, New York City, 2012-2013
AbstractGrilo, S. A., Shallcross, A. J., Ogedegbe, G., Odedosu, T., Levy, N., Lehrer, S., Chaplin, W., & Spruill, T. M. (n.d.).Publication year
2015Journal title
Preventing Chronic DiseaseVolume
12Issue
2AbstractIntroduction: Food insecurity is associated with diet-sensitive diseases and may be a barrier to successful chronic disease self-management. To evaluate the impact of food insecurity on blood pressure reduction in a pilot clinical trial, we tested the effectiveness of 2 behavioral interventions for hypertension in people with and without food security. Methods: A group of 28 men and women with type 2 diabetes and uncontrolled hypertension were randomized to either 1) home blood pressure telemonitoring alone or 2) home blood pressure telemonitoring plus telephone-based nurse case management. The primary outcome was 6-month change in systolic blood pressure. Results: The 2 interventions resulted in modest, nonsignificant blood pressure reductions. Food-secure patients experienced clinically and statistically significant reductions in blood pressure, whereas no significant change was seen among food-insecure patients. Conclusion: Screening for food insecurity may help identify patients in need of tailored disease management interventions.Human Papillomavirus Knowledge and Attitude among Homeless Women of New York City Shelters
AbstractAsgary, R., Alcabes, A., Feldman, R., Garland, V., Naderi, R., Ogedegbe, G., & Sckell, B. (n.d.).Publication year
2015Journal title
Women's Health IssuesVolume
25Issue
6Page(s)
727-731AbstractBackground: Human papillomavirus (HPV) has not been studied among homeless women in the United States. We assessed knowledge and attitudes regarding HPV infection and the HPV vaccine among homeless women. Methods: We enrolled 300 homeless women age 19 to 65 residing in multiple New York City shelters from 2012 to 2014. We used a national survey to collect HPV data. Results: Mean age was 44.7 ± 12.16 years. The majority were Black, heterosexual, and single; 50.6% were smokers. Almost all HPV knowledge and attitudes data were considerably below the national averages; 41.9% never heard of HPV. Only 36.5% knew that HPV is a sexually transmitted disease; 41.5% knew that HPV causes cervical cancer; and only 19.5% and 17.3% received provider counseling regarding HPV testing and vaccine, respectively. Among participants, 65.4% reported that they would vaccinate their eligible daughters for HPV. Lower rates of up-to-date Pap tests were associated with a lack of knowledge regarding relationship between HPV and abnormal Pap test (p < .01). Conclusions: We recommend improved HPV counseling by providers during any clinical encounter to reduce missed opportunities, coupled with employing patient teaching coach or navigators to improve health literacy and to connect patients to services regarding HPV and cervical cancer.Increased risk of stroke among hypertensive patients with abnormally short sleep duration: analysis of the national health interview survey
Akinseye, O., Ojike, N., Williams, S. K., Seixas, A., Zizi, F., Jean-louis, G., & Ogedegbe, O. (n.d.).Publication year
2015Journal title
Journal of the American Society of HypertensionVolume
9Issue
4Page(s)
e3Individual patient data meta-analysis of self-monitoring of blood pressure (BP-SMART): A protocol
AbstractTucker, K. L., Sheppard, J. P., Stevens, R., Bosworth, H. B., Bove, A., Bray, E. P., Godwin, M., Green, B., Hebert, P., Richard Hobbs, F. D., Kantola, I., Kerry, S., Magid, D. J., Mant, J., Margolis, K. L., McKinstry, B., Omboni, S., Ogedegbe, O., Parati, G., … McManus, R. J. (n.d.).Publication year
2015Journal title
BMJ openVolume
5Issue
9AbstractIntroduction: Self-monitoring of blood pressure is effective in reducing blood pressure in hypertension. However previous meta-analyses have shown a considerable amount of heterogeneity between studies, only part of which can be accounted for by meta-regression. This may be due to differences in design, recruited populations, intervention components or results among patient subgroups. To further investigate these differences, an individual patient data (IPD) meta-analysis of self-monitoring of blood pressure will be performed. Methods and analysis: We will identify randomised trials that have compared patients with hypertension who are self-monitoring blood pressure with those who are not and invite trialists to provide IPD including clinic and/or ambulatory systolic and diastolic blood pressure at baseline and all follow-up points where both intervention and control groups were measured. Other data requested will include measurement methodology, length of followup, cointerventions, baseline demographic (age, gender) and