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
Modifiable risk factors versus age on developing high predicted cardiovascular disease risk in blacks
AbstractBress, A. P., Colantonio, L. D., Booth, J. N., Spruill, T. M., Ravenell, J., Butler, M., Shallcross, A. J., Seals, S. R., Reynolds, K., Ogedegbe, G., Shimbo, D., & Muntner, P. (n.d.).Publication year
2017Journal title
Journal of the American Heart AssociationVolume
6Issue
2AbstractBackground-Clinical guidelines recommend using predicted atherosclerotic cardiovascular disease (ASCVD) risk to inform treatment decisions. The objective was to compare the contribution of changes in modifiable risk factors versus aging to the development of high 10-year predicted ASCVD risk. Methods and Results-A prospective follow-up was done of the Jackson Heart Study, an exclusively black cohort at visit 1 (2000-2004) and visit 3 (2009-2012). Analyses included 1115 black participants without high 10-year predicted ASCVD risk (<7.5%), hypertension, diabetes mellitus, or ASCVD at visit 1. We used the Pooled Cohort equations to calculate the incidence of high (≥7.5%) 10-year predicted ASCVD risk at visit 3. We recalculated the percentage with high 10-year predicted ASCVD risk at visit 3 assuming each risk factor (age, systolic blood pressure, antihypertensive medication use, diabetes mellitus, smoking, total and high-density lipoprotein cholesterol), one at a time, did not change from visit 1. The mean age at visit 1 was 45.2±9.5 years. Overall, 30.9% (95% CI 28.3-33.4%) of participants developed high 10-year predicted ASCVD risk. Aging accounted for 59.7% (95% CI 54.2-65.1%) of the development of high 10-year predicted ASCVD risk compared with 32.8% (95% CI 27.0-38.2%) for increases in systolic blood pressure or antihypertensive medication initiation and 12.8% (95% CI 9.6-16.5%) for incident diabetes mellitus. Among participants <50 years, the contribution of increases in systolic blood pressure or antihypertensive medication initiation was similar to aging. Conclusions-Increases in systolic blood pressure and antihypertensive medication initiation are major contributors to the development of high 10-year predicted ASCVD risk in blacks, particularly among younger adults.Neighborhood Socioeconomic Disadvantage; Neighborhood Racial Composition; and Hypertension Stage, Awareness, and Treatment Among Hypertensive Black Men in New York City: Does Nativity Matter?
AbstractCole, H., Duncan, D. T., Ogedegbe, G., Bennett, S., & Ravenell, J. (n.d.).Publication year
2017Journal title
Journal of Racial and Ethnic Health DisparitiesVolume
4Issue
5Page(s)
866-875AbstractObjective: Neighborhood-level poverty and racial composition may contribute to racial disparities in hypertension outcomes. Little is known about how the effects of neighborhood social environments may differ by nativity status among diverse urban Black adults. We aimed to characterize the influence of neighborhood-level socio-demographic factors on hypertension outcomes among US- and foreign-born Black men with uncontrolled blood pressure. Design: We conducted a cross-sectional analysis of baseline data from two large community-based trials of hypertensive Black men aged 50 and over linked with census tract data from the 2012 American Community Survey 5-year estimates. We defined census tracts with high racial segregation as those where 60 % or more self-identified as Black and high-poverty census tracts as those where 20 % or more lived below the poverty line. Multivariable general estimating equation models were used to measure associations between neighborhood characteristics and stage of hypertension, hypertension awareness, and treatment to yield adjusted prevalence ratios (aPR). Models were run separately for US- and foreign-born Black men. Results: Over 64 % of the 1139 participants lived in a census tract with a high percentage of Black residents and over 71 % lived in high-poverty census tracts. Foreign-born Black men living in neighborhoods with a high concentration of Black residents were less likely to be treated for their high blood pressure (aPR 0.44, 95 % CI 0.22–0.88), but this result did not hold for US-born Black men. There were no significant associations between neighborhood poverty and hypertension outcomes. Conclusions: Neighborhood context may impact treatment for hypertension, one of the most important factors in hypertension control and decreasing hypertension-related mortality, particularly among foreign-born Black men.Neighborhood walk score and selected Cardiometabolic factors in the French RECORD cohort study
AbstractMéline, J., Chaix, B., Pannier, B., Ogedegbe, G., Trasande, L., Athens, J., & Duncan, D. T. (n.d.).Publication year
2017Journal title
BMC public healthVolume
17Issue
