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
Treatment of Hypertension in Patients with Coronary Artery Disease. A Case-Based Summary of the 2015 AHA/ACC/ASH Scientific Statement
AbstractRosendorff, C., Lackland, D. T., Allison, M., Aronow, W. S., Black, H. R., Blumenthal, R. S., Cannon, C. P., De Lemos, J. A., Elliott, W. J., Findeiss, L., Gersh, B. J., Gore, J. M., Levy, D., Long, J. B., O’Connor, C. M., O’Gara, P. T., Ogedegbe, O., Oparil, S., & White, W. B. (n.d.).Publication year
2016Journal title
American Journal of MedicineVolume
129Issue
4Page(s)
372-378AbstractThe 2015 American Heart Association/American College of Cardiology/American Society of Hypertension Scientific Statement "Treatment of Hypertension in Patients with Coronary Artery Disease" is summarized in the context of a clinical case. The Statement deals with target blood pressures, and the optimal agents for the treatment of hypertension in patients with stable angina, in acute coronary syndromes, and in patients with ischemic heart failure. In all cases, the recommended blood pressure target is <140/90 mm Hg, but <130/80 mm Hg may be appropriate, especially in those with a history of a previous myocardial infarction or stroke, or at high risk for developing either. These numbers may need to be revised after the publication of the SPRINT data. Appropriate management should include beta-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and in the case of heart failure, aldosterone antagonists. Thiazide or thiazide-like (chlorthalidone) diuretics and calcium channel blockers can be used for the management of hypertension, but the evidence for improved outcomes compared with other agents in hypertension with coronary artery disease is meager. Loop diuretics should be reserved for patients with New York Heart Association Class III and IV heart failure or with a glomerular filtration rate of <30 mL/min.Uncontrolled blood pressure and risk of sleep apnea among blacks: Findings from the metabolic syndrome outcome (MetSO) study
AbstractSeixas, A., Ravenell, J., Williams, N. J., Williams, S. K., Zizi, F., Ogedegbe, G., & Jean-Louis, G. (n.d.).Publication year
2016Journal title
Journal of human hypertensionVolume
30Issue
3Page(s)
149-152AbstractUncontrolled blood pressure (BP) is linked to increased risk of obstructive sleep apnea (OSA). However, few studies have assessed the impact of this relationship among blacks with metabolic syndrome (MetS). Data for this study were collected from 1035 blacks (mean age=62±13 years) enrolled in the Metabolic Syndrome Outcome study. Patients with a score ≥6 on the Apnea Risk Evaluation System were considered at risk for OSA. Of the sample, 77.1% were low-to-high OSA risk and 92.3% were hypertensive, of which 16.8% had uncontrolled BP levels. Analysis also showed that 60.4% were diabetic, 8.9% had a stroke history, 74.3% had dyslipidemia, 69.8% were obese and 30.9% had a history of heart disease. Logistic regression analyses were employed to investigate associations between uncontrolled BP and OSA risk, while adjusting for known covariates. Findings showed that uncontrolled BP independently increased the odds of OSA risk twofold (odds ratio=2.02, 95% confidence interval=1.18-3.48, P<0.05). In conclusion, our findings show that uncontrolled BP was associated with a twofold greater risk of OSA among blacks, suggesting that those with MetS and who have uncontrolled BP should be screened for the presence of OSA.Using Qualitative Methods to Assess the Conceptual Equivalence of the Spanish and English Stroke Action Test (STAT)
AbstractRamirez, M., Teresi, J. A., Ogedegbe, G., & Williams, O. (n.d.).Publication year
2016Journal title
Qualitative Health ResearchVolume
26Issue
13Page(s)
1812-1822AbstractMembers of racial/ethnic minorities, in contrast to majority groups, experience disparities in stroke risk factors, recognition, evaluation, and treatment. This article describes the use of qualitative methods to examine the cultural and lifestyle appropriateness, clarity of item-wording, comprehension of item intent, and conceptual equivalence of the developed Spanish and the revised English Stroke Action Test (which includes three additional atypical stroke symptoms more common in women). Thirty in-depth cognitive interviews were conducted (10 in Spanish) using concurrent structured probes. The desired ultimate outcome was to obtain conceptually equivalent measures in both languages. Four sources of variability in comprehension were identified: unfamiliar and/or idiosyncratic Spanish words used in translation; phrases in the original (English) and in the literal (Spanish) translation that were not understood; and unclear intended meaning of the original (English) items. Cognitive interviews helped identify problematic items, highlighted potential response errors, and provided insight regarding putative causes for inconsistent interpretation.White-Coat Effect Among Older Adults: Data From the Jackson Heart Study
AbstractTanner, R. M., Shimbo, D., Seals, S. R., Reynolds, K., Bowling, C. B., Ogedegbe, G., & Muntner, P. (n.d.).Publication year
2016Journal title
Journal of Clinical HypertensionVolume
18Issue
2Page(s)
