Olugbenga Ogedegbe
Olugbenga Ogedegbe
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Professor of Social and Behavioral Sciences
Professor for the Department of Population Health at NYU Grossman School of Medicine
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Professional overview
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Gbenga Ogedegbe, a physician, is Professor of Population Health & Medicine, Chief Division of Health & Behavior and Director Center for Healthful Behavior Change in the Department of Population Health at the School of Medicine. Gbenga is a leading expert on health disparities research; his work focuses on the implementation of evidence-based interventions for cardiovascular risk reduction in minority populations. He is Principal Investigator on numerous NIH projects, and has expanded his work globally to Sub-Saharan Africa where he is funded by the NIH to strengthen research capacity and reduce the burden of noncommunicable diseases. He has co-authored over 250 publications and his work has been recognized by receipt of several research and mentoring awards including the prestigious John M. Eisenberg Excellence in Mentorship Award from the Agency for Healthcare Research and Quality, and the Daniel Savage Science Award. He has served on numerous scientific panels including the NIH, CDC, World Health Organization, and the European Union Research Council. Prior to joining NYU, he was faculty at Cornell Weill Medical School and Columbia University College of Physicians and Surgeons.
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Education
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MPH from Columbia University, 1999Residency, Montefiore Medical Center, Internal Medicine, 1998MD from Donetsk University, 1988
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Areas of research and study
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Access to HealthcareGlobal HealthHealth of Marginalized PopulationImplementation and Impact of Public Health RegulationsImplementation scienceStroke and Cardiovascular Disease
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Publications
Publications
Effect of two 12-minute culturally targeted films on intent to call 911 for stroke
AbstractWilliams, O., Leighton-Herrmann, E., Desorbo, A., Eimicke, J., Abel-Bey, A., Valdez, L., Noble, J., Gordillo, M., Ravenell, J., Ramirez, M., Teresi, J. A., Jean-Louis, G., & Ogedegbe, G. (n.d.).Publication year
2016Journal title
NeurologyVolume
86Issue
21Page(s)
1992-1995AbstractObjective: We assessed the behavioral effect of two 12-minute culturally targeted stroke films on immediately calling 911 for suspected stroke among black and Hispanic participants using a quasi-experimental pretest-posttest design. Methods: We enrolled 102 adult churchgoers (60 black and 42 Hispanic) into a single viewing of one of the 2 stroke films - a Gospel musical (English) or Telenovela (Spanish). We measured intent to immediately call 911 using the validated 28-item Stroke Action Test in English and Spanish, along with related variables, before and immediately after the intervention. Data were analyzed using repeated-measures analysis of variance. Results: An increase in intent to call 911 was seen immediately following the single viewing. Higher self-efficacy for calling 911 was associated with intent to call 911 among Hispanic but not black participants. A composite measure of barriers to calling 911 was not associated with intent to call 911 in either group. A significant association was found between higher stroke symptom knowledge and intent to call 911 at baseline, but not immediately following the intervention. No sex associations were found; however, being older was associated with greater intent to call 911. The majority of participants would strongly recommend the films to others. One participant appropriately called 911 for a real-life stroke event. Conclusions: Narrative communication in the form of tailored short films may improve intent to call 911 for stroke among the black and Hispanic population.Factors Associated With Waiting Time for Breast Cancer Treatment in a Teaching Hospital in Ghana
AbstractDedey, F., Wu, L., Ayettey, H., Sanuade, O. A., Akingbola, T. S., Hewlett, S. A., Tayo, B. O., Cole, H. V., De-Graft Aikins, A., Ogedegbe, G., & Adanu, R. (n.d.).Publication year
2016Journal title
Health Education and BehaviorVolume
43Issue
4Page(s)
420-427AbstractBackground. Breast cancer is the leading cause of cancer-related mortality among women in Ghana. Data are limited on the predictors of poor outcomes in breast cancer patients in low-income countries; however, prolonged waiting time has been implicated. Among breast cancer patients who received treatment at Korle Bu Teaching Hospital, this study evaluated duration and factors that influenced waiting time from first presentation to start of definitive treatment. Method. We conducted a hospital-based retrospective study of 205 breast cancer patients starting definitive treatment at Korle Bu Teaching Hospital between May and December 2013. We used descriptive statistics to summarize patient characteristics. Mann–Whitney U and Kruskal–Wallis tests and Spearman rank correlation were performed to examine the patients, health system, and health worker factors associated with median waiting time. Poisson regression was used to examine the determinants of waiting time. Results. The mean age of the patients was 51.1 ± 11.8 years. The median waiting time was 5 weeks. The determinants of waiting time were level of education, age, income, marital status, ethnicity, disease stage, health insurance status, study sites, time interval between when biopsy was requested and when results were received and receipt of adequate information from health workers. Conclusion. A prolonged waiting time to treatment occurs for breast cancer patients in Ghana, particularly for older patients, those with minimal or no education, with lower income, single patients, those with late disease, those who are insured, and who did not receive adequate information from the health workers. Time to obtain biopsy reports should be shortened. Patients and providers need education on timely treatment to improve prognosis.Hypertension Treatment in Blacks: Discussion of the U.S. Clinical Practice Guidelines
AbstractWilliams, S. K., Ravenell, J., Seyedali, S., Nayef, S., & Ogedegbe, G. (n.d.).Publication year
2016Journal title
Progress in Cardiovascular DiseasesVolume
59Issue
3Page(s)
282-288AbstractBlacks are especially susceptible to hypertension (HTN) and its associated organ damage leading to adverse cardiovascular, cerebrovascular and renal outcomes. Accordingly, HTN is particularly significant in contributing to the black-white racial differences in health outcomes in the US. As such, in order to address these health disparities, practical clinical practice guidelines (CPGs) on how to treat HTN, specifically in blacks, are needed. This review article is a timely addition to the literature because the most recent U.S. CPG more explicitly emphasizes race into the algorithmic management of HTN. However, recent clinical research cautions that use of race as a proxy to determine therapeutic response to pharmaceutical agents may be erroneous. This review will address the implications of the use of race in the hypertension CPGs. We will review the rationale behind the introduction of race into the U.S. CPG and the level of evidence that was available to justify this introduction. Finally, we will conclude with practical considerations in the treatment of HTN in blacks.Is insomnia related to cardiovascular disease incidence in a sample of community-dwelling Ghanaians?