1AbstractBackground: Walkable neighborhoods are purported to impact a range of cardiometabolic outcomes through increased walking, but there is limited research that examines multiple cardiometabolic outcomes. Additionally, few Walk Score (a novel measure of neighborhood walkability) studies have been conducted in a European context. We evaluated associations between neighborhood Walk Score and selected cardiometabolic outcomes, including obesity, hypertension and heart rate, among adults in the Paris metropolitan area. Methods and results: We used data from the second wave of the RECORD Study on 5993 participants recruited in 2011-2014, aged 34-84 years, and residing in Paris (France). To this existing dataset, we added Walk Score values for participants' residential address. We used multilevel linear models for the continuous outcomes and modified Poisson models were used for our categorical outcomes to estimate associations between the neighborhood Walk Score (both as a continuous and categorical variable) (0-100 score) and body mass index (BMI) (weight/height2 in kg/m2), obesity (kg/m2), waist circumference (cm), systolic blood pressure (SBP) (mmHg), diastolic blood pressure (DBP) (mmHg), hypertension (mmHg), resting heart rate (RHR) (beats per minute), and neighborhood recreational walking (minutes per week). Most participants lived in Walker's Paradise (48.3%). In multivariate models (adjusted for individual variables, neighborhood variables, and risk factors for cardiometabolic outcomes), we found that neighborhood Walk Score was associated with decreased BMI (β: -0.010, 95% CI: -0.019 to -0.002 per unit increase), decreased waist circumference (β: -0.031, 95% CI: -0.054 to -0.008), increased neighborhood recreational walking (β: +0.73, 95% CI: +0.37 to +1.10), decreased SBP (β: -0.030, 95% CI: -0.063 to -0.0004), decreased DBP (β: -0.028, 95% CI: -0.047 to -0.008), and decreased resting heart rate (β: -0.026 95% CI: -0.046 to -0.005). Conclusions: In this large population-based study, we found that, even in a European context, living in a highly walkable neighborhood was associated with improved cardiometabolic health. Designing walkable neighborhoods may be a viable strategy in reducing cardiovascular disease prevalence at the population level.Optimal Systolic Blood Pressure Target After SPRINT: Insights from a Network Meta-Analysis of Randomized Trials
AbstractBangalore, S., Toklu, B., Gianos, E., Schwartzbard, A., Weintraub, H., Ogedegbe, G., & Messerli, F. H. (n.d.).Publication year
2017Journal title
American Journal of MedicineVolume
130Issue
6Page(s)
707-719.e8AbstractBackground The optimal on-treatment blood pressure (BP) target has been a matter of debate. The recent SPRINT trial showed significant benefits of a BP target of <120 mm Hg, albeit with an increase in serious adverse effects related to low BP. Methods PubMed, EMBASE, and CENTRAL were searched for randomized trials comparing treating with different BP targets. Trial arms were grouped into 5 systolic BP target categories: 1) <160 mm Hg, 2) <150 mm Hg, 3) <140 mm Hg, 4) <130 mm Hg, and 5) <120 mm Hg. Efficacy outcomes of stroke, myocardial infarction, death, cardiovascular death, heart failure, and safety outcomes of serious adverse effects were evaluated using a network meta-analysis. Results Seventeen trials that enrolled 55,163 patients with 204,103 patient-years of follow-up were included. There was a significant decrease in stroke (rate ratio [RR] 0.54; 95% confidence interval [CI], 0.29-1.00) and myocardial infarction (RR 0.68; 95% CI, 0.47-1.00) with systolic BP <120 mm Hg (vs <160 mm Hg). Sensitivity analysis using achieved systolic BP showed a 72%, 97%, and 227% increase in stroke with systolic BP of <140 mm Hg, <150 mm Hg, and <160 mm, respectively, when compared with systolic BP <120 mm Hg. There was no difference in death, cardiovascular death, or heart failure when comparing any of the BP targets. However, the point estimate favored lower BP targets (<120 mm Hg, <130 mm Hg) when compared with higher BP targets (<140 mm Hg or <150 mm Hg). BP targets of <120 mm Hg and <130 mm Hg ranked #1 and #2, respectively, as the most efficacious target. There was a significant increase in serious adverse effects with systolic BP <120 mm Hg vs <150 mm Hg (RR 1.83; 95% CI, 1.05-3.20) or vs <140 mm Hg (RR 2.12; 95% CI, 1.46-3.08). BP targets of <140 mm Hg and <150 mm Hg ranked #1 and #2, respectively, as the safest target for the outcome of serious adverse effects. Cluster plots for combined efficacy and safety showed that a systolic BP target of <130 mm Hg had optimal balance between efficacy and safety. Conclusions In patients with hypertension, a on-treatment systolic BP target of <130 mm Hg achieved optimal balance between efficacy and safety.Predictors of quality of life in patients with diabetes mellitus in two tertiary health institutions in Ghana and Nigeria
AbstractAbabio, G. K., Bosomprah, S., Olumide, A., Aperkor, N., Aimakhu, C., Oteng-Yeboah, A., Agama, J., Chaplin, W. F., Okuyemi, K. S., Amoah, A. G., & Ogedegbe, G. (n.d.).Publication year
2017Journal title
The Nigerian postgraduate medical journalVolume
24Issue
1Page(s)
48-55AbstractBACKGROUND: Patients with chronic diseases such as Type 2 diabetes mellitus (DM) usually have a relatively poor quality of life (QoL), because the cost of care (living expenses and health) or diet restrictions are heavily felt by these patients, and this is of a public health concern. However, limited data on DM QoL exist in Ghana and Nigeria. This makes it imperative for data to be collated in that regard. MATERIALS AND METHODS: We adopted the Strengthening The reporting of observational studies in epidemiology (STROBE) consensus checklist to survey the patients with DM seen at the diabetic clinic at the Department of Medicine of the Korle-Bu Teaching Hospital and University College Hospital, Ibadan, Nigeria. Patients with Type 2 DM aged 40 years and older were recruited by using systematic random sampling method. The World Health Organization Quality of Life-BREF, diabetes empowerment scale, and DM knowledge scale were used to assess QoL, patient empowerment, and knowledge of DM, respectively. The predictors of QoL were determined using multiple linear regression analyses. RESULTS: A total of 198 patients in Ghana and 203 patients in Nigeria completed the survey, with female-to-male ratio being 3:1 and 2:1, respectively. The overall QoL in both countries was relatively low: 56.19 ± 8.23 in Ghana and 64.34 ± 7.34 in Nigeria. In Ghana, significant correlates of higher scores on the QoL scale were medication adherence (P = 0.02) and employment status (P = 0.02). Among patients in Nigeria, employment status (P = 0.02) and DM empowerment (0.03) were significant predictors of QoL in patients with DM. CONCLUSION: Our study revealed an association between a number of psychosocial factors and QoL among patients with DM in Ghana and Nigeria.Psychosocial correlates of apparent treatment-resistant hypertension in the Jackson Heart Study