139-145AbstractMany adults with elevated clinic blood pressure (BP) have lower BP when measured outside the clinic. This phenomenon, the "white-coat effect," may be larger among older adults, a population more susceptible to the adverse effects of low BP. The authors analyzed data from 257 participants in the Jackson Heart Study with elevated clinic BP (systolic/diastolic BP [SBP/DBP] ≥140/90 mm Hg) who underwent ambulatory BP monitoring (ABPM). The white-coat effect for SBP was larger for participants 60 years and older vs those younger than 60 years in the overall population (12.2 mm Hg, 95% confidence interval [CI], 9.2-15.1 mm Hg and 8.4 mm Hg, 95% CI, 5.7-11.1, respectively; P=06) and among those without diabetes or chronic kidney disease (15.2 mm Hg, 95% CI, 10.1-20.2 and 8.6 mm Hg, 95% CI, 5.0-12.3, respectively; P=04). After multivariable adjustment, clinic SBP ≥150 mm Hg vs <150 mm Hg was associated with a larger white-coat effect. Studies are needed to investigate the role of ABPM in guiding the initiation and titration of antihypertensive treatment, especially among older adults.A Concept Mapping Study of Physicians' Perceptions of Factors Influencing Management and Control of Hypertension in Sub-Saharan Africa
AbstractIwelunmor, J., Blackstone, S., Gyamfi, J., Airhihenbuwa, C., Plange-Rhule, J., Tayo, B., Adanu, R., & Ogedegbe, G. (n.d.).Publication year
2015Journal title
International Journal of HypertensionVolume
2015AbstractHypertension, once a rare problem in Sub-Saharan Africa (SSA), is predicted to be a major cause of death by 2020 with mortality rates as high as 75%. However, comprehensive knowledge of provider-level factors that influence optimal management is limited. The objective of the current study was to discover physicians' perceptions of factors influencing optimal management and control of hypertension in SSA. Twelve physicians attending the Cardiovascular Research Training (CaRT) Institute at the University of Ghana, College of Health Sciences, were invited to complete a concept mapping process that included brainstorming the factors influencing optimal management and control of hypertension in patients, sorting and organizing the factors into similar domains, and rating the importance and feasibility of efforts to address these factors. The highest ranked important and feasible factors include helping patients accept their condition and availability of adequate equipment to enable the provision of needed care. The findings suggest that patient self-efficacy and support, physician-related factors, policy factors, and economic factors are important aspects that must be addressed to achieve optimal hypertension management. Given the work demands identified by physicians, future research should investigate cost-effective strategies of shifting physician responsibilities to well-trained no-physician clinicians in order to improve hypertension management.A Global Perspective on Cardiovascular Disease in Vulnerable Populations
AbstractYeates, K., Lohfeld, L., Sleeth, J., Morales, F., Rajkotia, Y., & Ogedegbe, O. (n.d.).Publication year
2015Journal title
Canadian Journal of CardiologyVolume
31Issue
9Page(s)
1081-1093AbstractCardiovascular disease (CVD) is a major contributor to the growing public health epidemic in chronic diseases. Much of the disease and disability burden from CVDs are in people younger than the age of 70 years in low- and middle-income countries, formerly "the developing world." The risk of CVD is heavily influenced by environmental conditions and lifestyle variables. In this article we review the scope of the CVD problem in low- and middle-income countries, including economic factors, risk factors, at-risk groups, and explanatory frameworks that hypothesize the multifactorial drivers. Finally, we discuss current and potential interventions to reduce the burden of CVD in vulnerable populations including research needed to evaluate and implement promising solutions for those most at risk.A narrative synthesis of the health systems factors influencing optimal hypertension control in Sub-Saharan Africa
AbstractIwelunmor, J., Plange-Rhule, J., Airhihenbuwa, C. O., Ezepue, C., & Ogedegbe, O. (n.d.).Publication year
2015Journal title
PloS oneVolume
10Issue
7AbstractIntroduction: In sub-Saharan Africa (SSA), an estimated 74.7 million individuals are hypertensive. Reducing the growing burden of hypertension in sub-Saharan Africa will require a variety of strategies one of which is identifying the extent to which actions originating at the health systems level improves optimal management and control. Methods and Results: We conducted a narrative synthesis of available papers examining health systems factors influencing optimal hypertension in SSA. Eligible studies included those that analyzed the impact of health systems on hypertension awareness, treatment, control and medication adherence. Twenty-five articles met the inclusion criteria and the narrative synthesis identified the following themes: 1) how physical resources influence mechanisms supportive of optimal hypertension control; 2) the role of human resources with enabling and/or inhibiting hypertension control goals; 3) the availability and/or use of intellectual resources; 4) how health systems financing facilitate and/or compromise access to products necessary for optimal hypertension control. Conclusion: The findings highlight the need for further research on the health systems factors that influence management and control of hypertension in the region.Associations of Short Sleep and Shift Work Status with Hypertension among Black and White Americans
AbstractCeïde, M. E., Pandey, A., Ravenell, J., Donat, M., Ogedegbe, G., & Jean-Louis, G. (n.d.).Publication year
