1
|
Coy T, Brinza E, DeLozier S, Gornik HL, Webel AR, Longenecker CT, White Solaru KT. Black men's awareness of peripheral artery disease and acceptability of screening in barbershops: a qualitative analysis. BMC Public Health 2023; 23:46. [PMID: 36609297 PMCID: PMC9821364 DOI: 10.1186/s12889-022-14648-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/16/2022] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Peripheral artery disease (PAD) disproportionately burdens Black Americans, particularly Black men. Despite the significant prevalence and high rate of associated morbidity and mortality, awareness of and treatment initiation for PAD remains low in this demographic group. Given the well-established social cohesion among barbershops frequently attended by Black men, barbershops may be ideal settings for health screening and education to improve awareness, early detection, and treatment initiation of PAD among Black men. METHODS A qualitative study involving 1:1 participant interviews in Cleveland, Ohio assessed perspectives of Black men about barbershop-based screening and education about PAD. Inductive thematic analysis was performed to derive themes directly from the data to reflect perceived PAD awareness and acceptability of screening in a barbershop setting. RESULTS Twenty-eight African American/Black, non-Hispanic men completed a qualitative interview for this analysis. Mean age was 59.3 ± 11.2 years and 93% of participants resided in socioeconomically disadvantaged zip codes. Several themes emerged indicating increased awareness of PAD and acceptability of barbershop-based screenings for PAD, advocacy for systemic changes to improve the health of the community, and a desire among participants to increase knowledge about cardiovascular disease. CONCLUSIONS Participants were overwhelmingly accepting of PAD screenings and reported increased awareness of PAD and propensity to seek healthcare due to engagement in the study. Participants provided insight into barriers and facilitators of health and healthcare-seeking behavior, as well as into the community and the barbershop as an institution. Additional research is needed to explore the perspectives of additional stakeholders and to translate community-based screenings into treatment initiation.
Collapse
Affiliation(s)
- Tyler Coy
- Division of Cardiovascular Medicine and Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA
| | - Ellen Brinza
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Department of Internal Medicine, University of Colorado, Aurora, CO, USA
| | - Sarah DeLozier
- Clinical Research Center, University Hospitals, Cleveland, OH, USA
| | - Heather L Gornik
- Division of Cardiovascular Medicine and Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA.
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Allison R Webel
- University of Washington School of Nursing, Seattle, WA, USA
| | - Christopher T Longenecker
- Division of Cardiovascular Medicine and Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
- School of Medicine and Department of Global Health, University of Washington, Seattle, WA, USA
| | - Khendi T White Solaru
- Division of Cardiovascular Medicine and Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
2
|
White Solaru KT, Coy T, DeLozier S, Brinza E, Ravenell J, Longenecker CT, Wright JT, Gornik HL. Findings of a Novel Barbershop-Based Peripheral Artery Disease Screening Program for Black Men. J Am Heart Assoc 2022; 11:e026347. [PMID: 36250671 DOI: 10.1161/jaha.122.026347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Peripheral artery disease (PAD) increases the risk of cardiovascular events and limb events including amputations. PAD is twice as prevalent in Black compared with non-Hispanic White individuals, especially among men. Screening for PAD using the ankle-brachial index in community settings, such as the barbershop, could lead to earlier diagnosis and treatment. Methods and Results A pilot study was conducted at 2 barbershops in Cleveland, OH from June to December 2020 to assess the feasibility of screening for PAD in the barbershop setting and the effect of an educational intervention on PAD awareness. After screening with both automated and Doppler ankle-brachial index, PAD was identified in 5/31 (16.1%) of participants. Baseline systolic blood pressure, low-density lipoprotein cholesterol, and random blood glucose were higher in participants who screened positive for PAD (P<0.001). PAD awareness was low overall. There was a significant improvement in PAD awareness assessment scores obtained at the initial and exit visits (9.93±4.23 to 12.50±4.41, P=0.004). An association was found between PAD awareness at baseline and highest education level achieved: compared with those with some college/associate's degree or higher, non-high school graduates scored lower on PAD awareness (P=0.022), as did those who only had a high school diploma or tests of General Educational Development (P=0.049). Conclusions In a pilot study, barbershop-based screening for PAD among Black men revealed a higher than expected PAD prevalence and low PAD awareness. An educational video was effective at increasing PAD awareness. Ankle-brachial index screening and educational outreach in the barbershop may be a feasible and effective tool to diagnose PAD and reduce PAD disparities among Black men at highest risk.