AbstractShallcross, A. J., Butler, M., Tanner, R. M., Bress, A., Muntner, P., Shimbo, D., Ogedegbe, G., Sims, M., & Spruill, T. M. (n.d.).Publication year
2017Journal title
Journal of human hypertensionVolume
31Issue
7Page(s)
474-478AbstractApparent treatment-resistant hypertension (aTRH) is associated with adverse cardiovascular outcomes. aTRH is common and disproportionately affects African Americans. The objective of this study is to explore psychosocial correlates of aTRH in a population-based cohort of African Americans with hypertension. The sample included 1392 participants in the Jackson Heart Study with treated hypertension who reported being adherent to their antihypertensive medications. aTRH was defined as uncontrolled clinic BP (≥ 3/4140/90 mm Hg) with ≥ 3/43 classes of antihypertensive medication or treatment with ≥ 3/44 classes of antihypertensive medication, including a diuretic. Self-reported medication adherence was defined as taking all prescribed antihypertensive medication in the 24 h before the study visit. The association of psychosocial factors (chronic stress, depressive symptoms, perceived social support and social network) with aTRH was evaluated using Poisson regression with progressive adjustment for demographic, clinical and behavioural factors. The prevalence of aTRH was 15.1% (n=210). Participants with aTRH had lower social network scores (that is, fewer sources of regular social contact) compared with participants without aTRH (P<0.01). No other psychosocial factors differed between groups. Social network was also the only psychosocial factor that was associated with aTRH prevalence in regression analyses. In age-, sex-adjusted and fully adjusted models, one additional unique source of social contact was associated with a 19% (PR=0.81; 95% confidence interval (CI): 0.68-0.94, P=0.001) and a 13% (PR=0.87; 95% CI 0.74-1.0, P=0.041) lower prevalence of aTRH, respectively. Social network was independently associated with aTRH and warrants further investigation as a potentially modifiable determinant of aTRH in African Americans.Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis
AbstractTucker, K. L., Sheppard, J. P., Stevens, R., Bosworth, H. B., Bove, A., Bray, E. P., Earle, K., George, J., Godwin, M., Green, B. B., Hebert, P., Hobbs, F. D., Kantola, I., Kerry, S. M., Leiva, A., Magid, D. J., Mant, J., Margolis, K. L., McKinstry, B., … McManus, R. J. (n.d.).Publication year
2017Journal title
PLoS MedicineVolume
14Issue
9AbstractBackground: Self-monitoring of blood pressure (BP) appears to reduce BP in hypertension but important questions remain regarding effective implementation and which groups may benefit most. This individual patient data (IPD) meta-analysis was performed to better understand the effectiveness of BP self-monitoring to lower BP and control hypertension. Methods and findings: Medline, Embase, and the Cochrane Library were searched for randomised trials comparing self-monitoring to no self-monitoring in hypertensive patients (June 2016). Two reviewers independently assessed articles for eligibility and the authors of eligible trials were approached requesting IPD. Of 2,846 articles in the initial search, 36 were eligible. IPD were provided from 25 trials, including 1 unpublished study. Data for the primary outcomes—change in mean clinic or ambulatory BP and proportion controlled below target at 12 months—were available from 15/19 possible studies (7,138/8,292 [86%] of randomised participants). Overall, self-monitoring was associated with reduced clinic systolic blood pressure (sBP) compared to usual care at 12 months (−3.2 mmHg, [95% CI −4.9, −1.6 mmHg]). However, this effect was strongly influenced by the intensity of co-intervention ranging from no effect with self-monitoring alone (−1.0 mmHg [−3.3, 1.2]), to a 6.1 mmHg (−9.0, −3.2) reduction when monitoring was combined with intensive support. Self-monitoring was most effective in those with fewer antihypertensive medications and higher baseline sBP up to 170 mmHg. No differences in efficacy were seen by sex or by most comorbidities. Ambulatory BP data at 12 months were available from 4 trials (1,478 patients), which assessed self-monitoring with little or no co-intervention. There was no association between self-monitoring and either lower clinic or ambulatory sBP in this group (clinic −0.2 mmHg [−2.2, 1.8]; ambulatory 1.1 mmHg [−0.3, 2.5]). Results for diastolic blood pressure (dBP) were similar. The main limitation of this work was that significant heterogeneity remained. This was at least in part due to different inclusion criteria, self-monitoring regimes, and target BPs in included studies. Conclusions: Self-monitoring alone is not associated with lower BP or better control, but in conjunction with co-interventions (including systematic medication titration by doctors, pharmacists, or patients; education; or lifestyle counselling) leads to clinically significant BP reduction which persists for at least 12 months. The implementation of self-monitoring in hypertension should be accompanied by such co-interventions.Sustaining Nurse-Led Task-Shifting Strategies for Hypertension Control: A Concept Mapping Study to Inform Evidence-Based Practice
