Olugbenga Ogedegbe
Olugbenga Ogedegbe
Scroll
Professor of Social and Behavioral Sciences
Professor for the Department of Population Health at NYU Grossman School of Medicine
-
Professional overview
-
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.
-
Education
-
MPH from Columbia University, 1999Residency, Montefiore Medical Center, Internal Medicine, 1998MD from Donetsk University, 1988
-
Areas of research and study
-
Access to HealthcareGlobal HealthHealth of Marginalized PopulationImplementation and Impact of Public Health RegulationsImplementation scienceStroke and Cardiovascular Disease
-
Publications
Publications
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.Early childhood family intervention and long-term obesity prevention among high-risk minority youth
AbstractBrotman, L. M., Dawson-McClure, S., Huang, K. Y., Theise, R., Kamboukos, D., Wang, J., Petkova, E., & Ogedegbe, G. (n.d.).Publication year
2012Journal title
PediatricsVolume
129Issue
3Page(s)
e621-e628AbstractOBJECTIVES: To test the hypothesis that family intervention to promote effective parenting in early childhood affects obesity in preadolescence. METHODS: Participants were 186 minority youth at risk for behavior problems who enrolled in long-term follow-up studies after random assignment to family intervention or control condition at age 4. Follow-up Study 1 included 40 girls at familial risk for behavior problems; Follow-up Study 2 included 146 boys and girls at risk for behavior problems based on teacher ratings. Family intervention aimed to promote effective parenting and prevent behavior problems during early childhood; it did not focus on physical health. BMI and health behaviors were measured an average of 5 years after intervention in Study 1 and 3 years after intervention in Study 2. RESULTS: Youth randomized to intervention had significantly lower BMI at follow-up relative to controls (Study 1 P = .05; Study 2 P = .006). Clinical impact is evidenced by lower rates of obesity (BMI ≥95th percentile) among intervention girls and boys relative to controls (Study 2: 24% vs 54%, P = .002). There were significant intervention-control group differences on physical and sedentary activity, blood pressure, and diet. CONCLUSIONS: Two long-term follow-up studies of randomized trials show that relative to controls, youth at risk for behavior problems who received family intervention at age 4 had lower BMI and improved health behaviors as they approached adolescence. Efforts to promote effective parenting and prevent behavior problems early in life may contribute to the reduction of obesity and health disparities.Enhancing adherence of antihypertensive regimens in hypertensive African-Americans: Current and future prospects
AbstractLewis, L. M., Ogedegbe, C., & Ogedegbe, G. (n.d.).Publication year
2012Journal title
Expert Review of Cardiovascular TherapyVolume
10Issue
11Page(s)
1375-1380AbstractPatient adherence to antihypertensive medication is an important strategy for blood pressure control in hypertensive patients. However, rates of antihypertensive medication adherence among hypertensive African-Americans are unacceptably low. This article examines the current understanding of patient, clinical, provider and healthcare system factors associated with medication adherence in hypertensive African-Americans. Studies demonstrated that patient and clinical factors, such as self-efficacy and depression, are consistently associated with medication adherence in hypertensive African-Americans patients. Provider communication shows promise as a correlate of medication adherence, but more research on provider and healthcare system factors are still needed. The authors recommend that interventions targeted at increasing medication adherence among hypertensive African-Americans focus on self-efficacy. It is also imperative that clinicians screen hypertensive patients for depression and treat, if necessary.Establishing and sustaining research partnerships in Africa: a case study of the UK-Africa Academic Partnership on Chronic Disease
AbstractDe-Graft Aikins, A., Arhinful, D. K., Pitchforth, E., Ogedegbe, G., Allotey, P., & Agyemang, C. (n.d.).Publication year
2012Journal title
Globalization and HealthVolume