Ogedegbe, O., Zizi, F., Cole, H. V., Agyemang, C., Williams, N. J., & Newsome, V. (n.d.).Publication year
2016Journal title
SleepLinkage to care, early infant diagnosis, and perinatal transmission among infants born to HIV-infected nigerian mothers: Evidence from the healthy beginning initiative
AbstractPharr, J. R., Obiefune, M. C., Ezeanolue, C. O., Osuji, A., Ogidi, A. G., Gbadamosi, S., Patel, D., Iwelunmor, J., Yang, W., Ogedegbe, G., Ehiri, J. E., Sam-Agudu, N. A., & Ezeanolue, E. E. (n.d.).Publication year
2016Journal title
Journal of Acquired Immune Deficiency SyndromesVolume
72Page(s)
S154-S160AbstractBackground: In 2014, Nigeria accounted for 33% of all new childhood HIV infections that occurred among the 22 Global Plan priority countries where 80% of HIV-infected women reside. Even with a vertical HIV transmission rate of 27%, only 6% of infants born to HIV-infected women in Nigeria receive early infant diagnosis (EID). This article reports rates of antiretroviral prophylaxis, EID, and mother-to-child transmission in a congregation-based Healthy Beginning Initiative (HBI) designed to increase HIV testing among pregnant women in southeast Nigeria. Methods: This is a nested cohort study of HIV-exposed infants (HEI) within the HBI trial originally designed as a 2-arm cluster randomized trial. HIV-infected mothers and infants were followed between January 2013 and August 2014. Results: Across both arms of the study, 72 HIV-infected women delivered 69 live infants (1 set of twins) and 4 had miscarriages. Of the 69 live-born HEI, HIV status was known for 71% (49/69), 16% (11/69) died before sample collection, and 13% (9/69) were lost to follow-up. Complete information was available for 84% of HEI (58/69), of which 64% (37/58) received antiretroviral prophylaxis. Among the 49 infants tested for HIV, 88% (43/49) received EID within 2 months and 12% (6/49) received antibody testing after 18 months. The mother-to-child transmission rate was 8.2% (4/49). Conclusions: EID was higher and HIV transmission rate was lower among the HBI participants compared to reported rates in 2014. However, further progress is needed to achieve goals of elimination of infant HIV infection.Mentoring junior URM scientists to engage in sleep health disparities research: Experience of the NYU PRIDE Institute
AbstractJean-Louis, G., Ayappa, I., Rapoport, D., Zizi, F., Airhihenbuwa, C., Okuyemi, K., & Ogedegbe, G. (n.d.).Publication year
2016Journal title
Sleep MedicineVolume
18Page(s)
108-117AbstractAim: The aim of this study was to evaluate the National Institute of Health (NIH)-funded PRIDE Institute in Behavioral Medicine and Sleep Disorders Research at New York University (NYU) Langone Medical Center. The NYU PRIDE Institute provides intensive didactic and mentored research training to junior underrepresented minority (URM) faculty. Method: The Kirkpatrick model, a mixed-methods program evaluation tool, was used to gather data on participant's satisfaction and program outcomes. Quantitative evaluation data were obtained from all 29 mentees using the PRIDE REDcap-based evaluation tool. In addition, in-depth interviews and focus groups were conducted with 17 mentees to learn about their experiences at the institute and their professional development activities. Quantitative data were examined, and emerging themes from in-depth interviews and focus groups were studied for patterns of connection and grouped into broader categories based on grounded theory. Results: Overall, mentees rated all programmatic and mentoring aspects of the NYU PRIDE Institute very highly (80-100%). They identified the following areas as critical to their development: research and professional skills, mentorship, structured support and accountability, peer support, and continuous career development beyond the summer institute. Indicators of academic self-efficacy showed substantial improvement over time. Areas for improvement included tailoring programmatic activities to individual needs, greater assistance with publications, and identifying local mentors when K awards are sought. Conclusions: In order to promote career development, numerous factors that uniquely influence URM investigators' ability to succeed should be addressed. The NYU PRIDE Institute, which provides exposure to a well-resourced academic environment, leadership, didactic skills building, and intensive individualized mentorship proved successful in enabling URM mentees to excel in the academic environment. Overall, the institute accomplished its goals: to build an infrastructure enabling junior URM faculty to network with one another as well as with senior investigators, serving as a role model, in a supportive academic environment.MHealth to Train Community Health Nurses in Visual Inspection with Acetic Acid for Cervical Cancer Screening in Ghana
AbstractAsgary, R., Adongo, P. B., Nwameme, A., Cole, H. V. S., Maya, E., Liu, M., Yeates, K., Adanu, R., & Ogedegbe, O. (n.d.).Publication year
2016Journal title
Journal of Lower Genital Tract DiseaseVolume
20Issue
3Page(s)