AbstractBlackstone, S., Iwelunmor, J., Plange-Rhule, J., Gyamfi, J., Quakyi, N. K., Ntim, M., & Ogedegbe, G. (n.d.).Publication year
2017Journal title
Worldviews on Evidence-Based NursingVolume
14Issue
5Page(s)
350-357AbstractBackground: The use of task-shifting is an increasingly widespread delivery approach for health interventions targeting prevention, treatment, and control of hypertension in adults living in sub-Saharan Africa (SSA). Addressing a gap in the literature, this research examined the sustainability of an ongoing task-shifting strategy for hypertension (TASSH) from the perspectives of community health nurses (CHNs) implementing the program. Methods: We used concept-mapping, a mixed-methods participatory approach to understand CHNs’ perceptions of barriers and enablers to sustaining a task-shifting program. Participants responded to focal prompts, eliciting statements regarding perceived barriers and enablers to sustaining TASSH, and then rated these ideas based on importance to the research questions and feasibility to address. Twenty-eight community health nurses (21 women, 7 men) from the Ashanti region of Ghana completed the concept-mapping process. Results: Factors influencing sustainability were grouped into five categories: Limited Drug Supply, Financial Support, Provision of Primary Health Care, Personnel Training, and Patient-Provider Communication. The limited supply of antihypertensive medication was considered by CHNs as the most important item to address, while providing training for intervention personnel was considered most feasible to address. Linking Evidence to Action: This study's findings highlight the importance of examining nurses’ perceptions of factors likely to influence the sustainability of evidence-based, task-shifting interventions. Nurses’ perceptions can guide the widespread uptake and dissemination of these interventions in resource-limited settings.Tailored behavioral intervention among blacks with metabolic syndrome and sleep apnea: Results of the MetSO trial
AbstractJean-Louis, G., Newsome, V., Williams, N. J., Zizi, F., Ravenell, J., & Ogedegbe, G. (n.d.).Publication year
2017Journal title
SleepVolume
40Issue
1AbstractStudy Objectives: To assess effectiveness of a culturally and linguistically tailored telephone-delivered intervention to increase adherence to physician-recommended evaluation and treatment of obstructive sleep apnea (OSA) among blacks. Methods: In a two-arm randomized controlled trial, we evaluated effectiveness of the tailored intervention among blacks with metabolic syndrome, relative to those in an attention control arm (n = 380; mean age = 58 ± 13; female = 71%). The intervention was designed to enhance adherence using culturally and linguistically tailored OSA health messages delivered by a trained health educator based on patients' readiness to change and unique barriers preventing desired behavior changes. Results: Analysis showed 69.4% of the patients in the intervention arm attended initial consultation with a sleep specialist, compared to 36.7% in the control arm; 74.7% of those in the intervention arm and 66.7% in the control arm completed diagnostic evaluation; and 86.4% in the intervention arm and 88.9% in the control arm adhered to PAP treatment based on subjective report. Logistic regression analyses adjusting for sociodemographic factors indicated patients in the intervention arm were 3.17 times more likely to attend initial consultation, compared to those in the control arm. Adjusted models revealed no significant differences between the two arms regarding adherence to OSA evaluation or treatment. Conclusion: The intervention was successful in promoting importance of sleep consultation and evaluation of OSA among blacks, while there was no significant group difference in laboratory-based evaluation and treatment adherence rates. It seems that the fundamental barrier to OSA care in that population may be the importance of seeking OSA care.Thresholds for Ambulatory Blood Pressure among African Americans in the Jackson Heart Study
AbstractRavenell, J., Shimbo, D., Booth, J. N., Sarpong, D. F., Agyemang, C., Moody, D. L., Abdalla, M., Spruill, T. M., Shallcross, A. J., Bress, A. P., Muntner, P., & Ogedegbe, G. (n.d.).Publication year
2017Journal title
CirculationVolume
135Issue
25Page(s)
2470-2480AbstractBackground: Ambulatory blood pressure (BP) monitoring is the reference standard for out-of-clinic BP measurement. Thresholds for identifying ambulatory hypertension (daytime systolic BP [SBP]/diastolic BP [DBP] ≥135/85 mm Hg, 24-hour SBP/DBP ≥130/80 mm Hg, and nighttime SBP/DBP ≥120/70 mm Hg) have been derived from European, Asian, and South American populations. We determined BP thresholds for ambulatory hypertension in a US population-based sample of African American adults. Methods: We analyzed data from the Jackson Heart Study, a population-based cohort study comprised exclusively of African American adults (n=5306). Analyses were restricted to 1016 participants who completed ambulatory BP monitoring at baseline in 2000 to 2004. Mean SBP and DBP levels were calculated for daytime (10:00 am-8:00 pm), 24-hour (all available readings), and nighttime (midnight-6:00 am) periods, separately. Daytime, 