8AbstractThis paper examines the challenges and opportunities in establishing and sustaining north-south research partnerships in Africa through a case study of the UK-Africa Academic Partnership on Chronic Disease. Established in 2006 with seed funding from the British Academy, the partnership aimed to bring together multidisciplinary chronic disease researchers based in the UK and Africa to collaborate on research, inform policymaking, train and support postgraduates and create a platform for research dissemination. We review the partnership's achievements and challenges, applying established criteria for developing successful partnerships. During the funded period we achieved major success in creating a platform for research dissemination through international meetings and publications. Other goals, such as engaging in collaborative research and training postgraduates, were not as successfully realised. Enabling factors included trust and respect between core working group members, a shared commitment to achieving partnership goals, and the collective ability to develop creative strategies to overcome funding challenges. Barriers included limited funding, administrative support, and framework for monitoring and evaluating some goals. Chronic disease research partnerships in low-income regions operate within health research, practice, funding and policy environments that prioritise infectious diseases and other pressing public health and developmental challenges. Their long-term sustainability will therefore depend on integrated funding systems that provide a crucial capacity building bridge. Beyond the specific challenges of chronic disease research, we identify social capital, measurable goals, administrative support, creativity and innovation and funding as five key ingredients that are essential for sustaining research partnerships.Explanatory models of hypertension among Nigerian patients at a University Teaching Hospital
AbstractTaylor, K. D., Adedokun, A., Awobusuyi, O., Adeniran, P., Onyia, E., & Ogedegbe, G. (n.d.).Publication year
2012Journal title
Ethnicity and HealthVolume
17Issue
6Page(s)
615-629AbstractObjective. To elicit the explanatory models (EM) of hypertension among patients in a hospital-based primary care practice in Nigeria. Design. Semi-structured in-depth individual interviews and focus groups were conducted with 62 hypertensive patients. Interviews and focus groups were audiotaped and transcribed verbatim. Data analysis was guided by phenomenology and content analysis using qualitative research software ATLAS.ti 5.0. Results. Patients expressed four categories of EM of hypertension: (1) perceptions of hypertension, (2) consequences, (3) effect on daily life, and (4) perception of treatment. Focus group discussions and individual interviews yielded a wide range of insights into the social and cultural factors influencing patients' beliefs and health behavior. Participants were aware of the risks of hypertension. There was disagreement between participants' own understanding of the serious nature of hypertension, the need for long-term treatment, and the desire to take long-term medication. Participants acknowledged the use of traditional medicine (e.g. teas and herbs) and healers. Different themes emerged for men versus women such that women often focused on family issues while men tended to discuss external stressors stemming from work as a cause of hypertension. Men were concerned with frequent urination, decreased libido, and erectile dysfunction. Conclusion. Knowledge gained will inform development of patient-centered treatment plans and targeted behavioral and educational interventions.Functional capacity is a better predictor of coronary heart disease than depression or abnormal sleep duration in Black and White Americans
AbstractOlafiranye, O., Jean-Louis, G., Antwi, M., Zizi, F., Shaw, R., Brimah, P., & Ogedegbe, G. (n.d.).Publication year
2012Journal title
Sleep MedicineVolume
13Issue
6Page(s)
728-731AbstractObjective: To assess whether functional capacity is a better predictor of coronary heart disease (CHD) than depression or abnormal sleep duration. Methods: Adult civilians in the USA (n= 29,818, mean age 48 ± 18. years, range 18-85. years) were recruited by a cross-sectional household interview survey using multistage area probability sampling. Data on chronic conditions, estimated habitual sleep duration, functional capacity, depressed moods, and sociodemographic characteristics were obtained. Results: Thirty-five percent of participants reported reduced functional capacity. The CHD rates among White and Black Americans were 5.2% and 4%, respectively. Individuals with CHD were more likely to report extreme sleep durations (short sleep [≤5. h] or long sleep [≥9. h]; odds ratio [OR] 1.65, 95% confidence interval [CI] 1.38-1.97; P< 0.0001), less likely to be functionally active (anchored by the ability to walk one-quarter of a mile without assistance [OR 6.27, 95% CI 5.64-6.98; P< 0.0001]) and more likely to be depressed (OR 1.78, 95% CI 1.60-1.99; P< 0.0001) than their counterparts. On multivariate regression analysis adjusting for sociodemographic factors and health characteristics, only functional capacity remained an independent predictor of CHD (OR 1.81, 95% CI 1.42-2.31; P< 0.0001). Conclusion: Functional capacity was an independent predictor of CHD in the study population, whereas depression and sleep duration were not independent predictors.Lay representations of chronic diseases in Ghana: implications for primary prevention.
