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
Telephone-delivered behavioral intervention among blacks with sleep apnea and metabolic syndrome: Study protocol for a randomized controlled trial
AbstractWilliams, N. J., Jean-Louis, G., Brown, C. D., McFarlane, S. I., Boutin-Foster, C., & Ogedegbe, G. (n.d.).Publication year
2014Journal title
TrialsVolume
15Issue
1AbstractBackground: Lack of adherence to recommended treatment for obstructive sleep apnea remains an ongoing public health challenge. Despite evidence that continuous positive airway pressure (CPAP) is effective and improves overall quality of life, adherence with the use of CPAP in certain racial/ethnic groups, especially blacks, is suboptimal. Evidence indicates that the incidence and prevalence of obstructive sleep apnea are higher among blacks, relative to whites, and blacks are less likely to adhere to recommended treatment compared with other racial/ethnic groups.Methods: Using a two-arm randomized controlled design, this study will evaluate the effectiveness of a culturally and linguistically tailored telephone-delivered intervention to promote adherence to physician-recommended sleep apnea assessment and treatment among blacks with metabolic syndrome, versus an attention-control arm. The intervention is designed to foster adherence to recommended sleep apnea care using the stages-of-change model. The intervention will be delivered entirely over the telephone. Participants in the intervention arm will receive 10 phone calls to address challenges and barriers to recommended care. Outcomes will be assessed at baseline, and at 6- and 12-months post-randomization.Discussion: This tailored behavioral intervention will improve adherence to sleep apnea assessment and treatment among blacks with metabolic syndrome. We expect to demonstrate that this intervention modality is feasible in terms of time and cost and can be replicated in populations with similar racial/ethnic backgrounds.Trial registration: The study is registered at clinicaltrials.gov NCT01946659 (February 2013).Unconscious bias and real-world hypertension outcomes: Advancing disparities research
Ravenell, J., & Ogedegbe, G. (n.d.).Publication year
2014Journal title
Journal of general internal medicineVolume
29Issue
7Page(s)
973-975A novel community-based study to address disparities in hypertension and colorectal cancer: A study protocol for a randomized control trial
AbstractRavenell, J., Thompson, H., Cole, H., Plumhoff, J., Cobb, G., Afolabi, L., Boutin-Foster, C., Wells, M., Scott, M., & Ogedegbe, G. (n.d.).Publication year
2013Journal title
TrialsVolume
14Issue
1AbstractBackground: Black men have the greatest burden of premature death and disability from hypertension (HTN) in the United States, and the highest incidence and mortality from colorectal cancer (CRC). While several clinical trials have reported beneficial effects of lifestyle changes on blood pressure (BP) reduction, and improved CRC screening with patient navigation (PN), the effectiveness of these approaches in community-based settings remains understudied, particularly among Black men.Methods/design: MISTER B is a two-parallel-arm randomized controlled trial that will compare the effect of a motivational interviewing tailored lifestyle intervention (MINT) versus a culturally targeted PN intervention on improvement of BP and CRC screening among black men aged ≥50 with uncontrolled HTN who are eligible for CRC screening. Approximately 480 self-identified black men will be randomly assigned to one of the two study conditions. This innovative research design allows each intervention to serve as the control for the other. Specifically, the MINT arm is the control condition for the PN arm, and vice-versa. This novel, simultaneous testing of two community-based interventions in a randomized fashion is an economical and yet rigorous strategy that also enhances the acceptability of the project. Participants will be recruited during scheduled screening events at barbershops in New York City. Trained research assistants will conduct the lifestyle intervention, while trained community health workers will deliver the PN intervention. The primary outcomes will be 1) within-patient change in systolic and diastolic BP from baseline to six months and 2) CRC screening rates at six months.Discussion: This innovative study will provide a unique opportunity to test two interventions for two health disparities simultaneously in community-based settings. Our study is one of the first to test culturally targeted patient navigation for CRC screening among black men in barbershops. Thus, our study has the potential to improve the reach of hypertension control and cancer prevention efforts within a high-risk population that is under-represented in primary care settings.Trial registration: ClinicalTrials.gov, NCT01092078.Are there consequences of labeling patients with prehypertension? An experimental study of effects on blood pressure and quality of life
AbstractSpruill, T. M., Feltheimer, S. D., Harlapur, M., Schwartz, J. E., Ogedegbe, G., Park, Y., & Gerin, W. (n.d.).Publication year
2013Journal title
Journal of Psychosomatic ResearchVolume
74Issue
5Page(s)