24-hour, and nighttime BP thresholds for ambulatory hypertension were identified using regression-and outcome-derived approaches. The composite of a cardiovascular disease or an all-cause mortality event was used in the outcome-derived approach. For this latter approach, BP thresholds were identified only for SBP because clinic DBP was not associated with the outcome. Analyses were stratified by antihypertensive medication use. Results: Among participants not taking antihypertensive medication, the regression-derived thresholds for daytime, 24-hour, and nighttime SBP/DBP corresponding to clinic SBP/DBP of 140/90 mm Hg were 134/85 mm Hg, 130/81 mm Hg, and 123/73 mm Hg, respectively. The outcome-derived thresholds for daytime, 24-hour, and nighttime SBP corresponding to a clinic SBP ≥140 mm Hg were 138 mm Hg, 134 mm Hg, and 129 mm Hg, respectively. Among participants taking antihypertensive medication, the regression-derived thresholds for daytime, 24-hour, and nighttime SBP/DBP corresponding to clinic SBP/DBP of 140/90 mm Hg were 135/85 mm Hg, 133/82 mm Hg, and 128/76 mm Hg, respectively. The corresponding outcome-derived thresholds for daytime, 24-hour, and nighttime SBP were 140 mm Hg, 137 mm Hg, and 133 mm Hg, respectively, among those taking antihypertensive medication. Conclusions: On the basis of the outcome-derived approach for SBP and regression-derived approach for DBP, the following definitions for daytime, 24-hour, and nighttime hypertension corresponding to clinic SBP/DBP ≥140/90 mm Hg are proposed for African American adults: daytime SBP/DBP ≥140/85 mm Hg, 24-hour SBP/DBP ≥135/80 mm Hg, and nighttime SBP/DBP ≥130/75 mm Hg, respectively.Training nurses in task-shifting strategies for the management and control of hypertension in Ghana: a mixed-methods study
AbstractGyamfi, J., Plange-Rhule, J., Iwelunmor, J., Lee, D., Blackstone, S. R., Mitchell, A., Ntim, M., Apusiga, K., Tayo, B., Yeboah-Awudzi, K., Cooper, R., & Ogedegbe, G. (n.d.).Publication year
2017Journal title
BMC health services researchVolume
17Issue
1Page(s)
1-9AbstractBackground: Nurses in Ghana play a vital role in the delivery of primary health care at both the household and community level. However, there is lack of information on task shifting the management and control of hypertension to community health nurses in low- and middle-income countries including Ghana. The purpose of this study was to assess nurses' knowledge and practice of hypertension management and control pre- and post-training utilizing task-shifting strategies for hypertension control in Ghana (TASSH). Methods: A pre- and post- test survey was administered to 64 community health nurses (CHNs) and enrolled nurses (ENs) employed in community health centers and district hospitals before and after the TASSH training, followed by semi-structured qualitative interviews that assessed nurses' satisfaction with the training, resultant changes in practice and barriers and facilitators to optimal hypertension management. Results: A total of 64 CHNs and ENs participated in the TASSH training. The findings of the pre- and post-training assessments showed a marked improvement in nurses' knowledge and practice related to hypertension detection and treatment. At pre-assessment 26.9% of the nurses scored 80% or more on the hypertension knowledge test, whereas this improved significantly to 95.7% post-training. Improvement of interpersonal skills and patient education were also mentioned by the nurses as positive outcomes of participation in the intervention. Conclusions: Findings suggest that if all nurses receive even brief training in the management and control of hypertension, major public health benefits are likely to be achieved in low-income countries like Ghana. However, more research is needed to ascertain implementation fidelity and sustainability of interventions such as TASSH that highlight the potential role of nurses in mitigating barriers to optimal hypertension control in Ghana. Trial registration: Trial registration for parent TASSH study: NCT01802372 . Registered February 27, 2013.Transportability of an Evidence-Based Early Childhood Intervention in a Low-Income African Country: Results of a Cluster Randomized Controlled Study
AbstractHuang, K. Y., Nakigudde, J., Rhule, D., Gumikiriza-Onoria, J. L., Abura, G., Kolawole, B., Ndyanabangi, S., Kim, S., Seidman, E., Ogedegbe, G., & Brotman, L. M. (n.d.).Publication year
2017Journal title
Prevention ScienceVolume
18Issue
8Page(s)
964-975AbstractChildren in Sub-Saharan Africa (SSA) are burdened by significant unmet mental health needs. Despite the successes of numerous school-based interventions for promoting child mental health, most evidence-based interventions (EBIs) are not available in SSA. This study investigated the implementation quality and effectiveness of one component of an EBI from a developed country (USA) in a SSA country (Uganda). The EBI component, Professional Development, was provided by trained Ugandan mental health professionals to Ugandan primary school teachers. It included large-group experiential training and small-group coaching to introduce and support a range of evidence-based practices (EBPs) to create nurturing and predictable classroom experiences. The study was guided by the Consolidated Framework for Implementation Research, the Teacher Training Implementation Model, and the RE-AIM evaluation framework. Effectiveness outcomes were studied using a cluster randomized design, in which 10 schools were randomized to intervention and wait-list control conditions. A total of 79 early childhood teachers participated. Teacher knowledge and the use of EBPs were assessed at baseline and immediately post-intervention (4–5 months later). A sample of 154 parents was randomly selected to report on child behavior at baseline and post-intervention. Linear mixed effect modeling was applied to examine effectiveness outcomes. Findings support the feasibility of training Ugandan mental health professionals to provide Professional Development for Ugandan teachers. Professional Development was delivered with high levels of fidelity and resulted in improved teacher EBP knowledge and the use of EBPs in the classroom, and child social competence.What do You Need to Get Male Partners of Pregnant Women Tested for HIV in Resource Limited Settings? The Baby Shower Cluster Randomized Trial
