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
Psychosocial mediators of the relationship between race/ethnicity and depressive symptoms in latino and white patients with coronary artery disease
AbstractBoutin-Foster, C., Ogedegbe, G., Peterson, J., Briggs, W. M., Allegrante, J. P., & Charlson, M. E. (n.d.).Publication year
2008Journal title
Journal of the National Medical AssociationVolume
100Issue
7Page(s)
849-855AbstractBackground: The high prevalence of depressive symptoms in patients with coronary artery disease has been well documented. However, little is known about the prevalence and correlates of depressive symptoms in Latino patients with coronary artery disease. Purpose: Among Latino and white patients who had percutaneous transluminal coronary angioplasty (PTCA), this study examined whether differences in the prevalence of depressive symptoms exist and the degree to which psychosocial factors (years of education, employment status, stressful life events, emotional social support) explained any differences. Methods: Using a cross-sectional design, closed-format questionnaires were used to obtain clinical and psychosocial history. The definition of high depressive symptoms was based on a score of ≥16 on the Center for Epidemiologic Studies Depression Scale (CES-D). Results: Compared to whites (n=492), Latinos (n=59) were younger, and a greater proportion were female, but fewer completed high school and fewer were employed (P<0.05). More Latinos reported experiencing ≥2 recent stressful life events, but fewer reported having emotional social support (P<0.05). There was a significant association between race/ethnicity and depressive symptoms (OR=2.3, 95% CI: 1.3-4.5). In multivariate analyses, the significance of this association diminished when psychosocial variables were added to the model. Conclusions: In this study, education, employment, stressful life events and emotional social support partially explained the observed racial/ethnic differences in depressive symptoms.Revision and validation of the medication adherence self-efficacy scale (MASES) in hypertensive African Americans
AbstractFernandez, S., Chaplin, W., Schoenthaler, A. M., & Ogedegbe, G. (n.d.).Publication year
2008Journal title
Journal of Behavioral MedicineVolume
31Issue
6Page(s)
453-462AbstractStudy purpose was to revise and examine the validity of the Medication Adherence Self-Efficacy Scale (MASES) in an independent sample of 168 hypertensive African Americans: mean age 54 years (SD = 12.36); 86% female; 76% high school education or greater. Participants provided demographic information; completed the MASES, self-report and electronic measures of medication adherence at baseline and three months. Confirmatory (CFA), exploratory (EFA) factor analyses, and classical test theory (CTT) analyses suggested that MASES is unidimensional and internally reliable. Item response theory (IRT) analyses led to a revised 13-item version of the scale: MASES-R. EFA, CTT, and IRT results provide a foundation of support for MASES-R reliability and validity for African Americans with hypertension. Research examining MASES-R psychometric properties in other ethnic groups will improve generalizability of findings and utility of the scale across groups. The MASES-R is brief, quick to administer, and can capture useful data on adherence self-efficacy.The Epidemiology of Hypertension
Ogedegbe, O., & Pickering, T. G. (n.d.). In Hurst’s the Heart (8th eds., 1–).Publication year
2008Page(s)
1551 - 1570The misdiagnosis of hypertension: The role of patient anxiety
AbstractOgedegbe, G., Pickering, T. G., Clemow, L., Chaplin, W., Spruill, T. M., Albanese, G. M., Eguchi, K., Burg, M., & Gerin, W. (n.d.).Publication year
2008Journal title
Archives of Internal MedicineVolume
168Issue
22Page(s)
2459-2465AbstractBackground: The white coat effect (defined as the difference between blood pressure [BP] measurements taken at the physician's office and those taken outside the office) is an important determinant of misdiagnosis of hypertension, but little is known about the mechanisms underlying this phenomenon. We tested the hypothesis that the white coat effect may be a conditioned response as opposed to a manifestation of general anxiety. Methods: A total of 238 patients in a hypertension clinic wore ambulatory blood pressure monitors on 3 separate days 1 month apart. At each clinic visit, BP readings were manually triggered in the waiting area and the examination room (in the presence and absence of the physician) and were compared with the mercury sphygmomanometer readings taken by the physician in the examination room. Patients completed trait and state anxiety measures before and after each BP assessment. Results: A total of 35% of the sample was normotensive, and 9%, 37%, and 19% had white coat, sustained, and masked hypertension, respectively. The diagnostic category was associated with the state anxiety measure (F3,237 = 6.4, P < .001) but not with the trait anxiety measure. Patients with white coat hypertension had significantly higher state anxiety scores (t = 2.67, P < .01), with the greatest difference reported during the physician measurement. The same pattern was observed for BP changes, which generally paralleled the changes in state anxiety (t = 4.86, P < .002 for systolic BP; t = 3.51, P < .002 for diastolic BP). Conclusions: These findings support our hypothesis that the white coat effect is a conditioned response. The BP measurements taken by physicians appear to exacerbate the white coat effect more than other means. This problem could be addressed with uniform use of automated BP devices in office settings.The relative risk of cardiovascular death among racial and ethnic minorities with metabolic syndrome: Data from the NHANES-II mortality follow-up