433-438AbstractObjective: The prehypertension classification was introduced to facilitate prevention efforts among patients at increased risk for hypertension. Although patients who have been told that they have hypertension report worse outcomes than unaware hypertensives, little is known about whether or not prehypertension labeling has negative effects. We evaluated the effects of labeling individuals with prehypertension on blood pressure and health-related quality of life three months later. Methods: One hundred adults (aged 19 to 82 [mean=40.0] years; 54% women; 64% racial/ethnic minorities) with screening blood pressure in the prehypertensive range (120-139/80-89. mm. Hg) and no history of diagnosis or treatment of elevated blood pressure were randomly assigned to either a "Labeled" group in which they were informed of their prehypertension, or an "Unlabeled" group in which they were not informed. Subjects underwent office blood pressure measurement, 24-hour ambulatory blood pressure monitoring and completed self-report questionnaires at baseline and at three months. Results: Multilevel mixed effects regression analyses indicated that changes in the white coat effect, office blood pressure, mean daytime ambulatory blood pressure, and physical and mental health did not differ significantly between the two groups. Adjusting for age, sex, race/ethnicity and body mass index did not affect the results. Conclusion: These findings suggest that labeling patients with prehypertension does not have negative effects on blood pressure or quality of life. Additional research is needed to develop approaches to communicating with patients about their blood pressure that will maximize the clinical and public health impact of the prehypertension classification.Association of racial disparities in the prevalence of insulin resistance with racial disparities in vitamin D levels: National Health and Nutrition Examination Survey (2001-2006)
AbstractWilliams, S. K., Fiscella, K., Winters, P., Martins, D., & Ogedegbe, G. (n.d.).Publication year
2013Journal title
Nutrition ResearchVolume
33Issue
4Page(s)
266-271AbstractWe tested the hypothesis that racial differences in vitamin D levels are associated with racial disparities in insulin resistance between blacks and whites. Among 3628 non-Hispanic black and white adults in the National Health and Nutrition Examination Survey from 2001 to 2006, we examined the association between race and insulin resistance using the homeostasis assessment model for insulin resistance. We conducted analyses with and without serum 25-hydroxyvitamin D (25[OH]D). We adjusted for age, sex, educational level, body mass index, waist circumference, physical activity, alcohol intake, smoking, estimated glomerular filtration rate, and urinary albumin/creatinine ratio. Blacks had a lower mean serum 25(OH)D level compared with whites (14.6 [0.3] ng/mL vs 25.6 [0.4] ng/mL, respectively; P < .0001). Blacks had a higher odds ratio (OR) for insulin resistance without controlling for serum 25(OH)D levels (OR, 1.67; 95% confidence interval, 1.26-2.20). The association was not significant (OR, 1.28; 95% confidence interval, 0.90-1.82) after accounting for serum 25(OH)D levels. The higher burden of insulin resistance in blacks compared with whites may be partially mediated by the disparity in serum 25(OH)D levels.Beyond medications and diet: Alternative approaches to lowering blood pressure: A scientific statement from the american heart association
AbstractBrook, R. D., Appel, L. J., Rubenfire, M., Ogedegbe, G., Bisognano, J. D., Elliott, W. J., Fuchs, F. D., Hughes, J. W., Lackland, D. T., Staffileno, B. A., Townsend, R. R., & Rajagopalan, S. (n.d.).Publication year
2013Journal title
HypertensionVolume
61Issue
6Page(s)
1360-1383AbstractMany antihypertensive medications and lifestyle changes are proven to reduce blood pressure. Over the past few decades, numerous additional modalities have been evaluated in regard to their potential blood pressure-lowering abilities. However, these nondietary, nondrug treatments, collectively called alternative approaches, have generally undergone fewer and less rigorous trials. This American Heart Association scientific statement aims to summarize the blood pressure-lowering efficacy of several alternative approaches and to provide a class of recommendation for their implementation in clinical practice based on the available level of evidence from the published literature. Among behavioral therapies, Transcendental Meditation (Class IIB, Level of Evidence B), other meditation techniques (Class III, Level of Evidence C), yoga (Class III, Level of Evidence C), other relaxation therapies (Class III, Level of Evidence B), and biofeedback approaches (Class IIB, Level of Evidence B) generally had modest, mixed, or no consistent evidence demonstrating their efficacy. Between the noninvasive procedures and devices evaluated, device-guided breathing (Class IIA, Level of Evidence B) had greater support than acupuncture (Class III, Level of Evidence B). Exercise-based regimens, including aerobic (Class I, Level of Evidence A), dynamic resistance (Class IIA, Level of Evidence B), and isometric handgrip (Class IIB, Level of Evidence C) modalities, had relatively stronger supporting evidence. It is the consensus of the writing group that it is reasonable for all individuals with blood pressure levels >120/80 mm Hg to consider trials of alternative approaches as adjuvant methods to help lower blood pressure when clinically appropriate. A suggested management algorithm is provided, along with recommendations for prioritizing the use of the individual approaches in clinical practice based on their level of evidence for blood pressure lowering, risk-to-benefit ratio, potential ancillary health benefits, and practicality in a real-world setting. Finally, recommendations for future research priorities are outlined.Calorie labeling, Fast food purchasing and restaurant visits
AbstractElbel, B., Mijanovich, T., Dixon, L. B., Abrams, C., Weitzman, B., Kersh, R., Auchincloss, A. H., & Ogedegbe, G. (n.d.).Publication year
2013Journal title
ObesityVolume
21Issue
11Page(s)