2015Journal title
International Journal of HypertensionVolume
2015AbstractObjective. The purpose of this study was to investigate whether short sleepers (<6 hrs) who worked the non-day-shift were at greater likelihood of reporting hypertension and if these associations varied by individuals' ethnicity. Methods. Analysis was based on the 2010 National Health Interview Survey (NHIS). A total of 59,199 American adults provided valid data for the present analyses (mean age = 46.2 ± 17.7 years; 51.5% were female). Respondents provided work schedule and estimated habitual sleep durations as well as self-report of chronic conditions. Results. Of the sample, 30.8% reported a diagnosis of hypertension, 79.1% reported daytime shift work, 11.0% reported rotating shift work, and 4.0% reported night shift work. Logistic regression analysis showed that shift work was significantly associated with hypertension among Blacks [OR = 1.35, CI: 1.06-1.72. P < 0.05 ], but not among Whites [OR = 1.01, CI: 0.85-1.20, NS]. Black shift workers sleeping less than 6 hours had significantly increased odds of reporting hypertension [OR = 1.81, CI: 1.29-2.54, P < 0.01 ], while their White counterparts did not [OR = 1.17, CI: 0.90-1.52, NS]. Conclusions. Findings suggest that Black Americans working the non-day-shift especially with short sleep duration have increased odds of reporting hypertension.Behaviour change strategies for reducing blood pressure-related disease burden: Findings from a global implementation research programme
AbstractPeiris, D., Thompson, S. R., Beratarrechea, A., Cárdenas, M. K., Diez-Canseco, F., Goudge, J., Gyamfi, J., Kamano, J. H., Irazola, V., Johnson, C., Kengne, A. P., Keat, N. K., Miranda, J. J., Mohan, S., Mukasa, B., Ng, E., Nieuwlaat, R., Ogedegbe, O., Ovbiagele, B., … Uvere, E. (n.d.).Publication year
2015Journal title
Implementation ScienceVolume
10Issue
1AbstractBackground: The Global Alliance for Chronic Diseases comprises the majority of the world's public research funding agencies. It is focussed on implementation research to tackle the burden of chronic diseases in low- and middle-income countries and amongst vulnerable populations in high-income countries. In its inaugural research call, 15 projects were funded, focussing on lowering blood pressure-related disease burden. In this study, we describe a reflexive mapping exercise to identify the behaviour change strategies undertaken in each of these projects. Methods: Using the Behaviour Change Wheel framework, each team rated the capability, opportunity and motivation of the various actors who were integral to each project (e.g. community members, non-physician health workers and doctors in projects focussed on service delivery). Teams then mapped the interventions they were implementing and determined the principal policy categories in which those interventions were operating. Guidance was provided on the use of Behaviour Change Wheel to support consistency in responses across teams. Ratings were iteratively discussed and refined at several group meetings. Results: There was marked variation in the perceived capabilities, opportunities and motivation of the various actors who were being targeted for behaviour change strategies. Despite this variation, there was a high degree of synergy in interventions functions with most teams utilising complex interventions involving education, training, enablement, environmental restructuring and persuasion oriented strategies. Similar policy categories were also targeted across teams particularly in the areas of guidelines, communication/marketing and service provision with few teams focussing on fiscal measures, regulation and legislation. Conclusions: The large variation in preparedness to change behaviour amongst the principal actors across these projects suggests that the interventions themselves will be variably taken up, despite the similarity in approaches taken. The findings highlight the importance of contextual factors in driving success and failure of research programmes. Forthcoming outcome and process evaluations from each project will build on this exploratory work and provide a greater understanding of factors that might influence scale-up of intervention strategies.Blood Pressure Visit Intensification Study in Treatment: Trial design
AbstractFiscella, K., Ogedegbe, G., He, H., Carroll, J., Cassells, A., Sanders, M., Khalida, C., D’Orazio, B., & Tobin, J. N. (n.d.).Publication year
2015Journal title
American Heart JournalVolume
170Issue
6Page(s)
1202-1210AbstractBackground There is a presumption that, for patients with uncontrolled blood pressure (BP), early follow-up, that is, within 4 weeks of an elevated reading, improves BP control. However, data are lacking regarding effective interventions for increasing clinician frequency of follow-up visits and whether such interventions improve BP control. Methods/design Blood Pressure Visit Intensification Study in Treatment involves a multimodal approach to improving intensity of follow-up in 12 community health centers using a stepped wedge study design. Discussion The study will inform effective interventions for increasing frequency of follow-up visits among patients with uncontrolled BP and determine whether increasing follow-up frequency is associated with better BP control.Claim Your Space: Leadership Development as a Research Capacity Building Goal in Global Health