AbstractDe Graft Aikins, A., Anum, A., Agyemang, C., Addo, J., & Ogedegbe, O. (n.d.).Publication year
2012Journal title
Ghana medical journalVolume
46Issue
2Page(s)
59-68AbstractGhana's health system is ill-equipped to tackle the country's double burden of infectious and chronic diseases. The current focus is on empowering lay communities to adopt healthy practices to prevent chronic diseases. Understanding how individuals make sense of health, illness and chronic illnesses is an important first step to developing practical interventions. Six focus group discussions with lay people (N= 51) in Accra, Nkoranza and Kintampo to explore: (1) knowledge of prevalent chronic diseases in Ghana; (2) chronic disease causal theories; and (3) chronic disease treatment. Nineteen conditions were listed cumulatively. Diabetes and hypertension were listed by all groups. Rural groups included HIV/AIDS on their list as well as diseases with alleged spiritual roots, in particular epilepsy and sickle cell disease. Multiple causal theories were presented for diabetes and hypertension; cancers were attributed to toxic foods; asthma attributed to environmental pollution. Biomedical care was preferred by the majority. Lay representations were drawn from multiple sources: medical professionals and chronically ill individuals were the most legitimate knowledge sources. This study provides insights on how lay representations of common chronic diseases and their major risk factors provide public health specialists with the conceptual tools to develop primary prevention strategies. The first challenge will be to train health experts to provide accurate information in practical language that lay people can understand and apply to their daily lives. A second challenge will be to develop sustainable behaviour-change interventions. Best practices from other African countries can inform interventions in Ghana.Overcoming barriers to hypertension control in African Americans
AbstractOdedosu, T., Schoenthaler, A., Vieira, D. L., Agyemang, C., & Ogedegbe, G. (n.d.).Publication year
2012Journal title
Cleveland Clinic Journal of MedicineVolume
79Issue
1Page(s)
46-56AbstractBarriers to blood pressure control exist at the patient, physician, and system levels. We review the current evidence for interventions that target patient- and physician-related barriers, such as patient education, home blood pressure monitoring, and computerized decisionsupport systems for physicians, and we emphasize the need for more studies that address the effectiveness of these interventions in African American patients.Patient Factors, But Not Provider and Health Care System Factors, Predict Medication Adherence in Hypertensive Black Men
AbstractLewis, L. M., Schoenthaler, A. M., & Ogedegbe, G. (n.d.).Publication year
2012Journal title
Journal of Clinical HypertensionVolume
14Issue
4Page(s)
250-255AbstractThe problem of medication adherence is pronounced in hypertensive black men. However, factors influencing their adherence are not well understood. This secondary analysis of the ongoing Counseling African Americans to Control Hypertension (CAATCH) randomized clinical trial investigated the patient, provider, and health care system factors associated with medication adherence among hypertensive black men. Participants (N=253) were aged 56.6±11.6 years, earned <$20,000 yearly (72.7%), and almost one half were on Medicaid (44%). Mean systolic blood pressure was 148.7±15.8mmHg and mean diastolic blood pressure was 92.7±9.8mmHg. Over one half of participants (54.9%) were nonadherent. In a hierarchical regression analysis, the patient factors that predicted medication adherence were age, self-efficacy, and depression. The final model accounted for 32.1% of the variance (F=7.80, df 10, 165, P<.001). In conclusion, age, self-efficacy, and depression were associated with antihypertensive medication adherence in black men followed in Community/Migrant Health Centers. Age is a characteristic that may allow clinicians to predict who may be at risk for poor medication adherence. Depression can be screened for and treated. Self-efficacy is modifiable and its implications for practice would be the development of interventions to increase self-efficacy in black men with hypertension.Race differences in the physical and psychological impact of hypertension labeling