2172-2179AbstractObjective Obesity is a pressing public health problem without proven population-wide solutions. Researchers sought to determine whether a city-mandated policy requiring calorie labeling at fast food restaurants was associated with consumer awareness of labels, calories purchased and fast food restaurant visits. Design and Methods Difference-in-differences design, with data collected from consumers outside fast food restaurants and via a random digit dial telephone survey, before (December 2009) and after (June 2010) labeling in Philadelphia (which implemented mandatory labeling) and Baltimore (matched comparison city). Measures included: self-reported use of calorie information, calories purchased determined via fast food receipts, and self-reported weekly fast-food visits. Results The consumer sample was predominantly Black (71%), and high school educated (62%). Postlabeling, 38% of Philadelphia consumers noticed the calorie labels for a 33% point (P < 0.001) increase relative to Baltimore. Calories purchased and number of fast food visits did not change in either city over time. Conclusions While some consumers report noticing and using calorie information, no population level changes were noted in calories purchased or fast food visits. Other controlled studies are needed to examine the longer term impact of labeling as it becomes national law.Comparative effectiveness of congregation- versus clinic-based approach to prevention of mother-to-child HIV transmission: Study protocol for a cluster randomized controlled trial
AbstractEzeanolue, E. E., Obiefune, M. C., Yang, W., Obaro, S. K., Ezeanolue, C. O., & Ogedegbe, G. G. (n.d.).Publication year
2013Journal title
Implementation ScienceVolume
8Issue
1AbstractBackground: A total of 22 priority countries have been identified by the WHO that account for 90% of pregnant women living with HIV. Nigeria is one of only 4 countries among the 22 with an HIV testing rate for pregnant women of less than 20%. Currently, most pregnant women must access a healthcare facility (HF) to be screened and receive available prevention of mother-to-child HIV transmission (PMTCT) interventions. Finding new approaches to increase HIV testing among pregnant women is necessary to realize the WHO/ President's Emergency Plan for AIDS Relief (PEPFAR) goal of eliminating new pediatric infections by 2015.Methods: This cluster randomized trial tests the comparative effectiveness of a congregation-based Healthy Beginning Initiative (HBI) versus a clinic-based approach on the rates of HIV testing and PMTCT completion among a cohort of church attending pregnant women. Recruitment occurs at the level of the churches and participants (in that order), while randomization occurs only at the church level. The trial is unblinded, and the churches are informed of their randomization group. Eligible participants, pregnant women attending study churches, are recruited during prayer sessions. HBI is delivered by trained community health nurses and church-based health advisors and provides free, integrated on-site laboratory tests (HIV plus hemoglobin, malaria, hepatitis B, sickle cell gene, syphilis) during a church-organized 'baby shower.' The baby shower includes refreshments, gifts exchange, and an educational game show testing participants' knowledge of healthy pregnancy habits in addition to HIV acquisition modes, and effective PMTCT interventions. Baby receptions provide a contact point for follow-up after delivery. This approach was designed to reduce barriers to screening including knowledge, access, cost and stigma. The primary aim is to evaluate the effect of HBI on the HIV testing rate among pregnant women. The secondary aims are to evaluate the effect of HBI on the rate of HIV testing among male partners of pregnant women and the rate of PMTCT completion among HIV-infected pregnant women.Discussion: Results of this study will provide further understanding of the most effective strategies for increasing HIV testing among pregnant women in hard-to-reach communities.Trial Registration: Clinicaltrials.gov, NCT01795261.Correlates of isolated nocturnal hypertension and target organ damage in a population-based cohort of african americans: The jackson heart study
AbstractOgedegbe, G., Spruill, T. M., Sarpong, D. F., Agyemang, C., Chaplin, W., Pastva, A., Martins, D., Ravenell, J., & Pickering, T. G. (n.d.).Publication year
2013Journal title
American Journal of HypertensionVolume
26Issue
8Page(s)
1011-1016Abstractbackground African Americans have higher rates of nocturnal hypertension and less nocturnal blood pressure (BP) dipping compared with whites. Although nocturnal hypertension is associated with increased cardiovascular morbidity and mortality, its clinical significance among those with normal daytime BP is unclear. This paper reports the prevalence and correlates of isolated nocturnal hypertension (INH) in a population-based cohort of African Americans enrolled in the Jackson Heart Study (JHS). methods The study sample included 425 untreated, normotensive and hypertensive JHS participants who underwent 24-hour ambulatory BP monitoring (ABPM), echocardiography, and 24-hour urine collection. Multiple logistic regression and 1-way analysis of variance models were used to test the hypothesis that those with INH have worse target organ damage reflected by greater left ventricular (LV) mass and proteinuria compared with normotensive participants. results Based on 24-hour ABP profiles, 19.1% of participants had INH. In age and sex-adjusted models, participants with INH had greater LV mass compared with those who were normotensive (P = 0.02), as well as about 3 times the odds of LV hypertrophy and proteinuria (Ps > 0.10). However, multivariable adjustment reduced the magnitude and statistical significance of each of these differences. conclusions INH was associated with increased LV mass compared with normotension in a population-based cohort of African Americans enrolled in the JHS. There were trends toward a greater likelihood of LV hypertrophy and proteinuria among participants with INH vs. those who were normotensive. The clinical significance of the noted target organ damage should be explored in this population.European society of hypertension position paper on ambulatory blood pressure monitoring