AbstractAirhihenbuwa, C. O., Ogedegbe, G., Iwelunmor, J., Jean-Louis, G., Williams, N., Zizi, F., & Okuyemi, K. (n.d.).Publication year
2015Journal title
Health Education and BehaviorVolume
43Page(s)
17S-24SAbstractAs the burden of noncommunicable diseases (NCDs) rises in settings with an equally high burden of infectious diseases in the Global South, a new sense of urgency has developed around research capacity building to promote more effective and sustainable public health and health care systems. In 2010, NCDs accounted for more than 2.06 million deaths in sub-Saharan Africa. Available evidence suggests that the number of people in sub-Saharan Africa with hypertension, a major risk factor for cardiovascular diseases, will increase by 68% from 75 million in 2008 to 126 million in 2025. Furthermore, about 27.5 million people currently live with diabetes in Africa, and it is estimated that 49.7 million people living with diabetes will reside in Africa by 2030. It is therefore necessary to centralize leadership as a key aspect of research capacity building and strengthening in the Global South in ways that enables researchers to claim their spaces in their own locations. We believe that building capacity for transformative leadership in research will lead to the development of effective and appropriate responses to the multiple burdens of NCDs that coexist with infectious diseases in Africa and the rest of the Global South.Community programs for hypertension
AbstractRavenell, J. E., & Ogedegbe, G. (n.d.). In Hypertension in High Risk African Americans: A means of identification and intervention in the highest-risk population (1–).Publication year
2015Page(s)
59-70AbstractThe prevalence rate of hypertension among blacks in the United States currently exceeds 41 % and is among the highest in the world. Black men in particular have the greatest burden of death from hypertension (HTN), with death rates from hypertension being three times greater for black men compared to whites. A major reason for the disproportionate morbidity and mortality from HTN and its complications in blacks is suboptimal blood pressure (BP) control. In fact, the disparity in hypertension control between blacks and whites accounts for nearly 8,000 excess cardiovascular deaths annually for African Americans. Widespread hypertension control requires the engagement of patients and physicians and other clinical providers alike, and the involvement of individuals, health systems, and communities to facilitate two critical processes: (1) identification of individuals who have hypertension or at risk for developing hypertension and (2) therapeutic intervention to lower blood pressure and prevent complications of uncontrolled hypertension. Community-based hypertension programs have long been recognized as means to achieve these two requisite steps to achieve blood pressure control, particularly among high-risk populations such as black men who tend to underutilize primary care settings. In this chapter, we will briefly review the history of community-based hypertension control efforts and highlight selected community-based strategies from the peer-reviewed literature that have aimed to address blood pressure control in hypertensive African Americans.Comparative effectiveness of angiotensin-converting enzyme inhibitor-based treatment on cardiovascular outcomes in hypertensive blacks versus whites
AbstractOgedegbe, G., Shah, N. R., Phillips, C., Goldfeld, K., Roy, J., Guo, Y., Gyamfi, J., Torgersen, C., Capponi, L., & Bangalore, S. (n.d.).Publication year
2015Journal title
Journal of the American College of CardiologyVolume
66Issue
11Page(s)
1224-1233AbstractBackground Clinical trial evidence suggests poorer outcomes in blacks compared with whites when treated with an angiotensin-converting enzyme (ACE) inhibitor-based regimen, but this has not been evaluated in clinical practice. Objectives This study evaluated the comparative effectiveness of an ACE inhibitor-based regimen on a composite outcome of all-cause mortality, stroke, and acute myocardial infarction (AMI) in hypertensive blacks compared with whites. Methods We conducted a retrospective cohort study of 434,646 patients in a municipal health care system. Four exposure groups (Black-ACE, Black-NoACE, White-ACE, White-NoACE) were created based on race and treatment exposure (ACE or NoACE). Risk of the composite outcome and its components was compared across treatment groups and race using weighted Cox proportional hazard models. Results Our analysis included 59,316 new users of ACE inhibitors, 47% of whom were black. Baseline characteristics were comparable for all groups after inverse probability weighting adjustment. For the composite outcome, the race treatment interaction was significant (p = 0.04); ACE use in blacks was associated with poorer cardiovascular outcomes (ACE vs. NoACE: 8.69% vs. 7.74%; p = 0.05) but not in whites (6.40% vs. 6.74%; p = 0.37). Similarly, the Black-ACE group had higher rates of AMI (0.46% vs. 0.26%; p = 0.04), stroke (2.43% vs. 1.93%; p = 0.05), and congestive heart failure (3.75% vs. 2.25%; p < 0.0001) than the Black-NoACE group. However, the Black-ACE group was no more likely to develop adverse effects than the White-ACE group. Conclusions ACE inhibitor-based therapy was associated with poorer cardiovascular outcomes in hypertensive blacks but not in whites. These findings confirm clinical trial evidence that hypertensive blacks have poorer outcomes than whites when treated with an ACE inhibitor-based regimen.Comparative effectiveness of home blood pressure telemonitoring (HBPTM) plus nurse case management versus HBPTM alone among Black and Hispanic stroke survivors: Study protocol for a randomized controlled trial