AbstractSpruill, T. M., Gerber, L. M., Schwartz, J. E., Pickering, T. G., & Ogedegbe, G. (n.d.).Publication year
2012Journal title
American Journal of HypertensionVolume
25Issue
4Page(s)
458-463AbstractBackground: Blood pressure screening is an important component of cardiovascular disease prevention, but a hypertension diagnosis (i.e., label) can have unintended negative effects on patients' well-being. Despite persistent disparities in hypertension prevalence and outcomes, whether the impact of labeling differs by race is unknown. The purpose of this study was to evaluate possible race differences in the relationship between hypertension labeling and health-related quality of life and depression. Methods: The sample included 308 normotensive and unmedicated hypertensive subjects from the Neighborhood Study of Blood Pressure and Sleep, a cross-sectional study conducted between 1999 and 2003. Labeled hypertension was defined (by self-report) as having been diagnosed with high blood pressure or prescribed antihypertensive medications. Effects of labeling and race on self-reported physical and mental health and depressive symptoms were tested using multivariate analysis of covariance, controlling for age, sex, body mass index (BMI), previous medication use, and "true" hypertension status, defined by average daytime ambulatory blood pressure (ABP). Results: Both black and white subjects who had been labeled as hypertensive reported similarly poorer physical health than unlabeled subjects (P = 0.001). However, labeling was associated with poorer mental health and greater depressive symptoms only among blacks (Ps < 0.05 for the interactions). These findings were not explained by differences in socioeconomic status. Conclusions: These results are consistent with previous studies showing negative effects of hypertension labeling, and demonstrate important race differences in these effects. Clinical approaches to communicating diagnostic information that avoid negative effects on well-being are needed, and may require tailoring to patient characteristics such as race.Race/ethnicity, sleep duration, and diabetes mellitus: Analysis of the national health interview survey
AbstractZizi, F., Pandey, A., Murrray-Bachmann, R., Vincent, M., McFarlane, S., Ogedegbe, G., & Jean-Louis, G. (n.d.).Publication year
2012Journal title
American Journal of MedicineVolume
125Issue
2Page(s)
162-167AbstractBackground: The effect of race/ethnicity on the risk of diabetes associated with sleep duration has not been systematically investigated. This study assessed whether blacks reporting short (<6 hours) or long (>8 hours) sleep durations were at greater risk for diabetes than their white counterparts. In addition, this study also examined whether the influence of race/ethnicity on associations between abnormal sleep durations and the presence of diabetes were independent of individuals' sociodemographic and medical characteristics. Methods: A total of 29,818 Americans (age range: 18-85 years) enrolled in the 2005 National Health Interview Survey, a cross-sectional household interview survey, provided complete data for this analysis. Results: Of the sample, 85% self-ascribed their ethnicity as white and 15% as black. The average age was 47.4 years, and 56% were female. Results of univariate regression analysis adjusting for medical comorbidities showed that black and white participants who reported short sleep duration (<6 hours) were more likely to have diabetes than individuals who reported sleeping 6 to 8 hours (odds ratios 1.66 and 1.87, respectively). Likewise, black and white participants reporting long sleep duration (>8 hours) had a greater likelihood of reporting diabetes compared with those sleeping 6 to 8 hours (odds ratios 1.68 and 2.33, respectively). Significant interactions of short and long sleep with black and white race were observed. Compared with white participants, greater diabetes risk was associated with being short or long sleepers of black race. Conclusion: The present findings suggest that American short and long sleepers of black race may be at greater risk for diabetes independently of their sociodemographic profile or the presence of comorbid medical conditions, which have been shown to influence habitual sleep durations. Among black individuals at risk for diabetes, healthcare providers should stress the need for adequate sleep.Relationship between post-traumatic stress disorder and diabetes among 105 180 asylum seekers in the Netherlands