239-242AbstractObjective There is a shortage of trained health care personnel for cervical cancer screening in low-/middle-income countries. We evaluated the feasibility and limited efficacy of a smartphone-based training of community health nurses in visual inspection of the cervix under acetic acid (VIA). Materials and Methods During April to July 2015 in urban Ghana, we designed and developed a study to determine the feasibility and efficacy of an mHealth-supported training of community health nurses (CHNs, n = 15) to perform VIA and to use smartphone images to obtain expert feedback on their diagnoses within 24 hours and to improve VIA skills retention. The CHNs completed a 2-week on-site introductory training in VIA performance and interpretation, followed by an ongoing 3-month text messaging-supported VIA training by an expert VIA reviewer. Results Community health nurses screened 169 women at their respective community health centers while receiving real-time feedback from the reviewer. The total agreement rate between all VIA diagnoses made by all CHNs and the expert reviewer was 95%. The mean (SD) rate of agreement between each CHN and the expert reviewer was 89.6% (12.8%). The agreement rates for positive and negative cases were 61.5% and 98.0%, respectively. Cohen κ statistic was 0.67 (95% CI = 0.45-0.88). Around 7.7% of women tested VIA positive and received cryotherapy or further services. Conclusions Our findings demonstrate the feasibility and efficacy of mHealth-supported VIA training of CHNs and have the potential to improve cervical cancer screening coverage in Ghana.Music Upper Limb Therapy—Integrated: An enriched collaborative approach for stroke rehabilitation
AbstractRaghavan, P., Geller, D., Guerrero, N., Aluru, V., Eimicke, J. P., Teresi, J. A., Ogedegbe, G., Palumbo, A., & Turry, A. (n.d.).Publication year
2016Journal title
Frontiers in Human NeuroscienceVolume
10AbstractStroke is a leading cause of disability worldwide. It leads to a sudden and overwhelming disruption in one’s physical body, and alters the stroke survivors’ sense of self. Long-term recovery requires that bodily perception, social participation and sense of self are restored; this is challenging to achieve, particularly with a single intervention. However, rhythmic synchronization of movement to external stimuli facilitates sensorimotor coupling for movement recovery, enhances emotional engagement and has positive effects on interpersonal relationships. In this proof-of-concept study, we designed a group music-making intervention, Music Upper Limb Therapy-Integrated (MULT-I), to address the physical, psychological and social domains of rehabilitation simultaneously, and investigated its effects on long-term post-stroke upper limb recovery. The study used a mixed-method pre-post design with 1-year follow up. Thirteen subjects completed the 45-min intervention twice a week for 6 weeks. The primary outcome was reduced upper limb motor impairment on the Fugl-Meyer Scale (FMS). Secondary outcomes included sensory impairment (two-point discrimination test), activity limitation (Modified Rankin Scale, MRS), well-being (WHO well-being index), and participation (Stroke Impact Scale, SIS). Repeated measures analysis of variance (ANOVA) was used to test for differences between pre- and post-intervention, and 1-year follow up scores. Significant improvement was found in upper limb motor impairment, sensory impairment, activity limitation and well-being immediately post-intervention that persisted at 1 year. Activities of daily living and social participation improved only from post-intervention to 1-year follow up. The improvement in upper limb motor impairment was more pronounced in a subset of lower functioning individuals as determined by their pre-intervention wrist range of motion. Qualitatively, subjects reported new feelings of ownership of their impaired limb, more spontaneous movement, and enhanced emotional engagement. The results suggest that the MULT-I intervention may help stroke survivors re-create their sense of self by integrating sensorimotor, emotional and interoceptive information and facilitate long-term recovery across multiple domains of disability, even in the chronic stage post-stroke. Randomized controlled trials are warranted to confirm the efficacy of this approach. Clinical Trial Registration: National Institutes of Health, clinicaltrials.gov, NCT01586221.Perceived spatial stigma, body mass index and blood pressure: A global positioning system study among low-income housing residents in New York City
AbstractDuncan, D. T., Ruff, R. R., Chaix, B., Regan, S. D., Williams, J. H., Ravenell, J., Bragg, M. A., Ogedegbe, G., & Elbel, B. (n.d.).Publication year
2016Journal title
Geospatial HealthVolume
11Issue
2Page(s)