AbstractO’Brien, E., Parati, G., Stergiou, G., Asmar, R., Beilin, L., Bilo, G., Clement, D., De La Sierra, A., De Leeuw, P., Dolan, E., Fagard, R., Graves, J., Head, G. A., Imai, Y., Kario, K., Lurbe, E., Mallion, J. M., Mancia, G., Mengden, T., … Zhang, Y. (n.d.).Publication year
2013Journal title
Journal of HypertensionVolume
31Issue
9Page(s)
1731-1768AbstractAmbulatory blood pressure monitoring (ABPM) is being used increasingly in both clinical practice and hypertension research. Although there are many guidelines that emphasize the indications for ABPM, there is no comprehensive guideline dealing with all aspects of the technique. It was agreed at a consensus meeting on ABPM in Milan in 2011 that the 34 attendees should prepare a comprehensive position paper on the scientific evidence for ABPM. This position paper considers the historical background, the advantages and limitations of ABPM, the threshold levels for practice, and the cost-effectiveness of the technique. It examines the need for selecting an appropriate device, the accuracy of devices, the additional information and indices that ABPM devices may provide, and the software requirements. At a practical level, the paper details the requirements for using ABPM in clinical practice, editing considerations, the number of measurements required, and the circumstances, such as obesity and arrhythmias, when particular care needs to be taken when using ABPM. The clinical indications for ABPM, among which white-coat phenomena, masked hypertension, and nocturnal hypertension appear to be prominent, are outlined in detail along with special considerations that apply in certain clinical circumstances, such as childhood, the elderly and pregnancy, and in cardiovascular illness, examples being stroke and chronic renal disease, and the place of home measurement of blood pressure in relation to ABPM is appraised. The role of ABPM in research circumstances, such as pharmacological trials and in the prediction of outcome in epidemiological studies is examined and finally the implementation of ABPM in practice is considered in relation to the issue of reimbursement in different countries, the provision of the technique by primary care practices, hospital clinics and pharmacies, and the growing role of registries of ABPM in many countries.Excessive daytime sleepiness among hypertensive US-born blacks and foreign-born blacks: Analysis of the CAATCH data
AbstractWilliams, N., Abo Al Haija, O., Workneh, A., Sarpong, D., Keku, E., Ogedegbe, G., McFarlane, S. I., & Jean-Louis, G. (n.d.).Publication year
2013Journal title
International Journal of HypertensionVolume
2013AbstractBackground. Evidence shows that blacks exhibit greater daytime sleepiness compared with whites, based on the Epworth Sleepiness Scale. In addition, sleep complaints might differ based on individuals' country of origin. However, it is not clear whether individuals' country of origin has any influence on excessive daytime sleepiness (EDS). Study Objectives. We tested the hypothesis that US-born blacks would show a greater level of EDS compared with foreign-born blacks. The potential effects of sociodemographic and medical risk were also determined. Design. We used the Counseling African-Americans to Control Hypertension (CAATCH) data. CAATCH is a group randomized clinical trial that was conducted among 30 community healthcare centers in New York, yielding baseline data for 1,058 hypertensive black patients. Results. Results of univariate logistic regression analysis indicated that US-born blacks were nearly twice as likely as their foreign-born black counterparts to exhibit EDS (OR = 1.87, 95% CI: 1.30-2.68, P < 0.001). After adjusting for effects of age, sex, education, employment, body mass index, alcohol consumption, and smoking habit, US-born blacks were 69% more likely than their counterparts to exhibit EDS (OR = 1.69, 95% CI: 1.11-2.57, P < 0.01). Conclusion. Findings demonstrate the importance of considering individuals' country of origin, in addition to their race and ethnicity, when analyzing epidemiologic sleep data.Heart failure-associated hospitalizations in the United States
AbstractBlecker, S., Paul, M., Taksler, G., Ogedegbe, G., & Katz, S. (n.d.).Publication year
2013Journal title
Journal of the American College of CardiologyVolume
61Issue
12Page(s)