AbstractAgyemang, C., Goosen, S., Anujuo, K., & Ogedegbe, G. (n.d.).Publication year
2012Journal title
European Journal of Public HealthVolume
22Issue
5Page(s)
658-662AbstractBackground: Several reports have demonstrated a relationship between post-traumatic stress disorder (PTSD) and type 2 diabetes (T2DM) mainly in combat veterans. The relationship between PTSD and T2DM has not been evaluated among vulnerable migrant populations. The main objective of this study was therefore to assess the relationship between PTSD and T2DM among asylum seekers in the Netherlands. Methods: Analysis of a national electronic database of the Dutch Community Health Services for Asylum seekers aged 18 years (N=105180). Results: Asylum seekers with PTSD had a higher prevalence of T2DM compared with those without PTSD. The age-adjusted prevalence ratios (APR) were 1.40 (95 CI, 1.12-1.76) in men and 1.22 (95 CI, 0.95-1.56) in women compared with individuals without PTSD, respectively. There was an interaction between PTSD and comorbid depression (P<0.05) in men and women, indicating that the effect of PTSD and comorbid depression on T2DM differed. When the analyses were stratified by depression status, among non-depressed group, individuals with PTSD had a higher prevalence of T2DM compared with those without PTSD [APR=1.47 (95 CI, 1.15-1.87) in men and APR=1.27 (95 CI, 0.97-1.66) in women]. Among the depressed individuals, however, there was no association between PTSD and T2DM [APR=0.87 (95 CI, 0.43-1.76) in men, and APR=1.00, (95 CI, 0.54-1.83) in women]. Conclusion: The findings suggest that history of PTSD is related to high levels of T2DM among asylum seekers independent of comorbid depression. Clinicians and policy makers need to take PTSD into account when assessing and treating diabetes among vulnerable migrant populations.Resistant hypertension
Olafiranye, O., Mahmud, S., Zizi, F., McFarlane, S. I., Jean-Louis, G., & Ogedegbe, G. (n.d.). In Diabetes and Hypertension: Etiology, evaluation and management (1–).Publication year
2012Page(s)
65-73Secondary analysis of electronically monitored medication adherence data for a cohort of hypertensive African-Americans
AbstractKnafl, G. J., Schoenthaler, A., & Ogedegbe, G. (n.d.).Publication year
2012Journal title
Patient Preference and AdherenceVolume
6Page(s)
207-219AbstractBackground: Electronic monitoring devices (EMDs) are regarded as the "gold standard" for assessing medication adherence in research. Although EMD data provide rich longitudinal information, they are typically not used to their maximum potential. Instead, EMD data are usually combined into summary measures, which lack sufficient detail for describing complex medication-taking patterns. This paper uses recently developed methods for analyzing EMD data that capitalize more fully on their richness. Methods: Recently developed adaptive statistical modeling methods were used to analyze EMD data collected with medication event monitoring system (MEMS™) caps in a clinical trial testing the effects of motivational interviewing on adherence to antihypertensive medications in a cohort of hypertensive African-Americans followed for 12 months in primary care practices. This was a secondary analysis of EMD data for 141 of the 190 patients from this study for whom MEMS data were available. Results: Nonlinear adherence patterns for 141 patients were generated, clustered into seven adherence types, categorized into acceptable (for example, high or improving) versus unacceptable (for example, low or deteriorating) adherence, and related to adherence self-efficacy and blood pressure. Mean adherence self-efficacy was higher across all time points for patients with acceptable adherence in the intervention group than for other patients. By 12 months, there was a greater drop in mean post-baseline blood pressure for patients in the intervention group, with higher baseline blood pressure values than those in the usual care group. Conclusion: Adaptive statistical modeling methods can provide novel insights into patients' medication-taking behavior, which can inform development of innovative approaches for tailored interventions to improve medication adherence.Stroke in Ashanti region of Ghana.