AbstractEzeanolue, E. E., Obiefune, M. C., Yang, W., Ezeanolue, C. O., Pharr, J., Osuji, A., Ogidi, A. G., Hunt, A. T., Patel, D., Ogedegbe, G., & Ehiri, J. E. (n.d.).Publication year
2017Journal title
AIDS and BehaviorVolume
21Issue
2Page(s)
587-596AbstractMale partner involvement has the potential to increase uptake of interventions to prevent mother-to-child transmission of HIV (PMTCT). Finding cultural appropriate strategies to promote male partner involvement in PMTCT programs remains an abiding public health challenge. We assessed whether a congregation-based intervention, the Healthy Beginning Initiative (HBI), would lead to increased uptake of HIV testing among male partners of pregnant women during pregnancy. A cluster-randomized controlled trial of forty churches in Southeastern Nigeria randomly assigned to either the HBI (intervention group; IG) or standard of care referral to a health facility (control group; CG) was conducted. Participants in the IG received education and were offered onsite HIV testing. Overall, 2498 male partners enrolled and participated, a participation rate of 88.9%. Results showed that male partners in the IG were 12 times more likely to have had an HIV test compared to male partners of pregnant women in the CG (CG = 37.71% vs. IG = 84.00%; adjusted odds ratio = 11.9; p < .01). Culturally appropriate and community-based interventions can be effective in increasing HIV testing and counseling among male partners of pregnant women.A community-oriented framework to increase screening and treatment of obstructive sleep apnea among blacks
AbstractWilliams, N. J., Jean-Louis, G., Ravenell, J., Seixas, A., Islam, N., Trinh-Shevrin, C., & Ogedegbe, G. (n.d.).Publication year
2016Journal title
Sleep MedicineVolume
18Page(s)
82-87AbstractObjective: Obstructive sleep apnea (OSA) is a leading sleep disorder that is disproportionately more prevalent in minority populations and is a major risk factor for cardiovascular disease (CVD) morbidity and mortality. OSA is associated with many chronic conditions including hypertension, diabetes, and obesity, all of which are disproportionately more prevalent among blacks (ie, peoples of African American, Caribbean, or African descent). Methods: This article reviews studies conducted in the United States (US) that investigated sleep screenings and adherence to treatment for OSA among blacks. In addition, guidelines are provided for implementing a practical framework to increase OSA screening and management among blacks. Results: Several studies have documented racial/ethnic disparities in adherence to treatment for OSA. However, despite its public health significance, there is a paucity of studies addressing these disparities. Further, there is a lack of health programs and policies to increase screening and treatment of OSA among blacks and other minority populations. A practical framework to increase the number of blacks who are screened for OSA and treated appropriately is warranted. Such a framework is timely and major importance, as early identification of OSA in this high-risk population could potentially lead to early treatment and prevention of CVD, thereby reducing racial and ethnic disparities in sleep-related CVD morbidity and mortality.A Comparison of Measured and Self-Reported Blood Pressure Status among Low-Income Housing Residents in New York City
Williams, J., Duncan, D., Cantor, J., Elbel, B. D., Ogedegbe, O., & Ravenell, J. (n.d.).Publication year
2016Journal title
Journal of Health Disparities Research and PracticeVolume
9Issue
4Page(s)
153-165A perspective on promoting diversity in the biomedical research workforce: The national heart, lung, and blood institute's pri de program
AbstractBoyington, J. E. A., Maihle, N. J., Rice, T. K., Gonzalez, J. E., Hess, C. A., Makala, L. H., Jeffe, D. B., Ogedegbe, G., Rao, D. C., Dávila-Román, V. G., Pace, B. S., Jean-Louis, G., & Boutjdir, M. (n.d.).Publication year
2016Journal title
Ethnicity and DiseaseVolume
26Issue
3Page(s)