AbstractMartins, D., Tareen, N., Ogedegbe, G., Pan, D., & Norris, K. (n.d.).Publication year
2008Journal title
Journal of the National Medical AssociationVolume
100Issue
5Page(s)
565-571AbstractThe tendency for selected cardiovascular disease (CVD) risk factors to occur in clusters has led to the description of metabolic syndrome (MetS). The relative impact of the individual risk factor on the overall relative risk (RR) for cardiovascular death from metabolic syndrome is not well established and may differ across the different racial/ethnic groups. Using data from the National Health and Nutrition Examination Survey (NHANES II) mortality follow-up (NH2MS), we determined the prevalence and RR of cardiovascular death for individual components in the overall population and across racial and ethnic groups. The prevalence of MetS components varied significantly across gender and racial/ethnic groupings. The RR for CVD also varies for the number and different components of MetS. The adjusted RR for cardiovascular death was highest with diabetes (3.23; 95% CI: 2.70-3.88), elevated blood pressure (2.28; 95% CI: 1.94-2.67) and high triglycerides (1.63; 95% CI: 1.34-2.00). Although the RR for cardiovascular death differs significantly for some of the different components, the overall findings were similar across racial/ethnic groups. The two components that confer the highest risks for death are more prevalent in African Americans. We concluded that the RR of cardiovascular death associated with the diagnosis of MetS varies depending on the number and components used to establish the diagnosis of MetS and the racial/ethnic characteristic of the participants.Understanding the nature and role of spirituality in relation to medication adherence: A proposed conceptual model
AbstractLewis, L. M., & Ogedegbe, G. (n.d.).Publication year
2008Journal title
Holistic Nursing PracticeVolume
22Issue
5Page(s)
261-267AbstractRacial disparities in hypertension prevalence and its attendant complications are well documented. Spirituality is an important component of African American beliefs and a small body of literature suggests that spirituality influences hypertension management in African Americans. This article describes a conceptual model of spirituality that may be useful for developing interventions for increasing medication adherence and decreasing blood pressure in African Americans diagnosed with hypertension.African American Spirituality: A Process of Honoring God, Others, and Self
AbstractLewis, L. M., Hankin, S., Reynolds, D., & Ogedegbe, G. (n.d.).Publication year
2007Journal title
Journal of Holistic NursingVolume
25Issue
1Page(s)
16-23AbstractPurpose: The purpose of this pilot study was to explore African American definitions of practicing spirituality and to describe the process of spirituality and its relationship to health promotion. Method: Data were collected using semi-structured interview questions via two focus groups from a total of 12 participants who self-identified as African American. Findings: This grounded theory methodology generated three categories of spirituality: (a) love in action, (b) relationships and connections, and (c) unconditional love. The overall process of practicing spirituality and its relationship to health identified a process of honoring God, self, and others. Conclusion: Research studies that investigate the concept of spirituality and its relationship to health promotion and disease management need to address the subjective experience of spirituality based on participant definitions rather than researcher-focused definitions of spirituality.An RCT of the effect of motivational interviewing on medication adherence in hypertensive African Americans: Rationale and design
AbstractOgedegbe, G., Schoenthaler, A., Richardson, T., Lewis, L., Belue, R., Espinosa, E., Spencer, J., Allegrante, J. P., & Charlson, M. E. (n.d.).Publication year
2007Journal title
Contemporary Clinical TrialsVolume
28Issue
2Page(s)