psychosocial factors (deprivation, quality of life), setting, intensity of self-monitoring, self-monitored blood pressure, comorbidities, lifestyle factors (weight, smoking) and presence or not of antihypertensive treatment. Data on all available patients will be included in order to take an intention-to-treat approach. A twostage procedure for IPD meta-analysis, stratified by trial and taking into account age, sex, diabetes and baseline systolic BP will be used. Exploratory subgroup analyses will further investigate non-linear relationships between the prespecified variables. Sensitivity analyses will assess the impact of trials which have and have not provided IPD. Ethics and dissemination: This study does not include identifiable data. Results will be disseminated in a peer-reviewed publication and by international conference presentations. Conclusions: IPD analysis should help the understanding of which self-monitoring interventions for which patient groups are most effective in the control of blood pressure.Integrating mental health screening into routine community maternal and child health activity: experience from Prevention of Mother-to-child HIV transmission (PMTCT) trial in Nigeria
AbstractIheanacho, T., Obiefune, M., Ezeanolue, C. O., Ogedegbe, G., Nwanyanwu, O. C., Ehiri, J. E., Ohaeri, J., & Ezeanolue, E. E. (n.d.).Publication year
2015Journal title
Social psychiatry and psychiatric epidemiologyVolume
50Issue
3Page(s)
489-495AbstractPurpose: Although the prevalence of mental health disorders in Nigeria is comparable to most developed countries, access to mental health care in Nigeria is limited. Improving access to care requires innovative approaches that deliver mental health interventions at the community level. The aim of this study was to determine the feasibility and acceptability of integrating mental health screening into an existing community-based program for prevention of mother-to-child transmission of HIV targeted at pregnant women and their male partners. Methods: Pregnant women and their male partners from 117 churches enrolled in the healthy beginning initiative (HBI) in southeast Nigeria participated in the mental health screening project. Two members from each church were trained as church-based health advisors to administer the 12-item general health questionnaire. Results: Ninety-three percent of the pregnant women and their male partners agreed to participate and fully completed the questionnaire. Overall, 21.7 % of the respondents scored above the threshold of 11 indicating significant psychological distress, with women having significantly higher scores than men. Conclusion: Mental health screening is feasible and well accepted among a cohort of pregnant women and their male partners. Church members can be trained as health advisors to administer mental health screening. Mental health interventions can be developed on the framework of the HBI.Medication Routines and Adherence Among Hypertensive African Americans
AbstractSolomon, A., Schoenthaler, A., Seixas, A., Ogedegbe, G., Jean-Louis, G., & Lai, D. (n.d.).Publication year
2015Journal title
Journal of Clinical HypertensionVolume
17Issue
9Page(s)
668-672AbstractPoor adherence to prescribed medication regimens remains an important challenge preventing successful treatment of cardiovascular diseases such as hypertension. While studies have documented differences in the time of day or weekday vs weekend on medication adherence, no study has examined whether having a medication-taking routine contributes to increased medication adherence. The purpose of this study was to: (1) identify patients' sociodemographic factors associated with consistent medication-taking routine; (2) examine associations between medication-taking consistency, medication adherence, and blood pressure (BP) control. The study included black patients with hypertension (n = 190; 22 men and 168 women; age, mean±standard deviation 54 ± 12.08 years) who completed a practice-based randomized controlled trial. Findings showed that medication-taking consistency was significantly associated with better medication adherence (F = 9.54, P = .002). Associations with the consistency index were not statistically significant for diastolic BP control (odds ratio, 1.319; 95% confidence interval, 0.410-4.246; P = .642) and systolic BP control (odds ratio, 0.621; 95% confidence interval, 0.195-1.974; P = .419).Noncommunicable Diseases in Africa and the Global South
Airhihenbuwa, C. O., & Ogedegbe, G. (n.d.).Publication year
2015Journal title
Health Education and BehaviorVolume
43Page(s)
5S-6SOutcomes with Angiotensin-converting Enzyme Inhibitors vs Other Antihypertensive Agents in Hypertensive Blacks