1259-1267AbstractObjectives: This study sought to characterize temporal trends in hospitalizations with heart failure as a primary or secondary diagnosis. Background: Heart failure patients are frequently admitted for both heart failure and other causes. Methods: Using the Nationwide Inpatient Sample (NIS), we evaluated trends in heart failure hospitalizations between 2001 and 2009. Hospitalizations were categorized as either primary or secondary heart failure hospitalizations based on the location of heart failure in the discharge diagnosis. National estimates were calculated using the sampling weights of the NIS. Age- and sex-standardized hospitalization rates were determined by dividing the number of hospitalizations by the U.S. population in a given year and using direct standardization. Results: The number of primary heart failure hospitalizations in the United States decreased from 1,137,944 in 2001 to 1,086,685 in 2009, whereas secondary heart failure hospitalizations increased from 2,753,793 to 3,158,179 over the same period. Age- and sex-adjusted rates of primary heart failure hospitalizations decreased steadily from 2001 to 2009, from 566 to 468 per 100,000 people. Rates of secondary heart failure hospitalizations initially increased from 1,370 to 1,476 per 100,000 people from 2001 to 2006, then decreased to 1,359 per 100,000 people in 2009. Common primary diagnoses for secondary heart failure hospitalizations included pulmonary disease, renal failure, and infections. Conclusions Although primary heart failure hospitalizations declined, rates of hospitalizations with a secondary diagnosis of heart failure were stable in the past decade. Strategies to reduce the high burden of hospitalizations of heart failure patients should include consideration of both cardiac disease and noncardiac conditions.Linking sleep to hypertension: Greater risk for blacks
AbstractPandey, A., Williams, N., Donat, M., Ceide, M., Brimah, P., Ogedegbe, G., McFarlane, S. I., & Jean-Louis, G. (n.d.).Publication year
2013Journal title
International Journal of HypertensionVolume
2013AbstractBackground. Evidence suggests that insufficient sleep duration is associated with an increased likelihood for hypertension. Both short (<6 hours) and long (>8 hour) sleep durations as well as hypertension are more prevalent among blacks than among whites. This study examined associations between sleep duration and hypertension, considering differential effects of race and ethnicity among black and white Americans. Methods. Data came from a cross-sectional household interview with 25,352 Americans (age range: 18-85 years). Results. Both white and black short sleepers had a greater likelihood of reporting hypertension than those who reported sleeping 6 to 8 hours. Unadjusted logistic regression analysis exploring the race/ethnicity interactions between insufficient sleep and hypertension indicated that black short (<6 hours) and long (>8 hours) sleepers were more likely to report hypertension than their white counterparts (OR = 1.34 and 1.37, resp.; P < 0.01). Significant interactions of insufficient sleep with race/ethnicity were observed even after adjusting to effects of age, sex, income, education, body mass index, alcohol use, smoking, emotional distress, diabetes, coronary heart disease, and stroke. Conclusion. Results suggest that the race/ethnicity interaction is a significant mediator in the relationship between insufficient sleep and likelihood of having a diagnosis of hypertension.Obstructive sleep apnea and cardiovascular disease in blacks: A call to action from the association of black cardiologists
AbstractOlafiranye, O., Akinboboye, O., Mitchell, J. E., Ogedegbe, G., & Jean-Louis, G. (n.d.).Publication year
2013Journal title
American Heart JournalVolume
165Issue
4Page(s)
468-476AbstractObstructive sleep apnea (OSA) has emerged as a new and important risk factor for cardiovascular disease (CVD). Over the last decade, epidemiologic and clinical research has consistently supported the association of OSA with increased cardiovascular (CV) morbidity and mortality. Such evidence prompted the American Heart Association to issue a scientific statement describing the need to recognize OSA as an important target for therapy in reducing CV risk. Emerging facts suggest that marked racial differences exist in the association of OSA with CVD. Although both conditions are more prevalent in blacks, almost all National Institutes of Health-funded research projects evaluating the relationship between OSA and CV risk have been conducted in predominantly white populations. There is an urgent need for research studies investigating the CV impact of OSA among high-risk minorities, especially blacks. This article first examines the evidence supporting the association between OSA and CVD and reviews the influence of ethnic/racial differences on this association. Public health implications of OSA and future directions, especially regarding minority populations, are discussed.Racial and ethnic disparities in disease activity in patients with rheumatoid arthritis
AbstractGreenberg, J. D., Spruill, T. M., Shan, Y., Reed, G., Kremer, J. M., Potter, J., Yazici, Y., Ogedegbe, G., & Harrold, L. R. (n.d.).Publication year
2013Journal title
American Journal of MedicineVolume
126Issue
12Page(s)
1089-1098AbstractBackground Observational studies of patients with rheumatoid arthritis have suggested that racial and ethnic disparities exist for minority populations. We compared disease activity and clinical outcomes across racial and ethnic groups using data from a large, contemporary US registry. Methods We analyzed data from 2 time periods (2005-2007 and 2010-2012). The Clinical Disease Activity Index was examined as both a continuous measure and a dichotomous measure of disease activity states. Outcomes were compared in a series of cross-sectional and longitudinal multivariable regression models. Results For 2005-2007, significant differences of mean disease activity level (P <.001) were observed across racial and ethnic groups. Over the 5-year period, modest improvements in disease activity were observed across all groups, including whites (3.7; 95% confidence interval [CI], 3.2-4.1) compared with African Americans (4.3; 95% CI, 2.7-5.8) and Hispanics (2.7; 95% CI, 1.2-4.3). For 2010-2012, significant differences of mean disease activity level persisted (P <.046) across racial and ethnic groups, ranging from 11.6 (95% CI, 10.4-12.8) in Hispanics to 10.7 (95% CI, 9.6-11.7) in whites. Remission rates remained significantly different across racial/ethnic groups across all models for 2010-2012, ranging from 22.7 (95% CI, 19.5-25.8) in African Americans to 27.4 (95% CI, 24.9-29.8) in whites. Conclusions Despite improvements in disease activity across racial and ethnic groups over a 5-year period, disparities persist in disease activity and clinical outcomes for minority groups versus white patients.Role of bariatric surgery as treatment for type 2 diabetes in patients who do not meet current NIH Criteria: A systematic review and meta-analysis