164-173AbstractPrevious research has highlighted the salience of spatial stigma on the lives of low-income residents, but has been theoretical in nature and/or has predominantly utilised qualitative methods with limited generalisability and ability to draw associations between spatial stigma and measured cardiovascular health outcomes. The primary objective of this study was to evaluate relationships between perceived spatial stigma, body mass index (BMI), and blood pressure among a sample of low-income housing residents in New York City (NYC). Data come from the community-based NYC Low-income Housing, Neighborhoods and Health Study. We completed a crosssectional analysis with survey data, which included the four items on spatial stigma, as well objectively measured BMI and blood pressure data (analytic n=116; 96.7% of the total sample). Global positioning systems (GPS) tracking of the sample was conducted for a week. In multivariable models (controlling for individual-level age, gender, race/ethnicity, education level, employment status, total household income, neighborhood percent non-Hispanic Black and neighborhood median household income) we found that participants who reported living in an area with a bad neighborhood reputation had higher BMI (B=4.2, 95%CI: -0.01, 8.3, P=0.051), as well as higher systolic blood pressure (B=13.2, 95%CI: 3.2, 23.1, P=0.01) and diastolic blood pressure (B=8.5, 95%CI: 2.8, 14.3, P=0.004). In addition, participants who reported living in an area with a bad neighborhood reputation had increased risk of obesity/overweight [relative risk (RR)=1.32, 95%CI: 1.1, 1.4, P=0.02) and hypertension/pre-hypertension (RR=1.66, 95%CI: 1.2, 2.4, P=0.007). However, we found no differences in spatial mobility (based GPS data) among participants who reported living in neighborhoods with and without spatial stigma (P>0.05). Further research is needed to investigate how placebased stigma may be associated with impaired cardiovascular health among individuals in stigmatised neighborhoods to inform effective cardiovascular risk reduction interventions.Predictors of Changes in Medication Adherence in Blacks with Hypertension: Moving Beyond Cross-Sectional Data
AbstractSchoenthaler, A. M., Butler, M., Chaplin, W., Tobin, J., & Ogedegbe, G. (n.d.).Publication year
2016Journal title
Annals of Behavioral MedicineVolume
50Issue
5Page(s)
642-652AbstractBackground: Many studies have examined the multiple correlates of non-adherence in Blacks. However, they are largely cross-sectional; thus, these studies are unable to examine their predictive value on long-term medication adherence. Purpose: The purpose of this study is to examine the predictive role of key psychosocial and interpersonal factors on changes in medication adherence over a 1-year period. Methods: Data were collected from 815 Black patients with hypertension followed in community health centers. Hypothesized predictor variables included self-efficacy, depressive symptoms, social support, and patient-provider communication measured at baseline, 6, and 12 months. The dependent variable, medication adherence was assessed at baseline, 6, and 12 months. Latent Growth Modeling was used to evaluate the pathways between the latent predictor variables and medication adherence. Results: Participants were mostly female, low-income, with high school education or less, and mean age of 57 years. At baseline, high self-efficacy was associated with low depressive symptoms (β = −0.22, p = 0.05), collaborative patient-provider communication (β = 0.17, p = 0.006), and better medication adherence (β = 1.04, p < 0.001). More social support and collaborative patient-provider communication were associated with low depressive symptoms (β = −0.08, p = 0.02; β = −0.18, p = 0.01). More social support was positively associated with collaborative patient-provider communication (β = 0.32, p < 0.001). In the longitudinal model, increasing self-efficacy over time predicted improvements in medication adherence 1 year later (β = 1.76, p < 0.001; CFI = 0.95; RMSEA = 0.04; SRMR = 0.04; Chi-Squared Index of Model Fit = 1128.54). Conclusions: Self-efficacy is a key predictor of medication adherence over time in Black patients with hypertension. Initial levels of self-efficacy are influenced by the presence of depressive symptoms as well as the perceived quality of patient-provider communication.Psychological distress and hypertension: results from the national health interview survey for 2004-2013
AbstractOjike, N., Sowers, J. R., Seixas, A., Ravenell, J., Rodriguez-Figueroa, G., Awadallah, M., Zizi, F., Jean-Louis, G., Ogedegbe, O., & McFarlane, S. I. (n.d.).Publication year
2016Journal title
CardioRenal MedicineVolume
6Issue
3Page(s)
198-208AbstractBackground/Aims: Psychological conditions are increasingly linked with cardiovascular disorders. We aimed to examine the association between psychological distress and hypertension. Methods: We used data from the National Health Interview Survey for 2004-2013. Hypertension was self-reported and the 6-item Kessler Psychological Distress Scale was used to assess psychological distress (a score ≥13 indicated distress). We used a logistic regression model to test the assumption that hypertension was associated with psychological distress. Results: Among the study participants completing the survey (n = 288,784), 51% were female; the overall mean age (±SEM) was 35.3 ± 0.02 years and the mean body mass index was 27.5 ± 0.01. In the entire sample, the prevalence of psychological distress was 3.2%. The adjusted odds of reporting hypertension in psychologically distressed individuals was 1.53 (95% CI = 1.31-1.80, p = 0.01). Conclusion: The findings suggest that psychological distress is associated with higher odds of hypertension after adjusting for other risk factors for high blood pressure. Further studies are needed to confirm these findings and to elucidate the mechanisms by which stress increases hypertension risk.Psychosocial correlates and predictors of resistant hypertension in the Jackson Heart Study (JHS)”
