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Jean-Louis G, Jin P, Moise R, Blanc J, Rogers A, Bubu OM, Chung D, Zizi F, Seixas AA. Effectiveness of peer-delivered sleep health education and social support in increasing OSA evaluation among at-risk blacks. J Sleep Res 2024:e14213. [PMID: 38773705 DOI: 10.1111/jsr.14213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 03/16/2024] [Accepted: 04/02/2024] [Indexed: 05/24/2024]
Abstract
To assess the effectiveness of culturally and linguistically tailored, peer-delivered obstructive sleep apnea education and of social support to increase adherence to physician-recommended obstructive sleep apnea evaluation among blacks. In a two-arm randomised controlled trial, we ascertained the effectiveness of peer-delivered obstructive sleep apnea education in increasing obstructive sleep apnea evaluation among 319 blacks at risk of obstructive sleep apnea (intervention = 159 and control = 160); their average age was 47 ± 12.9 years, and 41% were male. Obstructive sleep apnea risk was assessed with the Apnea Risk Evaluation System questionnaire, administered in community venues. Participants in the intervention arm received tailored obstructive sleep apnea education during a 6 month period; those in the control arm received standard sleep and healthy lifestyle information. Analysis focussed on the effectiveness of peer-delivered obstructive sleep apnea education on adherence to obstructive sleep apnea evaluation, but also considered the role of psychosocial factors. The results showed no significant differences in baseline demographic and clinical measures when contrasting participants in the study arms. The adherence rates for home-based obstructive sleep apnea evaluation in the intervention and control arms were 45.9% and 45.6%, respectively. Overall, participants in both study arms (adherers) who underwent obstructive sleep apnea evaluations were likely to experience a greater level of social support (8.2 ± 2.4 vs. 7.3 ± 2.4; p = 0.06). Moreover, adherers showed greater psychosocial scores (i.e., Dysfunctional Beliefs and Attitudes about Sleep scale, Apnea Beliefs Scale (ABS) (and Apnea Knowledge) compared with non-adherers (6.0 ± 1.8 vs. 4.9 ± 2.2; p = 0.02; 77.0 ± 7.1 vs. 73.2 ± 7.4; p = 0.04, and 6.4 ± 3.1 vs. 7.6 ± 2.4; p = 0.06, respectively). The results of the present randomised controlled trial favoured a potential role of peer-based social support and psychosocial factors, associated with obstructive sleep apnea adherence behaviour.
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Affiliation(s)
- Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - P Jin
- Department of Population Health, NYU Grossman School of Medicine, New York City, New York, USA
| | - R Moise
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - J Blanc
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - A Rogers
- Department of Health and Human Services, St John's University, Jamaica, New York, USA
| | - O M Bubu
- Department of Population Health, NYU Grossman School of Medicine, New York City, New York, USA
| | - D Chung
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - F Zizi
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - A A Seixas
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
- Department of Informatics and Health Data Science, Miller School of Medicine, University of Miami, Miami, Florida, USA
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Bays HE, Gonsahn-Bollie S, Younglove C, Wharton S. Obesity Pillars Roundtable: Body mass index and body composition in Black and Female individuals. Race-relevant or racist? Sex-relevant or sexist? OBESITY PILLARS 2022; 4:100044. [PMID: 37990673 PMCID: PMC10662008 DOI: 10.1016/j.obpill.2022.100044] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2023]
Abstract
Background Body mass index (BMI or weight in kilograms/height in meters2) is the most common metric to diagnose overweight and obesity. However, a body composition analysis more thoroughly assesses adiposity, percent body fat, lean body mass (i.e., including skeletal muscle), and sometimes bone mineral density. BMI is not an accurate assessment of body fat in individuals with increased or decreased muscle mass; the diagnostic utility of BMI in individuals is also influenced by race and sex. Methods Previous Obesity Pillars Roundtables addressed the diagnostic limitations of BMI, the importance of android and visceral fat (especially among those with South and East Asian ancestry), and considerations of obesity among individuals who identify as Hispanic, diverse in sexual-orientation, Black, Native American, and having ancestry from the Mediterranean and Middle East regions. This roundtable examines considerations of BMI in Black and female individuals. Results The panelists agreed that body composition assessment was a more accurate measure of adiposity and muscle mass than BMI. When it came to matters of race and sex, one panelist felt: "race is a social construct and not a defining biology." Another felt that: "BMI should be a screening tool to prompt further evaluation of adiposity that utilizes better diagnostic tools for body composition." Regarding bias and misperceptions of resistance training in female individuals, another panelist stated: "I have spent my entire medical career taking care of women and have never seen a woman unintentionally gain 'too much' muscle mass and bulk up from moderate strength training." Conclusions Conveying the importance of race and sex regarding body composition has proven challenging, with the discussion sometimes devolving into misunderstandings or misinformation that may be perceived as racist or sexist. Body composition analysis is the ultimate diagnostic equalizer in addressing the inaccuracies and biases inherent in the exclusive use of BMI.