AbstractBangalore, S., Ogedegbe, G., Gyamfi, J., Guo, Y., Roy, J., Goldfeld, K., Torgersen, C., Capponi, L., Phillips, C., & Shah, N. R. (n.d.).Publication year
2015Journal title
American Journal of MedicineVolume
128Issue
11Page(s)
1195-1203AbstractBackground Angiotensin-converting enzyme inhibitors are used widely in the treatment of patients with hypertension. However, their efficacy in hypertensive blacks when compared with other antihypertensive agents is not well established. Methods We performed a cohort study of patients using data from a clinical data warehouse of 434,646 patients from New York City's Health and Hospitals Corporation from January 2004 to December 2009. Patients were divided into the following comparison groups: angiotensin-converting enzyme inhibitors vs calcium channel blockers, angiotensin-converting enzyme inhibitors vs thiazide diuretics, and angiotensin-converting enzyme inhibitors vs β-blockers. The primary outcome was a composite of death, myocardial infarction, and stroke. Secondary outcomes included the individual components and heart failure. Results In the propensity score-matched angiotensin-converting enzyme inhibitors vs calcium channel blocker comparison cohort (4506 blacks in each group), angiotensin-converting enzyme inhibitors were associated with a higher risk of primary outcome (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.19-1.77; P =.0003), myocardial infarction (HR, 3.40; 95% CI, 1.25-9.22; P =.02), stroke (HR, 1.82; 95% CI, 1.29-2.57; P =.001), and heart failure (HR, 1.77; 95% CI, 1.30-2.42; P =.0003) when compared with calcium channel blockers. For the angiotensin-converting enzyme inhibitors vs thiazide diuretics comparison (5337 blacks in each group), angiotensin-converting enzyme inhibitors were associated with a higher risk of primary outcome (HR, 1.65; 95% CI, 1.33-2.05; P <.0001), death (HR, 1.35; 95% CI, 1.03-1.76; P =.03), myocardial infarction (HR, 4.00; 95% CI, 1.34-11.96; P =.01), stroke (HR, 1.97; 95% CI, 1.34-2.92; P =.001), and heart failure (HR, 3.00; 95% CI, 1.99-4.54; P <.0001). For the angiotensin-converting enzyme inhibitors vs β-blocker comparison, the outcomes between the groups were not significantly different. Conclusions In a real-world cohort of hypertensive blacks, angiotensin-converting enzyme inhibitors were associated with a higher risk of cardiovascular events when compared with calcium channel blockers or thiazide diuretics.Perceptions, Attitudes, and Experience Regarding mHealth among Homeless Persons in New York City Shelters
AbstractAsgary, R., Sckell, B., Alcabes, A., Naderi, R., Adongo, P., & Ogedegbe, G. (n.d.).Publication year
2015Journal title
Journal of Health CommunicationVolume
20Issue
12Page(s)
1473-1480AbstractMobile health may be an effective means of providing access and education to the millions of homeless Americans. We conducted semi-structured interviews with 50 homeless people from different shelters in New York City to evaluate their perceptions, attitudes, and experiences regarding mobile health. Participants average age was 51.66 (SD = 11.34) years; duration of homelessness was 2.0 (SD = 3.10) years. The majority had a mobile phone with the ability to receive and send text messages. Most participants attempted to maintain the same phone number over time. The homeless were welcoming and supportive of text messaging regarding health care issues, including appointment reminders, health education, or management of diseases considering their barriers and mobility, and believed it would help them access necessary health care. Overwhelmingly they preferred text reminders that were short, positively framed, and directive in nature compared to lengthy or motivational texts. The majority believed that free cell phone plans would improve their engagement with, help them navigate, and ultimately improve their access to care. These positive attitudes and experience could be effectively used to improve health care for the homeless. Policies to improve access to mobile health and adapted text messaging strategies regarding the health care needs of this mobile population should be considered.Perspectives of cancer and cancer screening among homeless adults of New York City shelter-based clinics: a qualitative approach
AbstractAsgary, R., Sckell, B., Alcabes, A., Naderi, R., & Ogedegbe, G. (n.d.).Publication year
2015Journal title
Cancer Causes and ControlVolume
26Issue
10Page(s)