169-181AbstractBackground: Hypertension disproportionately affects African Americans compared to whites, and it is the single most common explanation for the disparity in mortality between African Americans and whites. Adherence with antihypertensive medications can help reduce risk of negative hypertension-related outcomes. Motivational interviewing is a promising patient-centered approach for improving adherence in patients with chronic diseases. In this paper we describe the rationale and design of an ongoing randomized controlled trial testing the effectiveness of motivational interviewing versus usual care in improving medication adherence among 190 African American uncontrolled hypertensive patients, who receive care in a primary care setting. Methods: The usual care group receives standard medical care, while those in the intervention group receive standard care plus four sessions of motivational interviewing at 3-month intervals for a period of 1 year. This technique consists of brief, patient-driven counseling sessions to facilitate initiation and maintenance of behavior change. The primary outcome is adherence to prescribed antihypertensive medication, assessed with the electronic medication events monitoring system (MEMS) and the Morisky self-report adherence questionnaire. Secondary outcomes are within-patient changes in blood pressure, self-efficacy, and intrinsic motivation between baseline and 12 months. We report the baseline sociodemographic and clinical characteristics of the participants. Conclusions: Despite the potential utility of motivational interviewing, little is known about its effectiveness in improving medication adherence among hypertensive patients, especially African Americans. In addition to the baseline data this study has generated, this trial should provide data with which we can assess the effectiveness of this approach as a behavioral intervention.Appointment-keeping behavior is not related to medication adherence in hypertensive African Americans
AbstractOgedegbe, G., Schoenthaler, A., & Fernandez, S. (n.d.).Publication year
2007Journal title
Journal of general internal medicineVolume
22Issue
8Page(s)
1176-1179AbstractOBJECTIVE: The relationship between appointment-keeping behavior, medication adherence (ADH), and systolic and diastolic blood pressure (SBP and DBP) was assessed in 153 hypertensive African Americans followed in a community-based practice. OBJECTIVE: ADH was assessed with a self-report questionnaire. BP was obtained from electronic medical records and appointment attendance was determined from the log of all appointments made during the 12-month study period. Nonadherence rates were compared across appointment attendance categories with chi-square. Logistic regression was used to assess the relationship between ADH and appointment attendance, whereas multivariate analysis of covariance (MANCOVA) was used to examine the relationship between appointment attendance and BP. RESULTS: Twenty-five percent of patients (87% women, mean age 52 years) did not miss any appointments, 44% missed 1-30%, and 31% missed greater than 30%. Adjusted nonadherence rates were similar for all 3 categories (70%, 66%, and 65%, respectively, p = 0.88) as were adjusted mean SBP and DBP in the MANCOVA model, [F (4, 218) = 1.13, p = .34]. Logistic regression analysis did not indicate a significant relationship between appointment attendance and ADH. CONCLUSIONS: Appointment-keeping behavior was not related to ADH or BP among hypertensive African Americans. It should not be used as a proxy for ADH in this patient population.Ascribing meaning to hypertension: A qualitative study among African Americans with uncontrolled hypertension
AbstractBoutin-Foster, C., Ogedegbe, G., Ravenell, J. E., Robbins, L., & Charlson, M. E. (n.d.).Publication year
2007Journal title
Ethnicity and DiseaseVolume
17Issue
1Page(s)
29-34AbstractObjective: The objective was to elicit patients' perceptions regarding the meaning of hypertension and to identify the personal, social, and environmental factors that might influence their perceptions. Design: Qualitative study. Setting: Adult ambulatory care practice. Participants: African American patients with uncontrolled hypertension. Intervention/Methods: In-depth structured interviews were conducted with a purposive sample of 60 patients. Interviews were audio-taped, transcribed verbatim, and analyzed by using grounded theory. Results: Patient descriptions of hypertension were grouped into three categories: 1) their thoughts on hypertension; 2) the consequences of hypertension; and 3) the impact that having hypertension had on their lifestyle. Factors that might have shaped how patients described hypertension were grouped into three categories: 1) the experiences of their social networks such as family and friends; 2) their personal experiences; and 3) information about hypertension that they might have gathered from the medical literature or during an encounter with a healthcare provider. Patients with family members who had experienced hypertension-related complications such as stroke were more likely to view hypertension as a serious condition. Patients who themselves experienced hypertension-related symptoms and who also had family members with a history of hypertensive disease were more likely to describe a willingness to make lifestyle changes. Conclusions: In this study, personal experiences, experiences of family and friends, and encounters with the healthcare environment influenced patients' perceptions of hypertension and their willingness to make lifestyle changes. These findings can be used as a framework for helping to tailor effective and culture-specific interventions.Perspectives on Mechanisms of Racial Disparities in Hypertension
Ogedegbe, O. (n.d.). In From Health Inequity to Equity in Health: A New Global Approach to Health Disparities (1–).Publication year