AbstractAgyemang, C., Attah-Adjepong, G., Owusu-Dabo, E., De-Graft Aikins, A., Addo, J., Edusei, A. K., Nkum, B. C., & Ogedegbe, G. (n.d.).Publication year
2012Journal title
Ghana medical journalVolume
46Issue
2Page(s)
12-17AbstractTo determine the morbidity and mortality in adult in-patients with stroke admitted to the Komfo Anokye Teaching Hospital (KATH). A retrospective study of in-patients with stroke admitted to the KATH, from January 2006 to december 2007 was undertaken. Data from admission and discharge registers were analysed to determine stroke morbidity and mortality. Stroke constituted 9.1% of total medical adult admissions and 13.2% of all medical adult deaths within the period under review. The mean age of stroke patients was 63.7 (95% ci=62.8, 64.57) years. Males were younger than females. The overall male to female ratio was 1:0.96, and the age-adjusted risk of death from stroke was slightly lower for females than males (relative risk= 0.88; 95% ci=0.79, 1.02, p=0.08). The stroke case fatality rate was 5.7% at 24 hours, 32.7% at 7 days, and 43.2% at 28 days. Stroke constitutes a significant cause of morbidity and mortality in Ghana. Major efforts are needed in the prevention and treatment of stroke. Population-based health education programs and appropriate public health policy need to be developed. This will require a multidisciplinary approach of key players with a strong political commitment. There is also a clear need for further studies on this topic including, for example, an assessment of care and quality of life after discharge from hospital. The outcomes of these studies will provide important information for the prevention efforts.The effect of patient-provider communication on medication adherence in hypertensive black patients: Does race concordance matter?
AbstractSchoenthaler, A., Allegrante, J. P., Chaplin, W., & Ogedegbe, G. (n.d.).Publication year
2012Journal title
Annals of Behavioral MedicineVolume
43Issue
3Page(s)
372-382AbstractBackground Despite evidence of a positive effect of collaborative patient-provider communication on patient outcomes, our understanding of this relationship is unclear. Purpose The purpose of this paper is to determine whether racial composition of the relationship modified the association between ratings of provider communication and medication adherence. Methods Effect modification of the communication-adherence association, by racial composition of the relationship, was evaluated using general linear mixed models while adjusting for selected covariates. Results Three hundred ninety patients were in raceconcordant (black patient, black provider) relationships, while 207 were in race-discordant (black patient, white provider) relationships. The communication-adherence association was significantly modified in race-discordant relationships (p00.04). Communication rated as more collaborative in race-discordant relationships was associated with better adherence, while communication rated as less collaborative was associated with poor adherence. There was no significant association between adherence and communication in race-concordant relationships (p00.24). Conclusions Collaborative patient-provider communication may play an influential role in black patients' adherence behaviors when receiving care from white providers.A practice-based trial of blood pressure control in African Americans (TLC-Clinic): study protocol for a randomized controlled trial
AbstractSchoenthaler, A., Luerassi, L., Teresi, J. A., Silver, S., Kong, J., Odedosu, T., Trilling, S., Errico, A., Uvwo, O., Sebek, K., Adekoya, A., & Ogedegbe, G. (n.d.).Publication year
2011Journal title
TrialsVolume
12AbstractBackground: Poorly controlled hypertension (HTN) remains one of the most significant public health problems in the United States, in terms of morbidity, mortality, and economic burden. Despite compelling evidence supporting the beneficial effects of therapeutic lifestyle changes (TLC) for blood pressure (BP) reduction, the effectiveness of these approaches in primary care practices remains untested, especially among African Americans, who share a disproportionately greater burden of HTN-related outcomes.Methods/Design: This randomized controlled trial tests the effectiveness of a practice-based comprehensive therapeutic lifestyle intervention, delivered through group-based counseling and motivational interviewing (MINT-TLC) versus Usual Care (UC) in 200 low-income, African Americans with uncontrolled hypertension. MINT-TLC is designed to help patients make appropriate lifestyle changes and develop skills to maintain these changes long-term. Patients in