Shallcross, A. J., Butler, M., Tanner, R. M., Muntner, P., Shimbo, D., Bress, A., Ogedegbe, O., & Spruill, T. M. (n.d.).Publication year
2016Journal title
Psychosomatic MedicineVolume
78Issue
3Page(s)
A129 - A129Psychosocial Correlates of Nocturnal Blood Pressure Dipping in African Americans: The Jackson Heart Study
AbstractSpruill, T. M., Shallcross, A. J., Ogedegbe, G., Chaplin, W. F., Butler, M., Palfrey, A., Shimbo, D., Muntner, P., Sims, M., Sarpong, D. F., Agyemang, C., & Ravenell, J. (n.d.).Publication year
2016Journal title
American Journal of HypertensionVolume
29Issue
8Page(s)
904-912AbstractBACKGROUND: African Americans exhibit a lower degree of nocturnal blood pressure (BP) dipping compared with Whites, but the reasons for reduced BP dipping in this group are not fully understood. The aim of this study was to identify psychosocial factors associated with BP dipping in a population-based cohort of African Americans. METHODS: This cross-sectional study included 668 Jackson Heart Study (JHS) participants with valid 24-hour ambulatory BP data and complete data on psychosocial factors of interest including stress, negative emotions, and psychosocial resources (e.g., perceived support). The association of each psychosocial factor with BP dipping percentage and nondipping status (defined as <10% BP dipping) was assessed using linear and Poisson regression models, respectively, with progressive adjustment for demographic, socioeconomic, biomedical, and behavioral factors. RESULTS: The prevalence of nondipping was 64%. Higher depressive symptoms, higher hostility, and lower perceived social support were associated with a lower BP dipping percentage in unadjusted models and after adjustment for age, sex, body mass index, and mean 24-hour systolic BP (P < 0.05). Only perceived support was associated with BP dipping percentage in fully adjusted models. Also, after full multivariable adjustment, the prevalence ratio for nondipping BP associated with 1 SD (7.1 unit) increase in perceived support was 0.93 (95% CI: 0.88-0.99). No other psychosocial factors were associated with nondipping status. CONCLUSIONS: Lower perceived support was associated with reduced BP dipping in this study. The role of social support as a potentially modifiable determinant of nocturnal BP dipping warrants further investigation.Racial and Ethnic Differences in Heart Failure Readmissions and Mortality in a Large Municipal Healthcare System
AbstractDurstenfeld, M. S., Ogedegbe, O., Katz, S. D., Park, H., & Blecker, S. (n.d.).Publication year
2016Journal title
JACC: Heart FailureVolume
4Issue
11Page(s)
885-893AbstractObjectives This study sought to determine whether racial and ethnic differences exist among patients with similar access to care. We examined outcomes after heart failure hospitalization within a large municipal health system. Background Racial and ethnic disparities in heart failure outcomes are present in administrative data, and one explanation is differential access to care. Methods We performed a retrospective cohort study of 8,532 hospitalizations of adults with heart failure at 11 hospitals in New York City from 2007 to 2010. Primary exposure was ethnicity and race, and outcomes were 30- and 90-day readmission and 30-day and 1-year mortality rates. Generalized estimating equations were used to test for associations between ethnicity and race and outcomes with covariate adjustment. Results Of the number of hospitalizations included, 4,305 (51%) were for blacks, 2,449 (29%) were for Hispanics, 1,494 (18%) were for whites, and 284 (3%) were for Asians. Compared to whites, blacks and Asians had lower 1-year mortality, with adjusted odds ratios (aORs) of 0.75 (95% confidence interval [CI]: 0.59 to 0.94) and 0.57 (95% CI: 0.38 to 0.85), respectively, and rates for Hispanics were not significantly different (aOR: 0.81; 95% CI: 0.64 to 1.03). Hispanics had higher odds of readmission than whites (aOR: 1.27; 95% CI: 1.03 to 1.57) at 30 (aOR: 1.40; 95% CI: 1.15 to 1.70) and 90 days. Blacks had higher odds of readmission than whites at 90 days (aOR:1.21; 95% CI: 1.01 to 1.47). Conclusions Racial and ethnic differences in outcomes after heart failure hospitalization were present within a large municipal health system. Access to a municipal health system may not be sufficient to eliminate disparities in heart failure outcomes.Rates and predictors of uncontrolled hypertension among hypertensive homeless adults using new york city shelter-based clinics
AbstractAsgary, R., Sckell, B., Alcabes, A., Naderi, R., Schoenthaler, A., & Ogedegbe, G. (n.d.).Publication year
2016Journal title