379-386AbstractAspiring junior investigators from groups underrepresented in the biomedical sciences face various challenges as they pursue research independence. However, the biomedical research enterprise needs their participation to effectively address critical research issues such as health disparities and health inequities. In this article, we share a research education and mentoring initiative that seeks to address this challenge: Programs to Increase Diversity among Individuals Engaged in Health Related Research (PRIDE), funded by the National Heart, Lung, and Blood Institute (NHLBI). This longitudinal research-education and mentoring program occurs through summer institute programs located at US-based academic institutions. Recruited participants are exposed to didactic and lab-based research-skill enhancement experiences, with year-round mentoring over the course of two years. Mentor-mentee matching is based on shared research interests to promote congruence and to enhance skill acquisition. Program descriptions and sample narratives of participants' perceptions of PRIDE's impact on their career progress are showcased. Additionally, we highlight the overall program design and structure of four of seven funded summer institutes that focus on cardiovascular disease, related conditions, and health disparities. Mentees' testimonials about the value of the PRIDE mentoring approach in facilitating career development are also noted. Meeting the clinical and research needs of an increasingly diverse US population is an issue of national concern. The PRIDE initiative, which focuses on increasing research preparedness and professional development of groups underrepresented in the biomedical research workforce, with an emphasis on mentoring as the critical approach, provides a robust model that is impacting the careers of future investigators.Angiotensin-Converting Enzyme Inhibitors or Angiotensin Receptor Blockers in Patients Without Heart Failure? Insights from 254,301 Patients from Randomized Trials
AbstractBangalore, S., Fakheri, R., Toklu, B., Ogedegbe, G., Weintraub, H., & Messerli, F. H. (n.d.).Publication year
2016Journal title
Mayo Clinic ProceedingsVolume
91Issue
1Page(s)
51-60AbstractObjectives To compare the efficacy and safety of angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) in patients without heart failure. Patients and Methods Meta-analysis of randomized trials identified using PubMed, Embase, and Cochrane Central Register of Controlled Trials searches from January 1, 1980, through April 13, 2015, of ACEis and ARBs compared with placebo or active controls and corroborated with head-to-head trials of ARBs vs ACEis. Outcomes were all-cause mortality, cardiovascular death, myocardial infarction (MI), angina, stroke, heart failure, revascularization, and new-onset diabetes. Results Our search yielded 106 randomized trials that enrolled 254,301 patients. Compared with placebo, ACEis but not ARBs reduced the outcomes of all-cause mortality (ACEis vs placebo: relative risk [RR], 0.89; 95% CI, 0.80-1.00; ARBs vs placebo: RR, 1.01; 95% CI, 0.96-1.06; Pinteraction=.04), cardiovascular death (RR, 0.83; 95% CI, 0.70-0.99 and RR, 1.02; 95% CI, 0.92-1.14; Pinteraction=.05), and MI (RR, 0.83; 95% CI, 0.78-0.90 and RR, 0.93; 95% CI, 0.85-1.03; Pinteraction=.06). The meta-regression analysis revealed that the difference between ACEis and ARBs compared with placebo was due to a higher placebo event rate in the ACEis trials (most of these trials were conducted a decade earlier than the ARB trials) for the outcome of all-cause mortality (P=.001), cardiovascular death (P<.001), and MI (P=.02). Sensitivity analyses restricted to trials published after 2000 revealed similar outcomes with ACEis vs placebo and ARBs vs placebo (Pinteraction>.05). Head-to-head comparison trials of ARBs vs ACEis exhibited no difference in outcomes except for a lower risk of drug withdrawal due to adverse effects with ARBs (RR, 0.72; 95% CI, 0.65-0.81). Conclusion In patients without heart failure, evidence from placebo-controlled trials (restricted to trials after 2000), active controlled trials, and head-to-head randomized trials all suggest ARBs to be as efficacious and safe as ACEis, with the added advantage of better tolerability.Cardiovascular Risk Factors and Masked Hypertension: The Jackson Heart Study
AbstractBromfield, S. G., Shimbo, D., Booth, J. N., Correa, A., Ogedegbe, G., Carson, A. P., & Muntner, P. (n.d.).Publication year
2016Journal title
HypertensionVolume
68Issue
6Page(s)
1475-1482AbstractMasked hypertension is associated with increased risk for cardiovascular disease. Identifying modifiable risk factors for masked hypertension could provide approaches to reduce its prevalence. Life's Simple 7 is a measure of cardiovascular health developed by the American Heart Association that includes body mass index, physical activity, diet, cigarette smoking, blood pressure (BP), cholesterol, and glucose. We examined the association between cardiovascular health and masked daytime hypertension in the Jackson Heart Study, an exclusively African American cohort. Life's Simple 7 factors were assessed during a study visit and categorized as poor, intermediate, or ideal. Ambulatory BP monitoring was performed after the study visit. Using BP measured between 10:00 am and 8:00 pm on ambulatory BP monitoring, masked daytime hypertension was defined as mean clinic systolic BP/diastolic BP <140/90 mm Hg and mean daytime systolic BP/diastolic BP ≥135/85 mm Hg. Among the 758 participants with systolic BP/diastolic BP <140/90 mm Hg, 30.5% had masked daytime hypertension. The multivariable-adjusted prevalence ratios for masked daytime hypertension comparing participants with 2, 3, and ≥4 versus ≤1 ideal Life's Simple 7 factors were 0.99 (95% confidence interval [CI], 0.74-1.33), 0.77 (95% CI, 0.57-1.03), and 0.51 (95% CI, 0.33-0.79), respectively. Masked daytime hypertension was less common among participants with ideal versus poor levels of physical activity (ratio, 0.74; 95% CI, 0.56-1.00), ideal or intermediate levels pooled together versus poor diet (prevalence ratio, 0.73; 95% CI, 0.58-0.91), ideal versus poor levels of cigarette smoking (prevalence ratio, 0.61; 95% CI, 0.46-0.82), and ideal versus intermediate levels of clinic BP (prevalence ratio, 0.28, 95% CI, 0.16-0.48). Better cardiovascular health is associated with a lower preva lence of masked hypertension.Cervical Cancer Screening 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