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Affiliation(s)
- Harold Edward Bays
- American Board of Obesity Medicine, Medical Director / President Louisville Metabolic and Atherosclerosis Research Center Clinical Associate Professor / University of Louisville Medical School, 3288 Illinois Avenue Louisville KY, 40213, USA
| | - Sylvia Gonsahn-Bollie
- American Board of Obesity Medicine, Embrace You Weight & Wellness Founder, Black Physicians Healthcare Network, Council of Black Obesity Physicians Founding Member, 8705 Colesville Rd Suite 103, Silver Spring, MD, 20910, USA
| | - Courtney Younglove
- American Board of Obesity Medicine, Founder/Medical Director: Heartland Weight Loss, 14205 Metcalf Avenue Overland Park, KS, 66223, USA
| | - Sean Wharton
- McMaster University, York University, University of Toronto Wharton Medical Clinic 2951 Walker’s Line, Burlington,Ontario, Canada
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Sleep Health among Racial/Ethnic groups and Strategies to achieve Sleep Health Equity. Respir Med 2022. [DOI: 10.1007/978-3-030-93739-3_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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He C, Wang W, Chen Q, Shen Z, Pan E, Sun Z, Lou P, Zhang X. Factors associated with stroke among patients with type 2 diabetes mellitus in China: a propensity score matched study. Acta Diabetol 2021; 58:1513-1523. [PMID: 34125293 DOI: 10.1007/s00592-021-01758-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/05/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE This study aimed to examine the prevalence of stroke and associated factors of stroke in patients with type 2 diabetes(T2DM) in China. METHODS Participants were 18,013 T2DM patients recruited with stratified random cluster sampling method from December 2013 to January 2014 in China. Propensity score matching was used to eliminate confounding effects between groups and logistic regression analysis was used to examine factors associated with stroke among T2DM patients. RESULTS Overall, the prevalence of stroke in the subjects with T2DM was 9.5%. After nearest neighbor matching, smoking (OR = 1.60, 95%CI: 1.26-2.03), hypertension (OR = 2.96, 95%CI: 2.55-3.43), dyslipidemia (OR = 2.00, 95%CI: 1.71-2.33), family history of stroke (OR = 2.02, 95%CI: 1.61-2.54), obesity (OR = 1.21, 95%CI: 1.01-1.45) and sleep duration < 6 h/day (OR = 1.44, 95%CI: 1.20-1.73) or > 8 h/day (OR = 1.22, 95%CI: 1.05-1.42) were positively associated with stroke, whereas drinking 1-3 days/week (OR = 0.64, 95%CI: 0.45-0.90) or daily (OR = 0.45, 95%CI: 0.33-0.60), effective exercise (OR = 0.65, 95%CI: 0.57-0.73) and underweight (OR = 0.30, 95%CI: 0.13-0.71) were negatively related to stroke. Besides, the risk of stroke increased substantially with accumulation of above seven modified risk factors. The odds ratio values of stroke in patients having ≥ 5 of the above seven risk factors was 14.39 (95% CI: 8.87-23.26). CONCLUSIONS The prevalence of stroke was high among T2DM in China. It is of great significance to strengthen comprehensive management of health-related behaviors including smoking cessation, moderate alcohol consumption, effective exercise, 6-8 h of sleep duration, keeping normal weight and the prevention of hypertension and dyslipidemia to have sustained beneficial effects on improvements of stroke risk factors.