Annals of family medicineVolume
14Issue
1Page(s)
41-46AbstractPURPOSE We undertook a study to determine the rates, predictors, and barriers to blood pressure control among homeless and nonhomeless hypertensive adult patients from 10 New York City shelter-based clinics. METHODS The study was a retrospective chart review of blood pressure measurements, sociodemographic characteristics, and factors associated with homelessness and hypertension extracted from the medical records of a random sample of hypertensive patients (N = 210) in 2014. RESULTS Most patients were African American or Hispanic; 24.8% were female, and 84.3% were homeless for a mean duration of 3.07 years (SD = 5.04 years). Homeless adult patients were younger, had less insurance, and were more likely to be a current smoker and alcohol abuser. Of the 210 hypertensive patients, 40.1% of homeless and 33.3% of nonhomeless patients had uncontrolled blood pressure (P = .29) when compared with US rates for hypertensive adults, which range between 19.6% and 24.8%, respectively; 15.8% of homeless patients had stage 2 hypertension (P = .27). Homeless hypertensive patients with diabetes or multiple chronic diseases had better blood pressure control (P <.01). In logistic regression, lack of insurance was associated with inadequate blood pressure control (P <.05). CONCLUSIONS The high rate of uncontrolled hypertension among hypertensive homeless adults is alarming. We propose comprehensive approaches to improve social support, access to medical insurance, and medication adherence, the lack of which complicate blood pressure control, targeted health education, and life style modifications using mobile health strategies for this mobile population.Reducing Health Inequities in the U.S.: Recommendations From the NHLBI's Health Inequities Think Tank Meeting
AbstractSampson, U. K. A., Kaplan, R. M., Cooper, R. S., Diez Roux, A. V., Marks, J. S., Engelgau, M. M., Peprah, E., Mishoe, H., Boulware, L. E., Felix, K. L., Califf, R. M., Flack, J. M., Cooper, L. A., Gracia, J. N., Henderson, J. A., Davidson, K. W., Krishnan, J. A., Lewis, T. T., Sanchez, E., … Mensah, G. A. (n.d.).Publication year
2016Journal title
Journal of the American College of CardiologyVolume
68Issue
5Page(s)
517-524AbstractThe National, Heart, Lung, and Blood Institute convened a Think Tank meeting to obtain insight and recommendations regarding the objectives and design of the next generation of research aimed at reducing health inequities in the United States. The panel recommended several specific actions, including: 1) embrace broad and inclusive research themes; 2) develop research platforms that optimize the ability to conduct informative and innovative research, and promote systems science approaches; 3) develop networks of collaborators and stakeholders, and launch transformative studies that can serve as benchmarks; 4) optimize the use of new data sources, platforms, and natural experiments; and 5) develop unique transdisciplinary training programs to build research capacity. Confronting health inequities will require engaging multiple disciplines and sectors (including communities), using systems science, and intervening through combinations of individual, family, provider, health system, and community-targeted approaches. Details of the panel's remarks and recommendations are provided in this report.Research needs to improve hypertension treatment and control in African Americans
Whelton, P. K., Einhorn, P. T., Muntner, P., Appel, L. J., Cushman, W. C., Roux, A. V., Ferdinand, K. C., Rahman, M., Taylor, H. A., Ard, J., Arnett, D. K., Carter, B. L., Davis, B. R., Freedman, B. I., Cooper, L. A., Cooper, R., Desvigne-Nickens, P., Gavini, N., Go, A. S., … Cutler, J. A. (n.d.).Publication year
2016Journal title
HypertensionVolume
68Issue
5Page(s)
1066-1072Research needs to improve hypertension treatment and control in African Americans
Whelton, P. K., Einhorn, P. T., Muntner, P., Appel, L. J., Cushman, W. C., Roux, A. V., Ferdinand, K. C., Rahman, M., Taylor, H. A., Ard, J., Arnett, D. K., Carter, B. L., Davis, B. R., Freedman, B. I., Cooper, L. A., Cooper, R., Desvigne-Nickens, P., Gavini, N., Go, A. S., … Cutler, J. A. (n.d.).Publication year
2016Journal title
HypertensionVolume
68Issue
5Page(s)
1066-1072Results from the trial using motivational interviewing, positive affect, and self-affirmation in African Americans with hypertension (TRIUM PH)
AbstractBoutin-Foster, C., Offidani, E., Kanna, B., Ogedegbe, G., Ravenell, J., Scott, E., Rodriguez, A., Ramos, R., Michelen, W., Gerber, L. M., & Charlson, M. (n.d.).Publication year
2016Journal title
Ethnicity and DiseaseVolume
26Issue
1Page(s)