2016Journal title
Maternal and Child Health JournalVolume
20Issue
6Page(s)
1143-1150AbstractIntroduction Homeless persons have minimal opportunities to complete recommended cancer screening. The rates and predictors of cervical cancer screening are understudied among homeless women in the US. Methods We enrolled 297 homeless women 21–65 years old residing in 6 major New York City shelters from 2012 to 2014. We used a validated national survey to determine the proportion and predictors of cervical cancer screening using cytology (Pap test). Results Mean age was 44.72 (±11.96) years. Majority was Black, heterosexual, single, with high school or lower education; 50.9 % were smokers and 41.7 % were homeless more than a year. Despite a 76.5 % proportion of self-reported Pap test within the past 3 years, 65 % of women assumed their Pap test results were normal or did not get proper follow up after abnormal results. Forty-five-point-nine percent of women did not know about frequency of Pap test or causes of cervical cancer. Lower proportion of up-to-date Pap test was associated with lack of knowledge of recommended Pap test frequency (p < 0.01) and relationship between HPV and an abnormal Pap test (p < 0.01). Conclusions Self-reported Pap testing in homeless women was similar to a national sample. However, the majority of women surveyed were not aware of their results, received limited if any follow up and had significant education gaps about cervical cancer screening. We recommend improved counseling and patient education, patient navigators to close screening loops, and consideration of alternative test-and-treat modalities to improve effective screening.Comparative Effectiveness of a Practice-Based Comprehensive Lifestyle Intervention vs. Single Session Counseling in Hypertensive Blacks
AbstractSchoenthaler, A., Luerassi, L., Silver, S., Odedosu, T., Kong, J., Ravenell, J., Teresi, J. A., & Ogedegbe, G. (n.d.).Publication year
2016Journal title
American Journal of HypertensionVolume
29Issue
2Page(s)
280-287AbstractBACKGROUND Although the efficacy of therapeutic lifestyle change (TLC) interventions are well proven, their relative effectiveness vs. single-session lifestyle counseling (SSC) on blood pressure (BP) reduction in primary care practices remains largely untested in hypertensive Blacks. The aim of this trial was to evaluate the comparative effectiveness of a comprehensive practice-based TLC intervention (motivational interviewing (MINT)-TLC) vs. SSC on BP reduction among 194 Blacks with uncontrolled hypertension. METHODS The MINT-TLC arm included 10 weekly group classes on TLC, followed by 3 individual MINT sessions. The SSC group received 1 individual counseling session on lifestyle modification plus print versions of the intervention material. The primary outcome was within-patient change in systolic BP (SBP) and diastolic BP (DBP) from baseline to 6 months. The secondary outcome was BP control at 6 months. RESULTS Mean age of the total sample was 57 (10.2) years; 50% were women, and the mean baseline BP was 147.4/89.3mm Hg. Eighty-four percent of SSC and 77% of MINT-TLC patients completed the final 6-month assessments. BP declined significantly (P < 0.001) in both groups at 6 months with a net-adjusted systolic BP reduction of 12.9mm Hg for the SSC group vs. 9.5mm Hg for the MINT-TLC group (P = 0.18); and diastolic BP reduction of 7.6 and 7.2mm Hg for the SSC and MINT-TLC group, respectively (P = 0.79). The between-group difference in proportion of patients with adequate BP control at 6 months was nonsignificant (P = 0.82). CONCLUSION A significant group difference in BP between the intervention groups was not observed among a sample of hypertensive Blacks. Implementation of the pragmatic single-session intervention and its effects on utilization of healthcare services should be further evaluated.Effect of Expectation of Care on Adherence to Antihypertensive Medications Among Hypertensive Blacks: Analysis of the Counseling African Americans to Control Hypertension (CAATCH) Trial
AbstractGrant, A. B., Seixas, A., Frederickson, K., Butler, M., Tobin, J. N., Jean-Louis, G., & Ogedegbe, G. (n.d.).Publication year
2016Journal title
Journal of Clinical HypertensionVolume
18Issue
7Page(s)
690-696AbstractNovel ideas are needed to increase adherence to antihypertensive medication. The current study used data from the Counseling African Americans to Control Hypertension (CAATCH) study, a sample of 442 hypertensive African Americans, to investigate the mediating effects of expectation of hypertension care, social support, hypertension knowledge, and medication adherence, adjusting for age, sex, number of medications, diabetes, education, income, employment, insurance status, and intervention. Sixty-six percent of patients had an income of $20,000 or less and 56% had a high school education or less, with a mean age of 57 years. Greater expectation of care was associated with greater medication adherence (P=.007), and greater social support was also associated with greater medication adherence (P=.046). Analysis also showed that expectation of care mediated the relationship between hypertension knowledge and medication adherence (P<.05). Expectation of care and social support are important factors for developing interventions to increase medication adherence among blacks.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
Sleep