2007Randomized controlled trials of positive affect and self-affirmation to facilitate healthy behaviors in patients with cardiopulmonary diseases: Rationale, trial design, and methods
AbstractCharlson, M. E., Boutin-Foster, C., Mancuso, C. A., Peterson, J. C., Ogedegbe, G., Briggs, W. M., Robbins, L., Isen, A. M., & Allegrante, J. P. (n.d.).Publication year
2007Journal title
Contemporary Clinical TrialsVolume
28Issue
6Page(s)
748-762AbstractSecondary prevention of adverse outcomes in patients with cardiopulmonary disease requires that patients become actively engaged in self-management efforts such as participation in physical activity or medication adherence. However, despite assiduous efforts to find strategies that help cardiovascular patients to adopt and maintain such behaviors, many studies of interventions designed to improve physical activity and adherence to medication have shown disappointing results. To this end, the Translational Behavioral Science Research Consortium was created by the National Heart, Lung, and Blood Institute to identify promising, but underutilized findings from basic behavioral science that might have potential application for translation to clinical populations where behavioral change has been refractory to standard intervention approaches. This paper describes the rationale and methods of a novel research project designed to test the efficacy of a behavioral intervention that combines constructs from two behavioral science theories (positive affect and self-affirmation) in order to help patients with coronary artery disease, asthma, and hypertension successfully change behaviors. The project consists of an intervention framed upon positive affect and self-affirmation and tested in three concurrent randomized controlled trials among three distinct populations. Each trial had a qualitative phase that served as a formative stage to inform the intervention; a pilot phase during which the feasibility of the intervention was tested and refined; and a randomized controlled phase conducted to investigate the effects of the interventions in these three patient groups.The impact of perceived hypertension status on anxiety and the white coat effect
AbstractSpruill, T. M., Pickering, T. G., Schwartz, J. E., Mostofsky, E., Ogedegbe, G., Clemow, L., & Gerin, W. (n.d.).Publication year
2007Journal title
Annals of Behavioral MedicineVolume
34Issue
1Page(s)
1-9AbstractBackground: The white coat effect can lead to overdiagnosis of hypertension and unnecessary pharmacologic treatment. Mechanisms underlying the white coat effect remain poorly understood but are critical to improving the accuracy of clinic blood pressure measurement. Purpose: This study investigated whether perceived hypertension status was associated with state anxiety levels during a clinic visit and the magnitude of the white coat effect, independent of true blood pressure status. Methods: This observational study included 214 normotensive and mildly hypertensive participants who were 18 to 80 years old, had no cardiac history, and were willing to discontinue antihypertensive medications for 8 weeks. Participants underwent 36 hr ambulatory blood pressure monitoring and physician blood pressure measurement. Outcome measures were state anxiety reported during the clinic visit and the white coat effect. Results: An analysis of covariance indicated that participants who perceived themselves as hypertensive reported greater state anxiety (p < .001) and showed larger white coat effects (ps < .01) compared with those who perceived themselves as normotensive. True hypertension status based on ambulatory blood pressure was not related to either outcome. Anxiety accounted for approximately 19% of the association between perceived hypertension status and the white coat effect. Conclusions: These findings suggest that the perception of being hypertensive is associated with greater anxiety during clinic blood pressure measurement and a larger white coat effect, independent of the true blood pressure level. Anxiety appears to be a mechanism by which perceived hypertension status contributes to the white coat effect.The medication Adherence and Blood Pressure Control (ABC) trial: A multi-site randomized controlled trial in a hypertensive, multi-cultural, economically disadvantaged population
AbstractGerin, W., Tobin, J. N., Schwartz, J. E., Chaplin, W., Rieckmann, N., Davidson, K. W., Goyal, T. M., Jhalani, J., Cassells, A., Feliz, K., Khalida, C., Diaz-Gloster, M., & Ogedegbe, G. (n.d.).Publication year
2007Journal title
Contemporary Clinical TrialsVolume
28Issue
4Page(s)