Parikh, M., Issa, R., Vieira, D., McMacken, M., Saunders, J. K., Ude-Welcome, A., Schubart, U., Ogedegbe, G., & Pachter, H. L. (n.d.).Publication year
2013Journal title
Journal of the American College of SurgeonsVolume
217Issue
3Page(s)
527-532The Counseling Older Adults to Control Hypertension (COACH) trial: Design and methodology of a group-based lifestyle intervention for hypertensive minority older adults
AbstractOgedegbe, G., Fernandez, S., Fournier, L., Silver, S. A., Kong, J., Gallagher, S., De La Calle, F., Plumhoff, J., Sethi, S., Choudhury, E., & Teresi, J. A. (n.d.).Publication year
2013Journal title
Contemporary Clinical TrialsVolume
35Issue
1Page(s)
70-79AbstractThe disproportionately high prevalence of hypertension and its associated mortality and morbidity in minority older adults is a major public health concern in the United States. Despite compelling evidence supporting the beneficial effects of therapeutic lifestyle changes on blood pressure reduction, these approaches remain largely untested among minority elders in community-based settings. The Counseling Older Adults to Control Hypertension trial is a two-arm randomized controlled trial of 250 African-American and Latino seniors, 60. years and older with uncontrolled hypertension, who attend senior centers. The goal of the trial is to evaluate the effect of a therapeutic lifestyle intervention delivered via group classes and individual motivational interviewing sessions versus health education, on blood pressure reduction. The primary outcome is change in systolic and diastolic blood pressure from baseline to 12. months. The secondary outcomes are blood pressure control at 12. months; changes in levels of physical activity; body mass index; and number of daily servings of fruits and vegetables from baseline to 12. months. The intervention group will receive 12 weekly group classes followed by individual motivational interviewing sessions. The health education group will receive an individual counseling session on healthy lifestyle changes and standard hypertension education materials. Findings from this study will provide needed information on the effectiveness of lifestyle interventions delivered in senior centers. Such information is crucial in order to develop implementation strategies for translation of evidence-based lifestyle interventions to senior centers, where many minority elders spend their time, making the centers a salient point of dissemination.The Nigerian antihypertensive adherence trial: A community-based randomized trial
AbstractAdeyemo, A., Tayo, B. O., Luke, A., Ogedegbe, O., Durazo-Arvizu, R., & Cooper, R. S. (n.d.).Publication year
2013Journal title
Journal of HypertensionVolume
31Issue
1Page(s)
201-207AbstractBackground: Research in industrialized countries has demonstrated that a key factor limiting the control of hypertension is poor patient adherence and that the most successful interventions for long-term adherence employ multiple strategies. Very little data exist on this question in low-income countries, wherein medication-taking behavior may be less well developed. Method: We conducted a treatment adherence trial of 544 patients [mean age ∼63 years, mean blood pressure (BP) ∼168/92 mmHg] with previously untreated hypertension in urban and rural Nigeria. Eligible participants were randomized to one of two arms: clinic management only, or clinic management and home visits. Both interventions included three elements: a community based, nurse-led treatment program with physician backup; facilitation of clinic visits and health education; and the use of diuretics and a β blocker as needed. After initial diagnosis, the management protocol was implemented by a nurse with physician backup. Participants were evaluated monthly for 6 months. Results: Medication adherence was assessed with pill count and urine testing. Drop-out rates, by treatment group, ranged from 12 to 28%. Among participants who completed the 6-month trial, overall adherence was high (∼77% of participants took >98% of prescribed pills). Adherence did not differ by treatment arm, but was better at the rural than the urban site and among those with higher baseline BP. Hypertension control (BP <140/90 mmHg) was achieved in approximately 66% of participants at 6 months. Conclusion: This community-based intervention confirms relatively modest default rates compared with industrialized societies, and suggests that medication adherence can be high in developing world settings in clinic attenders.The Trial Using Motivational Interviewing and Positive Affect and Self-Affirmation in African-Americans with Hypertension (TRIUMPH): From theory to clinical trial implementation
AbstractBoutin-Foster, C., Scott, E., Rodriguez, A., Ramos, R., Kanna, B., Michelen, W., Charlson, M., & Ogedegbe, G. (n.d.).Publication year
2013Journal title
Contemporary Clinical TrialsVolume
35Issue
1Page(s)