Collapse
Affiliation(s)
- Khendi T White Solaru
- Department of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute Cleveland OH.,Department of Medicine Case Western Reserve University School of Medicine Cleveland OH
| | - Tyler Coy
- Department of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute Cleveland OH
| | - Sarah DeLozier
- Clinical Research Center University Hospitals Cleveland OH
| | - Ellen Brinza
- Department of Medicine Case Western Reserve University School of Medicine Cleveland OH
| | - Joseph Ravenell
- Langone's Departments of Population Health and Medicine New York University School of Medicine New York NY
| | - Christopher T Longenecker
- Department of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute Cleveland OH.,Department of Medicine Case Western Reserve University School of Medicine Cleveland OH
| | - Jackson T Wright
- Department of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute Cleveland OH.,Department of Medicine Case Western Reserve University School of Medicine Cleveland OH
| | - Heather L Gornik
- Department of Cardiovascular Medicine University Hospitals Harrington Heart and Vascular Institute Cleveland OH.,Department of Medicine Case Western Reserve University School of Medicine Cleveland OH
| |
Collapse
|
3
|
Park C, Clemenceau JR, Seballos A, Crawford S, Lopez R, Coy T, Atluri G, Hwang TH. A spatiotemporal analysis of opioid poisoning mortality in Ohio from 2010 to 2016. Sci Rep 2021; 11:4692. [PMID: 33633131 PMCID: PMC7907120 DOI: 10.1038/s41598-021-83544-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 01/27/2021] [Indexed: 11/09/2022] Open
Abstract
Opioid-related deaths have severely increased since 2000 in the United States. This crisis has been declared a public health emergency, and among the most affected states is Ohio. We used statewide vital statistic data from the Ohio Department of Health (ODH) and demographics data from the U.S. Census Bureau to analyze opioid-related mortality from 2010 to 2016. We focused on the characterization of the demographics from the population of opioid-related fatalities, spatiotemporal pattern analysis using Moran's statistics at the census-tract level, and comorbidity analysis using frequent itemset mining and association rule mining. We found higher rates of opioid-related deaths in white males aged 25-54 compared to the rest of Ohioans. Deaths tended to increasingly cluster around Cleveland, Columbus and Cincinnati and away from rural regions as time progressed. We also found relatively high co-occurrence of cardiovascular disease, anxiety or drug abuse history, with opioid-related mortality. Our results demonstrate that state-wide spatiotemporal and comorbidity analysis of the opioid epidemic could provide novel insights into how the demographic characteristics, spatiotemporal factors, and/or health conditions may be associated with opioid-related deaths in the state of Ohio.
Collapse
Affiliation(s)
- Chihyun Park
- Department of Quantitative Health Sciences (QHS), Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA.,Department of Computer Science and Engineering, Kangwon National University, Chuncheon, Republic of Korea
| | - Jean R Clemenceau
- Department of Quantitative Health Sciences (QHS), Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Anna Seballos
- Department of Quantitative Health Sciences (QHS), Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Sara Crawford
- Department of Quantitative Health Sciences (QHS), Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Rocio Lopez
- Department of Quantitative Health Sciences (QHS), Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Tyler Coy
- Department of Quantitative Health Sciences (QHS), Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Gowtham Atluri
- Department of Electrical Engineering and Computer Science (EECS), University of Cincinnati, P.O. Box 210030, Cincinnati, OH, 45221, USA.
| | - Tae Hyun Hwang
- Department of Quantitative Health Sciences (QHS), Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
| |
Collapse
|
4
|
Crane A, Eltemamy M, Jacobsen D, Coy T, Babbar P, Ponziano M, Poggio E, Fatica R, Krishnamurthi V. MP61-09 CLEVELAND CLINIC KIDNEY TRANSPLANT RECIPIENT READMISSION EXPERIENCE. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
5
|
Crane A, Eltemamy M, Coy T, Babbar P, Jacobsen D, Ponziano M, Poggio E, Wee A, Fatica R, Krishnamurthi V. MP61-10 IDENTIFICATION OF PREVENTABLE READMISSIONS AND IMPLEMENTATION OF INTENSIVE STANDARDIZED FOLLOW-UP IN KIDNEY TRANSPLANT RECIPIENTS. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
6
|
Dimsdale JE, Coy T, Ancoli-Israel S, Mills P, Clausen J, Ziegler MG. Sympathetic nervous system alterations in sleep apnea. The relative importance of respiratory disturbance, hypoxia, and sleep quality. Chest 1997; 111:639-42. [PMID: 9118700 DOI: 10.1378/chest.111.3.639] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Numerous alterations in the sympathetic nervous system have been reported in patients with obstructive sleep apnea. It is unclear whether such alterations can be attributed to the respiratory disturbance itself, the resulting hypoxia, or disruption of sleep. We examined urinary norepinephrine levels in 45 individuals with varying amounts of respiratory disturbance and sleep disruption. All were of similar age (40 to 60 years) and body weight (100 to 160% ideal body weight), and all were free from antihypertensive medications that could influence norepinephrine levels. Twenty-four-hour urinary norepinephrine levels were correlated with respiratory disturbance index (r = 0.39, p < 0.01) and mean oxygen saturation (r = -0.36, p < 0.05). These variables, together with the time in slow-wave sleep, accounted for a statistically significant but modest percentage of the variance in urinary norepinephrine (R2 = 0.19, p < 0.05). However, the variables were so tightly intercorrelated that no single variable independently predicted norepinephrine levels in multiple regression analysis.
Collapse
Affiliation(s)
- J E Dimsdale
- Department of Psychiatry, University of California, San Diego, USA
| | | | | | | | | | | |
Collapse
|
7
|
Dimsdale JE, Coy T, Ziegler MG, Ancoli-Israel S, Clausen J. The effect of sleep apnea on plasma and urinary catecholamines. Sleep 1995; 18:377-81. [PMID: 7676172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Numerous studies have suggested an alteration of sympathetic nervous system functioning in sleep apnea. However, most of these studies did not control for confounding factors such as diet, obesity, hypertension and anti-hypertensive medications. We examined plasma and urinary catecholamines in 43 patients, including hypertensive and normotensive individuals with and without sleep apnea. Hypertensive patients were studied at least 3 weeks following tapering of anti-hypertensive medication. All patients consumed similar diets and were of similar age and level of obesity. Twenty-four-hour urinary norepinephrine levels were significantly higher in apneics (58.2 ng vs. 40.2 ng in nonapneics, p < 0.002). Urinary norepinephrine in apneics was increased during both day and night. Plasma norepinephrine levels were not significantly elevated in apneic patients but were elevated in hypertensive patients both during sleep and in the morning (p < 0.05).
Collapse
Affiliation(s)
- J E Dimsdale
- Department of Psychiatry, University of California, San Diego, La Jolla 92093-0804, USA
| | | | | | | | | |
Collapse
|
8
|
Affiliation(s)
- S Ancoli-Israel
- Department of Psychiatry, University of California, San Diego
| | | |
Collapse
|