459-471AbstractThe Medication Adherence and BP Control Trial (ABC Trial) is a randomized, controlled, multi-site, medication adherence and blood pressure (BP) control trial in an economically disadvantaged and multi-cultural population of hypertensive patients followed in primary care practices. To date, no other such trial has been published in which objective measures of adherence (electronic pill bottles) were used to assess the effectiveness of these behavioral interventions for hypertension. This study tested a combination of commercially-available interventions that can be easily accessed by health care providers and patients, and therefore may provide a real-world solution to the problem of non-adherence among hypertensives. The aim of the ABC Trial was to test the effectiveness of a stepped care intervention in improving both medication adherence to an antihypertensive medication regimen and BP control. Step 1 of the intervention employed home Self-BP Monitoring (SBPM); at this stage, there were two arms: (1) Usual Care (UC) and (2) Intervention. At Step 2, patients in the intervention arm whose BP had not come under control after 3 months were further randomized to one of two conditions: (1) continuation of SBPM (alone) or (2) continuation of SBPM plus telephone-based nurse case management (SBPM + NCM). Electronic Medication Event Monitoring (MEMS) was the primary measure of medication adherence, and in-office BP was the primary measure of hypertension control. We present an overview of the study design, details of the administrative structure of the study and a description of clinical site recruitment, patient recruitment, and follow-up assessments.A systematic review of the effects of home blood pressure monitoring on medication adherence.
AbstractOgedegbe, G., & Schoenthaler, A. (n.d.).Publication year
2006Journal title
Journal of clinical hypertension (Greenwich, Conn.)Volume
8Issue
3Page(s)
174-180AbstractHome blood pressure monitoring (HBPM) improves blood pressure control, but little is known about its effects on medication adherence. The authors conducted a systematic review of the published literature on the effects of HBPM on medication adherence. Of 440 abstracts and citations reviewed, 11 randomized control trials met predefined criteria. Six of the 11 randomized controlled trials reported statistically significant improvement in medication adherence; 84% of these were complex interventions involving the use of HBPM in combination with other adherence-enhancing strategies such as patient counseling by nurses, pharmacists, or a telephone-linked system; patient education; and the use of timed medication reminders. Interventions conducted in primary care settings were not effective compared with those that occurred in hospital-based clinics or nonclinical settings. The data on the effects of HBPM on patients' medication-taking behavior are mixed. Future studies should investigate the independent effects of HBPM in primary care practices where the majority of hypertensive patients receive their care.Assessment of the white-coat effect
AbstractGerin, W., Ogedegbe, G., Schwartz, J. E., Chaplin, W. F., Goyal, T., Clemow, L., Davidson, K. W., Burg, M., Lipsky, S., Kentor, R., Jhalani, J., Shimbo, D., & Pickering, T. G. (n.d.).Publication year
2006Journal title
Journal of HypertensionVolume
24Issue
1Page(s)
67-74AbstractBackground: A limitation of blood pressure measurements made in the physician's office is the transient elevation in pressure seen in many patients that does not appear to be linked to target organ damage or prognosis. This has been labeled the 'white-coat effect' (WCE), computed as the difference between blood pressure measurements taken by the physician and the ambulatory level or resting measures. It is unclear, however, which resting measure is most appropriate. The awake ambulatory blood pressure is the most widely used. However, while arguably the most useful measure for prediction of clinical outcomes, it is less appropriate for use as a resting measure, because it is influenced by many factors, including posture and physical activity level. Resting levels taken in the clinic may also be elevated, and will therefore underestimate the WCE. Methods: We addressed this question by taking resting measures in a non-medical setting on the day before patients were seen at a Hypertension Clinic (day 1), and comparing these with resting measures taken on the following day, in the clinic before the patient saw the physician. Results: As predicted, the day 1 resting levels were lower than those taken in the clinic prior to seeing the physician (P < 0.05 and P < 0.001 for systolic and diastolic pressures, respectively) in both normotensive and hypertensive patients. Using the day 1 resting levels, the estimated WCE for hypertensive patients was 5.3/6.9 mmHg (systolic/ diastolic blood pressures), compared with estimates, using the clinic resting levels, of 0.3/0.5 mm Hg. The pattern of changes was different in normotensive patients and hypertensive patients, with the physician pressures being slightly lower than day 1 pressures in the former, and substantially higher in the latter. Heart rate changes were similar and modest in both groups. Conclusion: The WCE may not just be limited to that narrow interval in which the patient actually sees the physician, but may generalize to the clinic setting, rendering a clinic 'resting' level invalid. While it is strongly positive in most hypertensive patients, it is frequently negative in normotensive patients. Our results suggest that improved methods of measuring blood pressure in the clinic setting are unlikely to resolve the confounding influence of the WCE, and that greater reliance will need to be placed on out-of-office monitoring.Role of home blood pressure and ambulatory blood pressure monitoring in decisions of when and whom to treat: recommendations for practicing clinicians.