AbstractSpruill, T. M., Williams, O., Teresi, J. A., Lehrer, S., Pezzin, L., Waddy, S. P., Lazar, R. M., Williams, S. K., Jean-Louis, G., Ravenell, J., Penesetti, S., Favate, A., Flores, J., Henry, K. A., Kleiman, A., Levine, S. R., Sinert, R., Smith, T. Y., Stern, M., … Ogedegbe, G. (n.d.).Publication year
2015Journal title
TrialsVolume
16Issue
1AbstractBackground: Black and Hispanic stroke survivors experience higher rates of recurrent stroke than whites. This disparity is partly explained by disproportionately higher rates of uncontrolled hypertension in these populations. Home blood pressure telemonitoring (HBPTM) and nurse case management (NCM) have proven efficacy in addressing the multilevel barriers to blood pressure (BP) control and reducing BP. However, the effectiveness of these interventions has not been evaluated in stroke patients. This study is designed to evaluate the comparative effectiveness, cost-effectiveness and sustainability of these two telehealth interventions in reducing BP and recurrent stroke among high-risk Black and Hispanic stroke survivors with uncontrolled hypertension. Methods/Design: A total of 450 Black and Hispanic patients with recent nondisabling stroke and uncontrolled hypertension are randomly assigned to one of two 12-month interventions: 1) HBPTM with wireless feedback to primary care providers or 2) HBPTM plus individualized, culturally-tailored, telephone-based NCM. Patients are recruited from stroke centers and primary care practices within the Health and Hospital Corporations (HHC) Network in New York City. Study visits occur at baseline, 6, 12 and 24 months. The primary outcomes are within-patient change in systolic BP at 12 months, and the rate of stroke recurrence at 24 months. The secondary outcome is the comparative cost-effectiveness of the interventions at 12 and 24 months; and exploratory outcomes include changes in stroke risk factors, health behaviors and treatment intensification. Recruitment for the stroke telemonitoring hypertension trial is currently ongoing. Discussion: The combination of two established and effective interventions along with the utilization of health information technology supports the sustainability of the HBPTM + NCM intervention and feasibility of its widespread implementation. Results of this trial will provide strong empirical evidence to inform clinical guidelines for management of stroke in minority stroke survivors with uncontrolled hypertension. If effective among Black and Hispanic stroke survivors, these interventions have the potential to substantially mitigate racial and ethnic disparities in stroke recurrence. Trial registration: ClinicalTrials.gov NCT02011685. Registered 10 December 2013.Designing and evaluating health systems level hypertension control interventions for African-Americans: Lessons from a pooled analysis of three cluster randomized trials
AbstractPavlik, V. N., Chan, W., Hyman, D. J., Feldman, P., Ogedegbe, G., Schwartz, J. E., McDonald, M., Einhorn, P., & Tobin, J. N. (n.d.).Publication year
2015Journal title
Current Hypertension ReviewsVolume
11Issue
2Page(s)
123-131AbstractObjectives: African-Americans (AAs) have a high prevalence of hypertension and their blood pressure (BP) control on treatment still lags behind other groups. In 2004, NHLBI funded five projects that aimed to evaluate clinically feasible interventions to effect changes in medical care delivery leading to an increased proportion of AA patients with controlled BP. Three of the groups performed a pooled analysis of trial results to determine: 1) the magnitude of the combined intervention effect; and 2) how the pooled results could inform the methodology for future health-system level BP interventions. Methods: Using a cluster randomized design, the trials enrolled AAs with uncontrolled hypertension to test interventions targeting a combination of patient and clinician behaviors. The 12-month Systolic BP (SBP) and Diastolic BP (DBP) effects of intervention or control cluster assignment were assessed using mixed effects longitudinal regression modeling. Results: 2,015 patients representing 352 clusters participated across the three trials. Pooled BP slopes followed a quadratic pattern, with an initial decline, followed by a rise toward baseline, and did not differ significantly between intervention and control clusters: SBP linear coefficient = -2.60±0.21 mmHg per month, p<0.001; quadratic coefficient = 0.167± 0.02 mmHg/month, p<0.001; group by time interaction group by time group x linear time coefficient=0.145 ± 0.293, p=0.622; group x quadratic time coefficient= -0.017 ± 0.026, p=0.525). Results were similar for DBP. The individual sites did not have significant intervention effects when analyzed separately. Conclusion: Investigators planning behavioral trials to improve BP control in health systems serving AAs should plan for small effect sizes and employ a “run-in” period in which BP can be expected to improve in both experimental and control clusters.Differential increase in prevalence estimates of inadequate sleep among black and white Americans