1429-1438AbstractPurpose: Millions of homeless Americans have lower cancer screening and higher cancer mortality rates. We explored perspectives and perceptions regarding cancer and cancer screening among homeless. Methods: Using random and criteria sampling, we conducted in-depth semi-structured interviews with 50 homeless adults from New York City’s (NYC) shelters and shelter-based clinics. Results: Mean age was 51.66 years with average 2.03 years of homelessness; 33/50 were older than 50. Only a small number of participants had their recommended cancer screening. Contrary to general assumptions and despite significant barriers, the homeless were concerned about cancer, believed their risk of cancer is higher compared to the general population, and generally considered screening a high priority during homelessness. While they acknowledged several individual- and systems-level barriers, they welcomed targeted measures to address their multi-level barriers. Suggested strategies included active counseling by providers, health education or reminders via mHealth strategies or face-to-face in shelters, addressing potential providers’ prejudice and biases regarding their priorities, incentives, and patient navigators or coach to help navigating the complex cancer screening process. Conclusions: There are gaps in effective cancer screening despite adequate attitude and perceptions among homeless. The health system needs to shift from addressing only basic care to a more equitable approach with accessible and acceptable opportunities for preventive cancer care for the homeless.Preparing for Ebola Virus Disease in West African countries not yet affected: Perspectives from Ghanaian health professionals
AbstractNyarko, Y., Goldfrank, L., Ogedegbe, G., Soghoian, S., & De-Graft Aikins, A. (n.d.).Publication year
2015Journal title
Globalization and HealthVolume
11Issue
1AbstractBackground: The current Ebola Virus Disease (EVD) epidemic has ravaged the social fabric of three West African countries and affected people worldwide. We report key themes from an agenda-setting, multi-disciplinary roundtable convened to examine experiences and implications for health systems in Ghana, a nation without cases but where risk for spread is high and the economic, social and political impact of the impending threat is already felt. Discussion: Participants' personal stories and the broader debates to define fundamental issues and opportunities for preparedness focused on three inter-related themes. First, the dangers of the fear response itself were highlighted as a threat to the integrity and continuity of quality care. Second, healthcare workers' fears were compounded by a demonstrable lack of societal and personal protections for infection prevention and control in communities and healthcare facilities, as evidenced by an ongoing cholera epidemic affecting over 20,000 patients in the capital Accra alone since June 2014. Third, a lack of coherent messaging and direction from leadership seems to have limited coordination and reinforced a level of mistrust in the government's ability and commitment to mobilize an adequate response. Initial recommendations include urgent investment in the needed supplies and infrastructure for basic, routine infection control in communities and healthcare facilities, provision of assurances with securities for frontline healthcare workers, establishment of a multi-sector, "all-hazards" outbreak surveillance system, and engaging directly with key community groups to co-produce contextually relevant educational messages that will help decrease stigma, fear, and the demoralizing perception that the disease defies remedy or control. Summary: The EVD epidemic provides an unprecedented opportunity for West African countries not yet affected by EVD cases to make progress on tackling long-standing health systems weaknesses. This roundtable discussion emphasized the urgent need to strengthen capacity for infection control, occupational health and safety, and leadership coordination. Significant commitment is needed to raise standards of hygiene in communities and health facilities, build mechanisms for collaboration across sectors, and engage community stakeholders in creating the needed solutions. It would be both devastating and irresponsible to waste the opportunity.Race/ethnicity moderates the relationship between chronic life stress and quality of life in type 2 diabetes
AbstractShallcross, A. J., Ojie, M. J., Chaplin, W., Levy, N., Odedosu, T., Ogedegbe, G., & Spruill, T. M. (n.d.).Publication year
2015Journal title
Diabetes Research and Clinical PracticeVolume
108Issue
1Page(s)