Ogedegbe, G. (n.d.).Publication year
2006Journal title
Journal of the cardiometabolic syndromeVolume
1Issue
3Page(s)
222-224Superiority of ambulatory to physician blood pressure is not an artifact of differential measurement reliability
AbstractGerin, W., Schwartz, J. E., Devereux, R. B., Goyal, T., Shimbo, D., Ogedegbe, G., Rieckmann, N., Abraham, D., Chaplin, W., Burg, M., Jhulani, J., & Pickering, T. G. (n.d.).Publication year
2006Journal title
Blood Pressure MonitoringVolume
11Issue
6Page(s)
297-301AbstractBACKGROUND: Ambulatory blood pressure is a better predictor of target organ damage and the risk of adverse cardiovascular events than office measurements. Whether this is due to the greater reliability owing to the larger number of measurements that are usually taken using ambulatory monitoring, or the greater validity of these measurements independent of the number, remains controversial. METHODS: We addressed this issue by comparing physician readings and ambulatory measurements as predictors of left ventricular mass index. The number of readings was controlled by using the average of three physician readings and randomly selecting three awake readings from a 24-h ambulatory recording. RESULTS: In a multiple regression analysis that included both the ambulatory and physician blood pressure measurements, only the ambulatory systolic measurements significantly predicted left ventricular mass index (B=0.37, t=3.11, P=0.002); the coefficient for physician's systolic measurements was essentially zero (B=-0.01, t=-0.26, NS). CONCLUSIONS: These findings suggest that the superiority of ambulatory blood pressure as a predictor of target organ damage, compared with physician measurements, cannot be adequately/fully explained by the impact of the larger number of measurements obtained with ambulatory monitoring.A new tool to assess treatment fidelity and evaluation of treatment fidelity across 10 years of health behavior research
AbstractBorrelli, B., Sepinwall, D., Bellg, A. J., Breger, R., DeFrancesco, C., Sharp, D. L., Ernst, D., Czajkowski, S., Levesque, C., Ogedegbe, G., Resnick, B., & Orwig, D. (n.d.).Publication year
2005Journal title
Journal of consulting and clinical psychologyVolume
73Issue
5Page(s)
852-860AbstractA. Bellg, B. Borrelli, et al. (2004) previously developed a framework that consisted of strategies to enhance treatment fidelity of health behavior interventions. The present study used this framework to (a) develop a measure of treatment fidelity and (b) use the measure to evaluate treatment fidelity in articles published in 5 journals over 10 years. Three hundred forty-two articles met inclusion criteria; 22% reported strategies to maintain provider skills, 27% reported checking adherence to protocol, 35% reported using a treatment manual, 54% reported using none of these strategies, and 12% reported using all 3 strategies. The mean proportion adherence to treatment fidelity strategies was .55; 15.5% of articles achieved greater than or equal to .80. This tool may be useful for researchers, grant reviewers, and editors planning and evaluating trials.Examples of implementation and evaluation of treatment fidelity in the BCC Studies: Where we are and where we need to go
AbstractResnick, B., Bellg, A. J., Borrelli, B., DeFrancesco, C., Breger, R., Hecht, J., Sharp, D. L., Levesque, C., Orwig, D., Ernst, D., Ogedegbe, G., & Czajkowski, S. (n.d.).Publication year
2005Journal title
Annals of Behavioral MedicineVolume
29Page(s)
46-54AbstractTreatment fidelity plays an important role in the research team's ability to ensure that a treatment has been implemented as intended and that the treatment has been accurately tested. Developing, implementing, and evaluating a treatment fidelity plan can be challenging. The treatment fidelity workgroup within the Behavior Change Consortium (BCC) developed guidelines to comprehensively evaluate treatment fidelity in behavior change research. The guidelines include evaluation of treatment fidelity with regard to study design, training of interventionists, delivery and receipt of the intervention, and enactment of the intervention in real-life settings. This article describes these guidelines and provides examples from four BCC studies as to how these recommended guidelines for fidelity were considered. Future work needs to focus not only on implementing treatment fidelity plans but also on quantifying the evaluations performed, developing specific criteria for interpretation of the findings, and establishing best practices of treatment fidelity.Knowledge attitudes, beliefs, and blood pressure control in a community-based sample in Ghana
AbstractSpencer, J., Phillips, E., & Ogedegbe, G. (n.d.).Publication year
2005Journal title
Ethnicity and DiseaseVolume