8-14AbstractThis paper describes the application of a translational research model in developing The Trial Using Motivational Interviewing and Positive Affect and Self-Affirmation in African-Americans with Hypertension (TRIUMPH), a theoretically-based, randomized controlled trial. TRIUMPH targets blood pressure control among African-Americans with hypertension in a community health center and public hospital setting. TRIUMPH applies positive affect, self-affirmation, and motivational interviewing as strategies to increase medication adherence and blood pressure control. A total of 220 participants were recruited in TRIUMPH and are currently being followed. This paper provides a detailed description of the theoretical framework and study design of TRIUMPH and concludes with a critical reflection of the lessons learned in the process of implementing a health behavior intervention in a community-based setting. TRIUMPH provides a model for incorporating the translational science research paradigm to conducting pragmatic behavioral trials in a real-world setting in a vulnerable population. Lessons learned through interactions with our community partners reinforce the value of community engagement in research.Translating basic behavioral and social science research to clinical application: the EVOLVE mixed methods approach
AbstractPeterson, J. C., Czajkowski, S., Charlson, M. E., Link, A. R., Wells, M. T., Isen, A. M., Mancuso, C. A., Allegrante, J. P., Boutin-Foster, C., Ogedegbe, G., & Jobe, J. B. (n.d.).Publication year
2013Journal title
Journal of consulting and clinical psychologyVolume
81Issue
2Page(s)
217-230AbstractOBJECTIVE: To describe a mixed-methods approach to develop and test a basic behavioral science-informed intervention to motivate behavior change in 3 high-risk clinical populations. Our theoretically derived intervention comprised a combination of positive affect and self-affirmation (PA/SA), which we applied to 3 clinical chronic disease populations.METHOD: We employed a sequential mixed methods model (EVOLVE) to design and test the PA/SA intervention in order to increase physical activity in people with coronary artery disease (post-percutaneous coronary intervention [PCI]) or asthma (ASM) and to improve medication adherence in African Americans with hypertension (HTN). In an initial qualitative phase, we explored participant values and beliefs. We next pilot tested and refined the intervention and then conducted 3 randomized controlled trials with parallel study design. Participants were randomized to combined PA/SA versus an informational control and were followed bimonthly for 12 months, assessing for health behaviors and interval medical events.RESULTS: Over 4.5 years, we enrolled 1,056 participants. Changes were sequentially made to the intervention during the qualitative and pilot phases. The 3 randomized controlled trials enrolled 242 participants who had undergone PCI, 258 with ASM, and 256 with HTN (n = 756). Overall, 45.1% of PA/SA participants versus 33.6% of informational control participants achieved successful behavior change (p = .001). In multivariate analysis, PA/SA intervention remained a significant predictor of achieving behavior change (p < .002, odds ratio = 1.66), 95% CI [1.22, 2.27], controlling for baseline negative affect, comorbidity, gender, race/ethnicity, medical events, smoking, and age.CONCLUSIONS: The EVOLVE method is a means by which basic behavioral science research can be translated into efficacious interventions for chronic disease populations.A randomized controlled trial of positive-affect intervention and medication adherence in hypertensive African Americans
AbstractOgedegbe, G. O., Boutin-Foster, C., Wells, M. T., Allegrante, J. P., Isen, A. M., Jobe, J. B., & Charlson, M. E. (n.d.).Publication year
2012Journal title
Archives of Internal MedicineVolume
172Issue
4Page(s)
322-326AbstractBackground: Poor adherence explains poor blood pressure (BP) control; however African Americans suffer worse hypertension-related outcomes. Methods: This randomized controlled trial evaluated whether a patient education intervention enhanced with positive-affect induction and self-affirmation (PA) was more effective than patient education (PE) alone in improving medication adherence and BP reduction among 256 hypertensive African Americans followed up in 2 primary care practices. Patients in both groups received a culturally tailored hypertension self-management workbook, a behavioral contract, and bimonthly telephone calls designed to help them overcome barriers to medication adherence. Also, patients in the PA group received small gifts and bi-monthly telephone calls to help them incorporate positive thoughts into their daily routine and foster self-affirmation. The main outcome measures were medication adherence (assessed with electronic pill monitors) and within-patient change in BP from baseline to 12 months. Results: The baseline characteristics were similar in both groups: the mean BP was 137/82 mm Hg; 36% of the patients had diabetes; 11% had stroke; and 3% had chronic kidney disease. Based on the intention-to-treat principle, medication adherence at 12 months was higher in the PA group than in the PE group (42% vs 36%, respectively; P =.049). The within-group reduction in systolic BP (2.14 mm Hg vs 2.18 mm Hg; P =.98) and diastolic BP (-1.59 mm Hg vs -0.78 mm Hg; P=.45) for the PA group and PE group, respectively, was not significant. Conclusions: A PE intervention enhanced with PA led to significantly higher medication adherence compared with PE alone in hypertensive African Americans. Future studies should assess the cost-effectiveness of integrating such interventions into primary care. Trial Registration: clinicaltrials.gov Identifier: NCT00227175A review of population-based studies on hypertension in Ghana.