51-60AbstractObjective: Our objective was to determine the effectiveness of combining positive affect and self-affirmation strategies with motivational interviewing in achieving blood pressure control among hypertensive African Americans (AA) compared with AA hypertensives in an education-only control group. Design: Randomized trial. Setting: Ambulatory practices in the South Bronx and Harlem, New York City. Participants: African American adults with uncontrolled hypertension. Interventions: Participants were randomized to a positive affect and self-affirmation intervention or an education control group. The positive affect and self-affirmation intervention involved having participants think about things that made them happy and that reminded them of their core values on a daily basis. These strategies were reinforced every two months through motivational interviewing. The control arm received a workbook of strategies on blood pressure control. All participants were called every two months for one year. Main Outcomes: Blood pressure control rate. Results: A total of 238 participants were randomized. The average age was 56 ± 11 years, approximately 70% were female, 80% were not married, and up to 70% had completed high school. There was no difference in control rates between the intervention and the control group. However, at one year, female participants were more likely to be controlled. Participants with high depressive symptoms or high perceived stress at baseline were less likely to be controlled. Conclusions: While this study did not demonstrate an intervention effect, it does provide important insight into the psychosocial factors that may underlie blood pressure control in African Americans. Implications for future behavioral intervention trials are discussed.Sex Disparity in Blood Pressure Levels Among Nigerian Health Workers
AbstractAdeoye, A. M., Adebiyi, A., Owolabi, M. O., Lackland, D. T., Ogedegbe, G., & Tayo, B. O. (n.d.).Publication year
2016Journal title
Journal of Clinical HypertensionVolume
18Issue
7Page(s)
685-689AbstractSex disparity in hypertension prevalence is well established in developed nations; however, there is paucity of data on the distribution of hypertension prevalence between the sexes in developing countries. Therefore, the authors examined sex differences in hypertension prevalence and cardiovascular risk factors in a sample of 352 healthy hospital workers in Nigeria. The mean ages of the men and women were 37.2±7.9 and 44.7±9.1 years, respectively. Thirty-five percent of participants were hypertensive, with 54% on treatment and 70% with controlled blood pressure. Men had a higher prevalence of hypertension (38.4% vs 33.0%) and prehypertension (37.6% vs 29.7%). Women had significantly higher odds of developing hypertension and of being on treatment. Mean blood pressure and fasting plasma glucose values were higher in men, while women were more often older, obese, and dyslipidemic and had a lower mean estimated glomerular filtration rate (P<.0001). These findings indicate sex disparity in blood pressure among hospital employees. Sex-focused management of hypertension is therefore advocated for hospital employees.Social and behavioral predictors of insufficient sleep among African Americans and Caucasians
AbstractWilliams, N. J., Grandner, M. A., Wallace, D. M., Cuffee, Y., Airhihenbuwa, C., Okuyemi, K., Ogedegbe, G., & Jean-Louis, G. (n.d.).Publication year
2016Journal title
Sleep MedicineVolume
18Page(s)
103-107AbstractBackground: Few studies have examined the social and behavioral predictors of insufficient sleep. Objective: To assess the social and behavioral predictors of insufficient sleep in the U.S. population. Methods: Data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Telephone interviews were conducted in six representative states that completed the optional sleep module. A total of 31,059 respondents were included in the present analysis. BRFSS-provided weights were applied to analyses to adjust for the use of complex design. Results: The mean age for the sample was 56 ± 16 years, with 63% of the sample being female; 88% identified as non-Hispanic white and 12% identified as non-Hispanic black; 42% were not married and 8% did not have a high school degree. The prevalence of insufficient sleep (<7 hours) was 37%. Multivariate-adjusted logistic regression revealed associations of four important factors with insufficient sleep, which were: working more than 40 hours per week [OR = 1.65, p < 0.001, 95% CI = 1.65-1.66], black race/ethnicity [OR = 1.37, p < 0.001, 95% CI = 1.37-1.38], history of heart disease [OR = 1.26, p < 0.001, 95% CI = 1.25-1.28], care-giving to family/friends [OR = 1.50, p < 0.001, 95% CI = 1.49-1.51], and lack of social and emotional support [OR = 1.24, p < 0.001, 95% CI = 1. 23-1.25]. Conclusion: Social and behavioral predictors of health uniquely contribute to the report of insufficient sleep and should be considered when developing programs to increase awareness of the adverse effects of insufficient sleep.Tailored Approach to Sleep Health Education (TASHE): A Community-engaged, Multiple-Stakeholder-Informed Project to Promote Awareness of Sleep Apnea Among Blacks
Robbins, R., Rapoport, D. M., Allegrante, J. P., Cohall, A. T., Ogedegbe, O., Williams, N. J., Newsome, V., & Jean-Louis, G. (n.d.).Publication year
2016Journal title
TrialsTesting the use of practice facilitation in a cluster randomized stepped-wedge design trial to improve adherence to cardiovascular disease prevention guidelines: HealthyHearts NYC