AbstractJean-Louis, G., Grandner, M. A., Youngstedt, S. D., Williams, N. J., Zizi, F., Sarpong, D. F., & Ogedegbe, G. G. (n.d.).Publication year
2015Journal title
BMC public healthVolume
15Issue
1AbstractBackground: The National Health Interview Survey (NHIS) was used to ascertain whether increases in inadequate sleep differentially affected black and white Americans. We tested the hypothesis that prevalence estimates of inadequate sleep were consistently greater among blacks, and that temporal changes have affected these two strata differentially. Methods: NHIS is an ongoing cross-sectional study of non-institutionalized US adults (≥18 years) providing socio-demographic, health risk, and medical factors. Sleep duration was coded as very short sleep [VSS] (<5 h), short sleep [SS] (5-6 h), or long sleep [LS] (>8 h), referenced to 7-8 h sleepers. Analyses adjusted for NHIS' complex sampling design using SAS-callable SUDAAN. Results: Among whites, the prevalence of VSS increased by 53 % (1.5 % to 2.3 %) from 1977 to 2009 and the prevalence of SS increased by 32 % (19.3 % to 25.4 %); prevalence of LS decreased by 30 % (11.2 % to 7.8 %). Among blacks, the prevalence of VSS increased by 21 % (3.3 % to 4.0 %) and the prevalence of SS increased by 37 % (24.6 % to 33.7 %); prevalence of LS decreased by 42 % (16.1 % to 9.4 %). Adjusted multinomial regression analysis showed that odds of reporting inadequate sleep for whites were: VSS (OR = 1.40, 95 % CI = 1.13-1.74, p < 0.001), SS (OR = 1.34, 95 % CI = 1.25-1.44, p < 0.001), and LS (OR = 0.94, 95 % CI = 0.85-1.05, NS). For blacks, estimates were: VSS (OR = 0.83, 95 % CI = 0.60-1.40, NS), SS (OR = 1.21, 95 % CI = 1.05-1.50, p < 0.001), and LS (OR = 0.84, 95 % CI = 0.64-1.08, NS). Conclusions: Blacks and whites are characteristically different regarding the prevalence of inadequate sleep over the years. Temporal changes in estimates of inadequate sleep seem dependent upon individuals' race/ethnicity.Effect of a congregation-based intervention on uptake of HIV testing and linkage to care in pregnant women in Nigeria (Baby Shower): A cluster randomised trial
AbstractEzeanolue, E. E., Obiefune, M. C., Ezeanolue, C. O., Ehiri, J. E., Osuji, A., Ogidi, A. G., Hunt, A. T., Patel, D., Yang, W., Pharr, J., & Ogedegbe, G. (n.d.).Publication year
2015Journal title
The Lancet Global HealthVolume
3Issue
11Page(s)
e692-e700AbstractBackground: Few effective community-based interventions exist to increase HIV testing and uptake of antiretroviral therapy (ART) in pregnant women in hard-to-reach resource-limited settings. We assessed whether delivery of an intervention through churches, the Healthy Beginning Initiative, would increase uptake of HIV testing in pregnant women compared with standard health facility referral. Methods: In this cluster randomised trial, we enrolled self-identified pregnant women aged 18 years and older who attended churches in southeast Nigeria. We randomised churches (clusters) to intervention or control groups, stratified by mean annual number of infant baptisms (<80 vs ≥80). The Healthy Beginning Initiative intervention included health education and on-site laboratory testing implemented during baby showers in intervention group churches, whereas participants in control group churches were referred to health facilities as standard. Participants and investigators were aware of church allocation. The primary outcome was confirmed HIV testing. This trial is registered with ClinicalTrials.gov, identifier number NCT 01795261. Findings: Between Jan 20, 2013, and Aug 31, 2014, we enrolled 3002 participants at 40 churches (20 per group). 1309 (79%) of 1647 women attended antenatal care in the intervention group compared with 1080 (80%) of 1355 in the control group. 1514 women (92%) in the intervention group had an HIV test compared with 740 (55%) controls (adjusted odds ratio 11·2, 95% CI 8·77-14·25; p<0·0001). Interpretation: Culturally adapted, community-based programmes such as the Healthy Beginning Initiative can be effective in increasing HIV screening in pregnant women in resource-limited settings. Funding: US National Institutes of Health and US President's Emergency Plan for AIDS Relief.Ethical oversight in quality improvement and quality improvement research: New approaches to promote a learning health care system Ethics in Biomedical Research
AbstractFiscella, K., Tobin, J. N., Carroll, J. K., He, H., & Ogedegbe, G. (n.d.).Publication year
2015Journal title
BMC Medical EthicsVolume
16Issue
1AbstractBackground: Institutional review boards (IRBs) distinguish health care quality improvement (QI) and health care quality improvement research (QIR) based primarily on the rigor of the methods used and the purported generalizability of the knowledge gained. Neither of these criteria holds up upon scrutiny. Rather, this apparently false dichotomy may foster under-protection of participants in QI projects and over-protection of participants within QIR. Discussion: Minimal risk projects should entail minimal oversight including waivers for informed consent for both QI and QIR projects. Minimizing the burdens of conducting QIR, while ensuring minimal safeguards for QI projects, is needed to restore this imbalance in oversight. Potentially, such ethical oversight could be provided by the integration of Institutional Review Boards and Clinical Ethical Committees, using a more integrated and streamlined approach such as a two-step process involving a screening review, followed by a review by committee trained in QIR. Standards for such ethical review and training in these standards, coupled with rapid review cycles, could facilitate an appropriate level of oversight within the context of creating and sustaining learning health care systems. Summary: We argue that QI and QIR are not reliably distinguishable. We advocate for approaches that improve protections for QI participants while minimizing over-protection for participants in QIR through reasonable ethical oversight that aligns risk to participants in both QI and QIR with the needs of a learning health care system.Excess Metabolic Syndrome Risks Among Women Health Workers Compared With Men