15Issue
4Page(s)
748-752AbstractCardiovascular disease, in particular hypertension (HTN), is a significant and growing public health problem in developing countries, such as sub-Saharan Africa. As such, it is imperative to develop a public health approach to the management and treatment of hypertension. In order to address the growing prevalence of hypertension in this region, an in-depth understanding of patients' knowledge, and awareness about the treatment and prevention of hypertension is needed. As part of a faith-based medical clinic in the Sekondi-Takoradi area in Ghana, we conducted a cross sectional survey of 1135 patients who attended a free medical clinic between March 2001 and March 2002, to assess the prevalence, awareness, knowledge, and treatment of HTN. Using qualitative methodology, we also explored patients' beliefs about hypertension and its consequences. Of the 1135 patients, 30% were hypertensive (and 62% of these had Stage II hypertension), 73% were aware of their diagnosis, 59% were being treated, and only 5% had adequate blood pressure (BP) control defined as blood pressure <140/90 mm Hg. Patients with hypertension were typically older (average age was 61 vs 42 for normotensives), obese (30% had a BMI ≥30) and not physically active (65%). These findings resemble trends noted in developed countries. Results of the qualitative interviews indicated that patients had several misconceptions about hypertension that were not consistent with a traditional biomedical model. For example, one person defined high blood pressure as having "too much blood in the body." In collaboration with the Ghana ministry of health we plan to utilize the findings of this study to develop a community-based educational program that will provide culturally competent patient education about hypertension, with a particular emphasis on the misconceptions about the etiology of hypertension and its associated complications.Perceptions of barriers and facilitators of cancer early detection among low-income minority women in community health centers
AbstractOgedegbe, G., Cassells, A. N., Robinson, C. M., DuHamel, K., Tobin, J. N., Sox, C. H., & Dietrich, A. J. (n.d.).Publication year
2005Journal title
Journal of the National Medical AssociationVolume
97Issue
2Page(s)
162-170AbstractAfrican-American and Hispanic women receive fewer indicated cancer early detection services than do majority women. Low rates of cancer screening may, in part, explain the disproportionately higher rates of cancer deaths in this population. The aim of this qualitative study was to explore through individual interviews the perceptions of barriers and facilitators of colorectal, cervical and breast cancer screening among 187 low-income, primarily minority women in four New-York-City-based community/migrant health centers. We identified various barriers and facilitators within each of these categories. Clinician recommendation was the most commonly cited encouragement to cancer screening. Other facilitators of cancer screening identified by patients included personal medical history, such as the presence of a symptom. The perception of screening as routine was cited as a facilitator far more commonly for mammography and Pap tests than for either of the colorectal screenings. Less commonly cited facilitators were insurance coverage and information from the media. The most common barriers were a lack of cancer screening knowledge, patients' perception of good health or absence of symptoms attributable to ill health, fear of pain from the cancer test and a lack of a clinician recommendation. Using standard qualitative techniques, patients' responses were analyzed and grouped into a taxonomy of three major categories reflecting: 1) patients' attitudes and beliefs, 2) their social network experience and 3) accessibility of services. This taxonomy may serve as a useful framework for primary care providers to educate and counsel their patients about cancer screening behaviors.Barriers and facilitators of medication adherence in hypertensive African Americans: A qualitative study
AbstractOgedegbe, G., Harrison, M., Robbins, L., Mancuso, C. A., & Allegrante, J. P. (n.d.).Publication year
2004Journal title
Ethnicity and DiseaseVolume
14Issue
1Page(s)