150-156AbstractAims: To determine whether chronic life stress is differentially associated with quality of life (QoL) for Blacks vs. Hispanics with type 2 diabetes. Methods: We assessed self-reported chronic stress and QoL in 125 patients with type 2 diabetes who self-identified as either non-Hispanic Black or Hispanic. Separate cross-sectional two-way interaction models (stress × race/ethnicity) with physical and mental health as outcomes were examined. Results: The two-way interaction predicted mental (b = 3.12, P = .04) but not physical health. Simple slopes analyses indicated that under conditions of high stress, Blacks (b = -4.4, P < .001), but not Hispanics, experienced significantly lower levels of mental health. In exploratory analyses, we examined a three-way interaction (stress × race/ethnicity × social support) with physical and mental health as outcomes. Results indicated the three-way interaction predicted mental (b = .62, P = .01) but not physical health. Simple slopes analyses indicated that under conditions of high stress, high levels of social support improved mental health for Hispanics (b = 1.2, P < .001), but not for Blacks. Conclusions: Black patients with type 2 diabetes may be particularly vulnerable to the deleterious effects of high chronic stress. Social support buffers effects of stress on mental health in Hispanics but not Blacks, which suggests differences in the use and/or quality of social support between Hispanics and Blacks. Longitudinal investigations that examine race/ethnicity, stress, social support, and QoL should help clarify the processes that underlie these observed relations.Recognition and management of hypertension in older persons: Focus on African Americans
AbstractStill, C. H., Ferdinand, K. C., Ogedegbe, G., & Wright, J. T. (n.d.).Publication year
2015Journal title
Journal of the American Geriatrics SocietyVolume
63Issue
10Page(s)
2130-2138AbstractHypertension is the most commonly diagnosed condition in persons aged 60 and older and is the single most important risk factor for cardiovascular disease (ischemic heart disease, heart failure, and stroke), kidney disease, and dementia. More than half of individuals with hypertension in the United States are aged 60 and older. Hypertension disproportionately affects African Americans, with all age groups, including elderly adults, having a higher burden of hypertension-related complications than other U.S. populations. Multiple clinical trials have demonstrated the beneficial effects of blood pressure (BP) reduction on cardiovascular morbidity and mortality, with most of the evidence in individuals aged 60 and older. Several guidelines have recently been published on the specific management of hypertension in individuals aged 60 and older, including in high-risk groups such as African Americans. Most recommend careful evaluation, thiazide diuretics and calcium-channel blockers for initial drug therapy in most African Americans, and angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in those with chronic kidney disease or heart failure. Among the areas of controversy is the recommended target BP in African Americans aged 60 and older. A recent U.S. guideline recommended raising the systolic BP target from less than 140 mmHg to less than 150 mmHg in this population. This article will review the evidence and current guideline recommendations for hypertension treatment in older African Americans, including the rationale for continuing to recommend a SBP target of less than 140 mmHg in this population.Self-report measures of medication adherence behavior: recommendations on optimal use
AbstractStirratt, M. J., Dunbar-Jacob, J., Crane, H. M., Simoni, J. M., Czajkowski, S., Hilliard, M. E., Aikens, J. E., Hunter, C. M., Velligan, D. I., Huntley, K., Ogedegbe, G., Rand, C. S., Schron, E., & Nilsen, W. J. (n.d.).Publication year
2015Journal title
Translational Behavioral MedicineVolume
5Issue
4Page(s)
470-482AbstractMedication adherence plays an important role in optimizing the outcomes of many treatment and preventive regimens in chronic illness. Self-report is the most common method for assessing adherence behavior in research and clinical care, but there are questions about its validity and precision. The NIH Adherence Network assembled a panel of adherence research experts working across various chronic illnesses to review self-report medication adherence measures and research on their validity. Self-report medication adherence measures vary substantially in their question phrasing, recall periods, and response items. Self-reports tend to overestimate adherence behavior compared with other assessment methods and generally have high specificity but low sensitivity. Most evidence indicates that self-report adherence measures show moderate correspondence to other adherence measures and can significantly predict clinical outcomes. The quality of self-report adherence measures may be enhanced through efforts to use validated scales, assess the proper construct, improve estimation, facilitate recall, reduce social desirability bias, and employ technologic delivery. Self-report medication adherence measures can provide actionable information despite their limitations. They are preferred when speed, efficiency, and low-cost measures are required, as is often the case in clinical care.Sleep Disorders, Obesity, Hypertension, and Cardiovascular Risk