AbstractAdeoye, A. M., Adewoye, I. A., Dairo, D. M., Adebiyi, A., Lackland, D. T., Ogedegbe, G., & Tayo, B. O. (n.d.).Publication year
2015Journal title
Journal of Clinical HypertensionVolume
17Issue
11Page(s)
880-884AbstractMetabolic syndrome is associated with higher rates of cardiovascular morbidity and mortality. Although significant disparities in the risks of metabolic syndrome by occupation type and sex are well documented, the factors associated with metabolic syndrome in low- to middle-income countries remain unclear. These gaps in evidence identify the need for patterns of metabolic syndrome among hospital personnel of both sexes in Nigeria. A total of 256 hospital workers comprising 32.8% men were studied. The mean age of the participants was 42.03±9.4 years. Using International Diabetic Federation criteria, the prevalence of metabolic syndrome was 24.2%. Women were substantially and significantly more likely to be identified with metabolic syndrome compared with men (34.9% vs 2.4%, respectively; P=.0001). This study identified metabolic syndrome among health workers with over one third of women with metabolic syndrome compared with <10% of men. These results support the implementation of lifestyle modification programs for management of metabolic syndrome in the health care workplace.Explanatory models of diabetes in urban poor communities in Accra, Ghana
AbstractDe-Graft Aikins, A., Awuah, R. B., Pera, T. A., Mendez, M., & Ogedegbe, G. (n.d.).Publication year
2015Journal title
Ethnicity and HealthVolume
20Issue
4Page(s)
391-408AbstractObjectives. The objective of the study was to examine explanatory models of diabetes and diabetes complications among urban poor Ghanaians living with diabetes and implications for developing secondary prevention strategies.Design. Twenty adults with type 2 diabetes were recruited from three poor communities in Accra. Qualitative data were obtained using interviews that run between 40 and 90 minutes. The interviews were audio-taped, transcribed and analysed thematically, informed by the explanatory model of disease concept.Results. Respondents associated diabetes and its complications with diet, family history, lifestyle factors (smoking, excessive alcohol consumption and physical inactivity), psychological stress and supernatural factors (witchcraft and sorcery). These associations were informed by biomedical and cultural models of diabetes and disease. Subjective experience, through a process of body-listening, constituted a third model on which respondents drew to theorise diabetes complications. Poverty was an important mediator of poor self-care practices, including treatment non-adherence.Conclusions. The biomedical model of diabetes was a major source of legitimate information for self-care practices. However, this was understood and applied through a complex framework of cultural theories of chronic disease, the biopsychological impact of everyday illness experience and the disempowering effects of poverty. An integrated biopsychosocial approach is proposed for diabetes intervention in this research community.Factors Associated with Medication Nonadherence among Hypertensives in Ghana and Nigeria
AbstractBoima, V., Ademola, A. D., Odusola, A. O., Agyekum, F., Nwafor, C. E., Cole, H., Salako, B. L., Ogedegbe, G., & Tayo, B. O. (n.d.).Publication year
2015Journal title
International Journal of HypertensionVolume
2015AbstractBackground. Blood pressure (BP) control is poor among hypertensives in many parts of sub-Saharan Africa. A potentially modifiable factor for control of BP is medication nonadherence (MNA); our study therefore aimed to determine factors associated with MNA among hypertensives in Ghana and Nigeria. Methodology. We conducted a multicenter cross-sectional study. Patients were recruited from Korle-Bu Hospital (n=120), Ghana; and University of Port Harcourt Teaching Hospital, (n=73) Apapa General Hospital Lagos (n=79) and University College Hospital Ibadan (n=85), Nigeria. Results. 357 hypertensive patients (42.6% males) participated. MNA was found in 66.7%. Adherence showed correlation with depression (r=-0.208, P<0.001), concern about medications (r=-0.0347, P=0.002), and knowledge of hypertension (r=0.14, P=0.006). MNA was associated with formal education (P=0.001) and use of herbal preparation (P=0.014). MNA was found in 61.7% of uninsured participants versus 73.1% of insured participants (P=0.032). Poor BP control was observed in 69.7% and there was significant association between MNA and poor BP control (P=0.006). Conclusion. MNA is high among hypertensives in Ghana and Nigeria and is associated with depression, concern about hypertensive medications, formal education, and use of herbal preparations. The negative association between health insurance and MNA suggests interplay of other factors and needs further investigation.Factors associated with referrals for obstructive sleep apnea evaluation among community physicians