3-12AbstractObjective: This study explored the perspectives of hypertensive African-American patients, in 2 primary care practices, regarding the factors they perceived as barriers or facilitators of adherence to prescribed antihypertensive medications. Design: This qualitative study used a grounded theory methodology with data collection occurring through in-depth individual patient interviews. Setting and Participants: One hundred and six hypertensive African-American patients followed at 2 urban primary care practices participated in the open-ended interviews. Methods: During interviews, patients' experiences taking antihypertensive medications and their perceptions of the challenges they face in adhering to their medications as prescribed were explored. Patients were also asked about the situations that make it easy or difficult for them to take their antihypertensive medications as prescribed and the skills they thought were necessary for patients to adhere to their medications as prescribed. All responses were recorded verbatim and analyzed using grounded theory methodology. Results: Fifty-eight percent of participants were women, mean age was 56 years, and 60% had uncontrolled hypertension. Four categories of barriers and 5 categories of facilitators were identified. The barriers included patient-specific, medication-specific, logistic, and disease-specific barriers. The facilitators included use of reminders, having a routine, knowledge about hypertension, its treatment and complications, having social support and good doctor-patient communication. Conclusion: This study provides a framework for investigating issues of medication adherence in hypertensive African Americans by describing a taxonomy of barriers and facilitators of adherence identified by patients.Colorectal Carcinoma in Young Females
AbstractOlofinlade, O., Adeonigbagbe, O., Gualtieri, N., Freiman, H., Ogedegbe, O., & Robilotti, J. (n.d.).Publication year
2004Journal title
Southern Medical JournalVolume
97Issue
3Page(s)
231-235AbstractBackground: We sought to study the clinicopathologic characteristics of colorectal cancer in young female patients. We also wanted to determine the association of colorectal cancer with anemia in these female patients and, finally, to determine the effect of gender on prognosis in young patients with colorectal cancer. Methods: We performed a retrospective analysis of all young patients diagnosed with colorectal cancer between 1982 and 1999 in two teaching hospitals in New York City. Results: A total of 3,546 cases of colorectal cancer were diagnosed. Sixty-one (1.63%) of these patients were young patients and 32 (0.85%) were female. Young refers to all patients in the study who were younger than 40 years of age. The clinical presentation and mean age at presentation were very similar in both male and female patients. At presentation, 87.5% of female patients had anemia compared with only 69% of male patients. Males had a statistically significant higher mean hemoglobin level compared with females (12.87 versus 10.29 g) at P = 0.0001. Seventy-nine percent of female patients compared with 86% of male patients presented with left-sided tumors. Fifty-five percent of males presented with late stage disease compared with 68% of females (P = 0.27). Female sex seemed to adversely affect the prognosis, although this did not reach statistical significance (P = 0.08). Stage of disease was associated with worse prognosis and this was independent of sex. Age and hemoglobin were not independent predictors of mortality. Conclusion: Colorectal cancer does occur in females of childbearing age who might have a tendency to present with late stage disease as evidence from this study. Young female patients with anemia should be questioned about gastrointestinal symptoms, and colorectal cancer should definitely be in the differential diagnoses. This might conceivably allow for earlier diagnosis and potential for cure in this patient group.Enhancing treatment fidelity in health behavior change studies: Best practices and recommendations from the NIH Behavior Change Consortium
AbstractBellg, A. J., Resnick, B., Minicucci, D. S., Ogedegbe, G., Ernst, D., Borrelli, B., Hecht, J., Ory, M., Orwig, D., & Czajkowski, S. (n.d.).Publication year
2004Journal title
Health PsychologyVolume
23Issue
5Page(s)
443-451AbstractTreatment fidelity refers to the methodological strategies used to monitor and enhance the reliability and validity of behavioral interventions. This article describes a multisite effort by the Treatment Fidelity Workgroup of the National Institutes of Health Behavior Change Consortium (BCC) to identify treatment fidelity concepts and strategies in health behavior intervention research. The work group reviewed treatment fidelity practices in the research literature, identified techniques used within the BCC, and developed recommendations for incorporating these practices more consistently. The recommendations cover study design, provider training, treatment delivery, treatment receipt, and enactment of treatment skills. Funding agencies, reviewers, and journal editors are encouraged to make treatment fidelity a standard part of the conduct and evaluation of health behavior intervention research.