McFarlane, S. I., Ogedegbe, O., Makaryus, A. N., Agyemang, C., & Jean-Louis, G. (n.d.).Publication year
2015Journal title
International Journal of HypertensionVolume
2015Tailored approaches to stroke health education (TASHE): Study protocol for a randomized controlled trial
AbstractRavenell, J., Leighton-Herrmann, E., Abel-Bey, A., DeSorbo, A., Teresi, J., Valdez, L., Gordillo, M., Gerin, W., Hecht, M., Ramirez, M., Noble, J., Cohn, E., Jean-Louis, G., Spruill, T., Waddy, S., Ogedegbe, G., & Williams, O. (n.d.).Publication year
2015Journal title
TrialsVolume
16Issue
1AbstractBackground: Stroke is a leading cause of adult disability and mortality. Intravenous thrombolysis can minimize disability when patients present to the emergency department for treatment within the 3-41/2h of symptom onset. Blacks and Hispanics are more likely to die and suffer disability from stroke than whites, due in part to delayed hospital arrival and ineligibility for intravenous thrombolysis for acute stroke. Low stroke literacy (poor knowledge of stroke symptoms and when to call 911) among Blacks and Hispanics compared to whites may contribute to disparities in acute stroke treatment and outcomes. Improving stroke literacy may be a critical step along the pathway to reducing stroke disparities. The aim of the current study is to test a novel intervention to increase stroke literacy in minority populations in New York City. Design and Methods: In a two-arm cluster randomized trial, we will evaluate the effectiveness of two culturally tailored stroke education films - one in English and one in Spanish - on changing behavioral intent to call 911 for suspected stroke, compared to usual care. These films will target knowledge of stroke symptoms, the range of severity of symptoms and the therapeutic benefit of calling 911, as well as address barriers to timely presentation to the hospital. Given the success of previous church-based programs targeting behavior change in minority populations, this trial will be conducted with 250 congregants across 14 churches (125 intervention; 125 control). Our proposed outcomes are (1) recognition of stroke symptoms and (2) behavioral intent to call 911 for suspected stroke, measured using the Stroke Action Test at the 6-month and 1-year follow-up. Discussion: This is the first randomized trial of a church-placed narrative intervention to improve stroke outcomes in urban Black and Hispanic populations. A film intervention has the potential to make a significant public health impact, as film is a highly scalable and disseminable medium. Since there is at least one church in almost every neighborhood in the USA, churches have the ability and reach to play an important role in the dissemination and translation of stroke prevention programs in minority communities.Teaching global health with simulations and case discussions in a medical student selective
AbstractBertelsen, N. S., DallaPiazza, M., Hopkins, M. A., & Ogedegbe, G. (n.d.).Publication year
2015Journal title
Globalization and HealthVolume
11Issue
1AbstractBackground: Among US medical schools, demand for Global Health (GH) programs continues to grow. At the same time, cultural competency training has become a priority for medical students who will care for an increasingly diverse US patient population. We describe a pilot period for a new GH Selective designed to introduce medical students to global medicine and enhance culturally-sensitive communication skills. Methods: As a 4-week clinical clerkship, the GH Selective was offered annually over a three-year period to a total of 33 students. Activities included clinical assignments, cultural competency and clinical skills simulations, patient case discussions in tropical medicine, journal clubs, and lectures. Faculty assessments of student performance and student evaluations of course content were focused on 6 course objectives, adapted from standardized GH objectives. Results: For each offering of the GH Selective, at least 40 faculty members and fellows volunteered over 200 teaching hours from 11 medical school departments. Student feedback was consistently positive through competency-based curricular evaluations. As a result of its successes, the course is now offered on a biannual basis. Discussion: Experiential, student-centered teaching employed in this course proved successful as an introduction to delivery of evidence-based and culturally sensitive GH. Special emphasis on working with standardized patients in interdisciplinary and cross-cultural simulations provided students with clinical skills applicable for care provided both locally and on international rotations. Conclusion: With a special emphasis on cross-cultural sensitivity, this pilot elective trained future practitioners in fund of knowledge, clinical skills, and service delivery methods in GH.The association of physical activity, body mass index and the blood pressure levels among urban poor youth in Accra, Ghana