AbstractWilliams, N. J., Nunes, J. V., Zizi, F., Okuyemi, K., Airhihenbuwa, C. O., Ogedegbe, G., & Jean-Louis, G. (n.d.).Publication year
2015Journal title
Journal of Clinical Sleep MedicineVolume
11Issue
1Page(s)
23-26AbstractStudy Objectives: This study assessed knowledge and attitudes toward obstructive sleep apnea (OSA) among community physicians and explored factors that are associated with referrals for OSA evaluation. Methods: Medical students and residents collected data from a convenience sample of 105 physicians practicing at communitybased clinics in a large metropolitan area. Average age was 48 ± 14 years; 68% were male, 70% black, 24% white, and 6% identified as "other." Physicians completed the Obstructive Sleep Apnea Knowledge and Attitudes questionnaire. Results: The average year in physician practice was 18 ± 19 years. Of the sample, 90% reported providing care to black patients. The overall OSA referral rate made by physicians was 75%. OSA knowledge and attitudes scores ranged from 5 to 18 (mean = 14 ± 2) and from 7 to 20 (mean = 13 ± 3), respectively. OSA knowledge was associated with white race/ethnicity (rp = 0.26, p < 0.05), fewer years in practice (rp = -0.38, p < 0.01), patients inquiring about OSA (rp = 0.31, p < 0.01), and number of OSA referrals made for OSA evaluation (rp = 0.30, p < 0.01). Positive attitude toward OSA was associated with patients inquiring about OSA (rp = 0.20, p < 0.05). Adjusting for OSA knowledge and attitudes showed that physicians whose patients inquired about OSA were nearly 10 times as likely to make a referral for OSA evaluation (OR = 9.38, 95% CI: 2.32-38.01, p < 0.01). Conclusion: Independent of physicians' knowledge and attitudes toward obstructive sleep apnea, the likelihood of making a referral for obstructive sleep apnea evaluation was influenced by whether patients inquired about the condition.Food insecurity and effectiveness of behavioral interventions to reduce blood pressure, New York City, 2012-2013
AbstractGrilo, S. A., Shallcross, A. J., Ogedegbe, G., Odedosu, T., Levy, N., Lehrer, S., Chaplin, W., & Spruill, T. M. (n.d.).Publication year
2015Journal title
Preventing Chronic DiseaseVolume
12Issue
2AbstractIntroduction: Food insecurity is associated with diet-sensitive diseases and may be a barrier to successful chronic disease self-management. To evaluate the impact of food insecurity on blood pressure reduction in a pilot clinical trial, we tested the effectiveness of 2 behavioral interventions for hypertension in people with and without food security. Methods: A group of 28 men and women with type 2 diabetes and uncontrolled hypertension were randomized to either 1) home blood pressure telemonitoring alone or 2) home blood pressure telemonitoring plus telephone-based nurse case management. The primary outcome was 6-month change in systolic blood pressure. Results: The 2 interventions resulted in modest, nonsignificant blood pressure reductions. Food-secure patients experienced clinically and statistically significant reductions in blood pressure, whereas no significant change was seen among food-insecure patients. Conclusion: Screening for food insecurity may help identify patients in need of tailored disease management interventions.Human Papillomavirus Knowledge and Attitude among Homeless Women of New York City Shelters
AbstractAsgary, R., Alcabes, A., Feldman, R., Garland, V., Naderi, R., Ogedegbe, G., & Sckell, B. (n.d.).Publication year
2015Journal title
Women's Health IssuesVolume
25Issue
6Page(s)
727-731AbstractBackground: Human papillomavirus (HPV) has not been studied among homeless women in the United States. We assessed knowledge and attitudes regarding HPV infection and the HPV vaccine among homeless women. Methods: We enrolled 300 homeless women age 19 to 65 residing in multiple New York City shelters from 2012 to 2014. We used a national survey to collect HPV data. Results: Mean age was 44.7 ± 12.16 years. The majority were Black, heterosexual, and single; 50.6% were smokers. Almost all HPV knowledge and attitudes data were considerably below the national averages; 41.9% never heard of HPV. Only 36.5% knew that HPV is a sexually transmitted disease; 41.5% knew that HPV causes cervical cancer; and only 19.5% and 17.3% received provider counseling regarding HPV testing and vaccine, respectively. Among participants, 65.4% reported that they would vaccinate their eligible daughters for HPV. Lower rates of up-to-date Pap tests were associated with a lack of knowledge regarding relationship between HPV and abnormal Pap test (p < .01). Conclusions: We recommend improved HPV counseling by providers during any clinical encounter to reduce missed opportunities, coupled with employing patient teaching coach or navigators to improve health literacy and to connect patients to services regarding HPV and cervical cancer.Increased risk of stroke among hypertensive patients with abnormally short sleep duration: analysis of the national health interview survey
Akinseye, O., Ojike, N., Williams, S. K., Seixas, A., Zizi, F., Jean-louis, G., & Ogedegbe, O. (n.d.).Publication year
2015Journal title
Journal of the American Society of HypertensionVolume
9Issue
4Page(s)
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