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Affiliation(s)
- Chenlu He
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
| | - Qian Chen
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Ziyuan Shen
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Enchun Pan
- Huai´an Center for Disease Control and Prevention, Huai´an, 223001, Jiangsu, China
| | - Zhongming Sun
- Huai´an Center for Disease Control and Prevention, Huai´an, 223001, Jiangsu, China
| | - Peian Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou, 221000, Jiangsu, China
| | - Xunbao Zhang
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
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Wan JY, Goodman DL, Willems EL, Freedland AR, Norden-Krichmar TM, Santorico SA, Edwards KL. Genome-wide association analysis of metabolic syndrome quantitative traits in the GENNID multiethnic family study. Diabetol Metab Syndr 2021; 13:59. [PMID: 34074324 PMCID: PMC8170963 DOI: 10.1186/s13098-021-00670-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To identify genetic associations of quantitative metabolic syndrome (MetS) traits and characterize heterogeneity across ethnic groups. METHODS Data was collected from GENetics of Noninsulin dependent Diabetes Mellitus (GENNID), a multiethnic resource of Type 2 diabetic families and included 1520 subjects in 259 African-American, European-American, Japanese-Americans, and Mexican-American families. We focused on eight MetS traits: weight, waist circumference, systolic and diastolic blood pressure, high-density lipoprotein, triglycerides, fasting glucose, and insulin. Using genotyped and imputed data from Illumina's Multiethnic array, we conducted genome-wide association analyses with linear mixed models for all ethnicities, except for the smaller Japanese-American group, where we used additive genetic models with gene-dropping. RESULTS Findings included ethnic-specific genetic associations and heterogeneity across ethnicities. Most significant associations were outside our candidate linkage regions and were coincident within a gene or intergenic region, with two exceptions in European-American families: (a) within previously identified linkage region on chromosome 2, two significant GLI2-TFCP2L1 associations with weight, and (b) one chromosome 11 variant near CADM1-LINC00900 with pleiotropic blood pressure effects. CONCLUSIONS This multiethnic family study found genetic heterogeneity and coincident associations (with one case of pleiotropy), highlighting the importance of including diverse populations in genetic research and illustrating the complex genetic architecture underlying MetS.
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Affiliation(s)
- Jia Y Wan
- Department of Epidemiology and Biostatistics, Program in Public Health, University of California, 635 E. Peltason Dr, Mail Code: 7550, Irvine, CA, 92697, USA
| | - Deborah L Goodman
- Department of Epidemiology and Biostatistics, Program in Public Health, University of California, 635 E. Peltason Dr, Mail Code: 7550, Irvine, CA, 92697, USA
| | - Emileigh L Willems
- Department of Mathematical and Statistical Sciences, University of Colorado, Denver, CO, USA
| | - Alexis R Freedland
- Department of Epidemiology and Biostatistics, Program in Public Health, University of California, 635 E. Peltason Dr, Mail Code: 7550, Irvine, CA, 92697, USA
| | - Trina M Norden-Krichmar
- Department of Epidemiology and Biostatistics, Program in Public Health, University of California, 635 E. Peltason Dr, Mail Code: 7550, Irvine, CA, 92697, USA
| | - Stephanie A Santorico
- Department of Mathematical and Statistical Sciences, University of Colorado, Denver, CO, USA
- Human Medical Genetics and Genomics Program, University of Colorado, Denver, CO, USA
- Department of Biostatistics & Informatics, University of Colorado, Denver, CO, USA
- Division of Biomedical Informatics & Personalized Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Karen L Edwards
- Department of Epidemiology and Biostatistics, Program in Public Health, University of California, 635 E. Peltason Dr, Mail Code: 7550, Irvine, CA, 92697, USA.
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