AbstractAfrifa-Anane, E., Agyemang, C., Codjoe, S. N. A., Ogedegbe, G., & De-Graft Aikins, A. (n.d.).Publication year
2015Journal title
BMC public healthVolume
15Issue
1AbstractBackground: Globally, there is an increasing prevalence of high blood pressure (HBP) among adults and youth. However, the mechanisms of how the risk factors (physical inactivity and obesity) relate with blood pressure (BP) are not well known especially among the urban poor youth in low and middle income countries. Meanwhile childhood and adolescent physical inactivity and obesity, particularly in conditions of poverty, predispose individuals to cardiovascular diseases (CVDs) in later life. The aim of this study was to assess the BP levels and to examine its associations with physical activity (PA) and body mass index (BMI) amongst urban poor youth in Accra, Ghana. Methods: We studied 201 youth aged 15-24 years in three urban poor communities in Accra, Ghana. Height, weight and BP were measured in all subjects. PA levels were assessed using the Edulink Urban Health and Poverty project questionnaire. Multiple linear regression analysis was used to determine the factors influencing BP levels. Results: The proportion of pre-hypertension and hypertension among the youth was 32.3% and 4%, respectively. The rates of pre-hypertension (42.0 vs. 24.8) and hypertension (6.8 vs. 1.8) were higher in males than in females. More than three-quarters (84.1%) of the youth were not physically active. Females were more physically inactive compared to the males (94.7% vs. 70.5%). The average BMI was 22.8 kg/m2. For overweight (17.7 vs. 6.8) and obesity (13.3 vs. 2.3), females had higher rates than males. BMI was positively related to systolic BP, and significantly associated with systolic BP (β∈=∈1.4, p∈<∈0.000 and β∈=∈0.8, p∈<∈0.000; respectively for male and female youth) compared to diastolic BP. Youth with low PA had raised BP. Conclusion: The positive association of BMI and BP in the study communities suggests the need for health measures to tackle their increase and related public health consequences. Further studies on BP and other risk factors among the youth of rural populations and other developing countries will be important to stall the rising prevalence and implications for adult morbidity and mortality.The FAITH trial: Baseline characteristics of a church-based trial to improve blood pressure control in blacks
AbstractSchoenthaler, A., Lancaster, K., Midberry, S., Nulty, M., Ige, E., Palfrey, A., Kumar, N., & Ogedegbe, G. (n.d.).Publication year
2015Journal title
Ethnicity and DiseaseVolume
25Issue
3Page(s)
337-344AbstractObjective: To describe the baseline characteristics of participants in the Faith-based Approaches in the Treatment of Hypertension (FAITH) Trial. Design: FAITH evaluates the effectiveness of a faith-based lifestyle intervention vs health education control on blood pressure (BP) reduction among hypertensive Black adults. Setting, Participants, and Main Measures: Participants included 373 members of 32 Black churches in New York City. Baseline data collected included participant demographic characteristics, clinical measures (eg, blood pressure), behaviors (eg, diet, physical activity), and psychosocial factors (eg, self-efficacy, depressive symptoms). Results: Participants had a mean age of 63.4 ± 11.9 years and 76% were female. About half completed at least some college (53%), 66% had an income =$20,000, and 42.2% were retired or on disability. Participants had a mean systolic and diastolic BP of 152.1 ± 16.8 mm Hg and 86.2 ± 12.2 mm Hg, respectively, and a mean BMI of 32 kg/m2. Hypertension (HTN) medications were taken by 95% of participants, but most (79.1%) reported non-adherence to their regimen. Participants reported consuming 3.4 ± 2.6 servings of fruits and vegetables and received 30.9% of their energy from fat. About one-third (35.9%) reported a low activity level. Conclusion: Participants in the FAITH trial exhibited several adverse clinical and behavioral characteristics at baseline. Future analyses will evaluate the effectiveness of the faith-based lifestyle intervention on changes in BP and lifestyle behaviors among hypertensive Black adults.