AbstractAddo, J., Agyemang, C., Smeeth, L., De-Graft Aikins, A., Edusei, A. K., & Ogedegbe, O. (n.d.).Publication year
2012Journal title
Ghana medical journalVolume
46Issue
2Page(s)
4-11AbstractHypertension is becoming a common health problem worldwide with increasing life expectancy and increasing prevalence of risk factors. Epidemiological data on hypertension in Ghana is necessary to guide policy and develop effective interventions. A review of population-based studies on hypertension in Ghana was conducted by a search of the PUBMED database, supplemented by a manual search of bibliographies of the identified articles and through the Ghana Medical Journal. A single reviewer extracted data using standard data collection forms. Eleven studies published on hypertension with surveys conducted between 1973 and 2009 were identified. The prevalence of hypertension was higher in urban than rural areas in studies that covered both types of area and increased with increasing age (prevalence ranging from 19.3% in rural to 54.6% in urban areas). Factors associated with high blood pressure included increasing body mass index, increased salt consumption, family history of hypertension and excessive alcohol intake. The levels of hypertension detection, treatment and control were generally low (control rates ranged from 1.7% to 12.7%). An increased burden of hypertension should be expected in Ghana as life expectancy increases and with rapid urbanisation. Without adequate detection and control, this will translate into a higher incidence of stroke and other adverse health outcomes for which hypertension is an established risk factor. Prevention and control of hypertension in Ghana is thus imperative and any delays in instituting preventive measures would most likely pose a greater challenge on the already overburdened health system.Beliefs and attitudes toward obstructive sleep apnea evaluation and treatment among blacks
AbstractShaw, R., McKenzie, S., Taylor, T., Olafiranye, O., Boutin-Foster, C., Ogedegbe, G., & Jean-Louis, G. (n.d.).Publication year
2012Journal title
Journal of the National Medical AssociationVolume
104Issue
11Page(s)
510-519AbstractObjective: Although blacks are at higher risk for obstructive sleep apnea (OSA), they are not as likely as their white counterparts to receive OSA evaluation and treatment. This study assessed knowledge, beliefs, and attitudes towards OSA evaluation and treatment among blacks residing in Brooklyn, New York. Methods: Five focus groups involving 39 black men and women (aged ≥18 years) were conducted at State University of New York (SUNY) Downstate Medical Center in Brooklyn to ascertain barriers preventing or delaying OSA evaluation and treatment. Results: Misconceptions about sleep apnea were a common theme that emerged from participants' responses. Obstructive sleep apnea was often viewed as a type of insomnia, an age-related phenomenon, and as being caused by certain bedtime activities. The major theme that emerged about barriers to OSA evaluation was unfamiliarity with the study environment. Barriers were categorized as: problems sleeping in a strange and unfamiliar environment, unfamiliarity with the study protocol, and fear of being watched while sleeping. Barriers to continuous positive airway pressure (CPAP) treatment adoption were related to the confining nature of the device, discomfort of wearing a mask while they slept, and concerns about their partner's perceptions of treatment. Conclusion: Results of this study suggest potential avenues for interventions to increase adherence to recommended evaluation and treatment of OSA. Potential strategies include reducing misconceptions about OSA, increasing awareness of OSA in vulnerable communities, familiarizing patients and their partners with laboratory procedures used to diagnose and treat OSA. We propose that these strategies should be used to inform the development of culturally and linguistically tailored sleep apnea interventions to increase awareness of OSA among blacks who are at risk for OSA and associated comorbidities.Culture, ethnicity and chronic conditions: Reframing concepts and methods for research, interventions and policy in low- and middle-income countries
De-Graft Aikins, A., Pitchforth, E., Allotey, P., Ogedegbe, G., & Agyemang, C. (n.d.).Publication year
2012Journal title
Ethnicity and HealthVolume
17Issue
6Page(s)
551-561Does a preoperative medically supervised weight loss program improve bariatric surgery outcomes? A pilot randomized study
AbstractParikh, M., Dasari, M., McMacken, M., Ren, C., Fielding, G., & Ogedegbe, G. (n.d.).Publication year
2012Journal title
Surgical EndoscopyVolume
26Issue
3Page(s)
853-861AbstractBackground: Many insurance payors mandate that bariatric surgery candidates undergo a medically supervised weight management (MSWM) program as a prerequisite for surgery. However, there is little evidence to support this requirement. We evaluated in a randomized controlled trial the hypothesis that participation in a MSWM program does not predict outcomes after laparoscopic adjustable gastric banding (LAGB) in a publicly insured population. Methods: This pilot randomized trial was conducted in a large academic urban public hospital. Patients who met NIH consensus criteria for bariatric surgery and whose insurance did not require a mandatory 6-month MSWM program were randomized to a MSWM program with monthly visits over 6 months (individual or group) or usual care for 6 months and then followed for bariatric surgery outcomes postoperatively. Demographics, weight, and patient behavior scores, including patient adherence, eating behavior, patient activation, and physical activity, were collected at baseline and at 6 months (immediately preoperatively and postoperatively). Results: A total of 55 patients were enrolled in the study with complete follow-up on 23 patients. Participants randomized to a MSWM program attended an average of 2 sessions preoperatively. The majority of participants were female and non-Caucasian, mean age was 46 years, average income was less than $20,000/year, and most had Medicaid as their primary insurer, consistent with the demographics of the hospital's bariatric surgery program. Data analysis included both intention-to-treat and completers' analyses. No significant differences in weight loss and most patient behaviors were found between the two groups postoperatively, suggesting that participation in a MSWM program did not improve weight loss outcomes for LAGB. Participation in a MSWM program did appear to have a positive effect on physical activity postoperatively. Conclusion: MSWM does not appear to confer additional benefit as compared to the standard preoperative bariatric surgery protocol in terms of weight loss and most behavioral outcomes after LAGB in our patient population.