the MINT-TLC group attend 10 weekly group classes focused on healthy lifestyle changes (intensive phase); followed by 3 monthly individual motivational interviewing (MINT) sessions (maintenance phase). The intervention is delivered by trained research personnel with appropriate treatment fidelity procedures. Patients in the UC condition receive a single individual counseling session on healthy lifestyle changes and print versions of the intervention materials. The primary outcome is within-patient change in both systolic and diastolic BP from baseline to 6 months. In addition to BP control at 6 months, other secondary outcomes include changes in the following lifestyle behaviors from baseline to 6 months: a) physical activity, b) weight loss, c) number of daily servings of fruits and vegetables and d) 24-hour urinary sodium excretion.Discussion: This vanguard trial will provide information on how to refine MINT-TLC and integrate it into a standard treatment protocol for hypertensive African Americans as a result of the data obtained; thus maximizing the likelihood of its translation into clinical practice.Trial Registration: Clinicaltrials.gov NCT01070056.Cardiovascular disease prevention in Ghana: Feasibility of a faith-based organizational approach
AbstractAbanilla, P. K. A., Huang, K. Y., Shinners, D., Levy, A., Ayernor, K., Aikins, A. D. G., & Ogedegbe, O. (n.d.).Publication year
2011Journal title
Bulletin of the World Health OrganizationVolume
89Issue
9Page(s)
648-656AbstractObjective: To examine the feasibility of using community health workers (CHWs) to implement cardiovascular disease (CVD) prevention programmes within faith-based organizations in Accra, Ghana. Methods: Faith-based organization capacity, human resources, health programme sustainability/barriers and community members' knowledge were evaluated. Data on these aspects were gathered through a mixed method design consisting of in-depth interviews and focus groups with 25 church leaders and health committee members from five churches, and of a survey of 167 adult congregants from two churches. Findings: The delivery of a CVD prevention programme in faith-based organizations by CHWs is feasible. Many faith-based organizations already provide health programmes for congregants and involve non-health professionals in their health-care activities, and most congregants have a basic knowledge of CVD. Yet despite the feasibility of the proposed approach to CVD prevention through faith-based organizations, sociocultural and health-care barriers such as poverty, limited human and economic resources and limited access to health care could hinder programme implementation. Conclusion: The barriers to implementation identified in this study need to be considered when defining CVD prevention programme policy and planning.Correlations between different measures of clinic, home, and ambulatory blood pressure in hypertensive patients
AbstractEguchi, K., Kuruvilla, S., Ishikawa, J., Ogedegbe, G., Gerin, W., Schwartz, J. E., & Pickering, T. G. (n.d.).Publication year
2011Journal title
Blood Pressure MonitoringVolume
16Issue
3Page(s)
142-148AbstractObjectives: It is not well known how clinic, home, and ambulatory measures of blood pressure (BP) correlate with each other. We performed this study to clarify the level of agreement among these different BP measures. Materials and methods: We enrolled 56 hypertensive patients (mean age: 60±14 years; 54% were females). The study consisted of three clinic visits, self-monitoring of home BP between visits, and ambulatory blood pressure (ABP) monitoring at the second visit. Patients were given a home BP monitor programmed to automatically take three consecutive readings at fixed intervals of 1 min. The associations between clinic BP (mercury sphygmomanometer and HEM-5001), home BP (the average of morning and evening, second and third BP readings), and average awake ABP were compared using the intraclass correlation for agreement and Bland-Altman plots. Results: The averages of clinic sphygmomanometer, clinic HEM-5001, awake ABP, and home BP were 129 of 77, 131 of 76, 131 of 79, and 133 of 77 mmHg, respectively. Clinic BP by HEM-5001 was strongly correlated with that of mercury sphygmomanometer. Home systolic blood pressure was moderately correlated with awake ABP, but mercury diastolic blood pressure (DBP) was more closely correlated with awake DBP than home DBP. Conclusion: Clinic BP measured with the automated monitor could be used as an alternative for the evaluation of BP in the office. Under rigorously standardized conditions, clinic and home BP could be used as an alternative to awake ABP.