AbstractShelley, D. R., Ogedegbe, G., Anane, S., Wu, W. Y., Goldfeld, K., Gold, H. T., Kaplan, S., & Berry, C. (n.d.).Publication year
2016Journal title
Implementation ScienceVolume
11Issue
1AbstractBackground: HealthyHearts NYC (HHNYC) will evaluate the effectiveness of practice facilitation as a quality improvement strategy for implementing the Million Hearts' ABCS treatment guidelines for reducing cardiovascular disease (CVD) among high-risk patients who receive care in primary care practices in New York City. ABCS refers to (A) aspirin in high-risk individuals; (B) blood pressure control; (C) cholesterol management; and (S) smoking cessation. The long-term goal is to create a robust infrastructure for implementing and disseminating evidence-based practice guidelines (EBPG) in primary care practices. Methods/design: We are using a stepped-wedge cluster randomized controlled trial design to evaluate the implementation process and the impact of practice facilitation (PF) versus usual care on ABCS outcomes in 250 small primary care practices. Randomization is at the practice site level, all of which begin as part of the control condition. The intervention consists of one year of PF that includes a combination of one-on-one onsite visits and shared learning across practice sites. PFs will focus on helping sites implement evidence-based components of patient-centered medical home (PCMH) and the chronic care model (CCM), which include decision support, provider feedback, self-management tools and resources, and linkages to community-based services. Discussion: We hypothesize that practice facilitation will result in superior clinical outcomes compared to usual care; that the effects of practice facilitation will be mediated by greater adoption of system changes in accord with PCMH and CCM; and that there will be increased adaptive reserve and change capacity.The Global Alliance for Chronic Diseases Supports 15 Major Studies in Hypertension Prevention and Control in Low- and Middle-Income Countries
W.Tobe, S., Attaran, A., De Villiers, A., Featherstone, A., Forrest, J., Kalyesubula, R., Kamwesiga, J., Kengne, A. P., Lopez, P. C., Mills, E., Mukasa, B., Muldoon, K., Tayari, J. C., Yaya, S., Kien Keat, N., Lopez, P., Casas, J. L., McCready, T., McKee, M., … Warth, S. (n.d.).Publication year
2016Journal title
Journal of Clinical HypertensionVolume
18Issue
7Page(s)
600-605Toward the sustainability of health interventions implemented in sub-Saharan Africa: A systematic review and conceptual framework
AbstractIwelunmor, J., Blackstone, S., Veira, D., Nwaozuru, U., Airhihenbuwa, C., Munodawafa, D., Kalipeni, E., Jutal, A., Shelley, D., & Ogedegbe, G. (n.d.).Publication year
2016Journal title
Implementation ScienceVolume
11Issue
1AbstractBackground: Sub-Saharan Africa (SSA) is facing a double burden of disease with a rising prevalence of non-communicable diseases (NCDs) while the burden of communicable diseases (CDs) remains high. Despite these challenges, there remains a significant need to understand how or under what conditions health interventions implemented in sub-Saharan Africa are sustained. The purpose of this study was to conduct a systematic review of empirical literature to explore how health interventions implemented in SSA are sustained. Methods: We searched MEDLINE, Biological Abstracts, CINAHL, Embase, PsycInfo, SCIELO, Web of Science, and Google Scholar for available research investigating the sustainability of health interventions implemented in sub-Saharan Africa. We also used narrative synthesis to examine factors whether positive or negative that may influence the sustainability of health interventions in the region. Results: The search identified 1819 citations, and following removal of duplicates and our inclusion/exclusion criteria, only 41 papers were eligible for inclusion in the review. Twenty-six countries were represented in this review, with Kenya and Nigeria having the most representation of available studies examining sustainability. Study dates ranged from 1996 to 2015. Of note, majority of these studies (30 %) were published in 2014. The most common framework utilized was the sustainability framework, which was discussed in four of the studies. Nineteen out of 41 studies (46 %) reported sustainability outcomes focused on communicable diseases, with HIV and AIDS represented in majority of the studies, followed by malaria. Only 21 out of 41 studies had clear definitions of sustainability. Community ownership and mobilization were recognized by many of the reviewed studies as crucial facilitators for intervention sustainability, both early on and after intervention implementation, while social and ecological conditions as well as societal upheavals were barriers that influenced the sustainment of interventions in sub-Saharan Africa. Conclusion: The sustainability of health interventions implemented in sub-Saharan Africa is inevitable given the double burden of diseases, health care worker shortage, weak health systems, and limited resources. We propose a conceptual framework that draws attention to sustainability as a core component of the overall life cycle of interventions implemented in the region.