Abstract
BackgroundCompared to whites, blacks are at increased risk for obstructive sleep apnea (OSA) yet less likely to adhere to physician-recommended sleep assessment and treatment. Poor OSA health literacy and lack of social support to navigate the current healthcare system are two potential barriers to adequate OSA care. This study is designed to address these barriers by evaluating the effectiveness of a peer-based sleep health education program on adherence to OSA assessment and treatment among blacks at risk for OSA.Method/DesignIn a two-arm, randomized controlled trial, we will ascertain the effectiveness of peer-based sleep health education and social support in increasing OSA evaluation and treatment rates among 398 blacks at low to high OSA risk. Participants at risk of OSA will receive quality controlled, culturally, and linguistically tailored peer education based on Motivational Enhancement principles over a period of 12 months. During this 12-month period, participants are encouraged to participate in a sleep home study to determine risk of OSA and, if found to be at risk, they are invited to undergo a diagnostic sleep assessment at a clinic. Participants who are diagnosed with OSA and who are prescribed continuous positive airway pressure treatment will be encouraged, through peer-based education, to adhere to recommended treatment. Recruitment for the project is ongoing.DiscussionThe use of a culturally tailored sleep health education program, peer health educators trained in sleep health, and home-based sleep assessment are novel approaches in improving OSA assessment and treatment adherence in blacks who are significantly at risk for OSA. Empirical evidence from this trial will provide clinical and population level solutions on how to improve and increase assessment and treatment of OSA among blacks.Trial registrationNCT02427815. Registered on 20 April 2015.ClinicalTrials.gov title: Sleep Health Education and Social Support Among Blacks With OSA.
Highlights
Compared to whites, blacks are at increased risk for obstructive sleep apnea (OSA) yet less likely to adhere to physician-recommended sleep assessment and treatment
The use of a culturally tailored sleep health education program, peer health educators trained in sleep health, and home-based sleep assessment are novel approaches in improving OSA assessment and treatment adherence in blacks who are significantly at risk for OSA
The current study is an outgrowth of our previous National Institute on Minority Health and Health Disparities-funded randomized controlled study (NCT01946659), which investigated whether blacks with metabolic syndrome are at increased risk for OSA
Summary
Our study is innovative in the following ways To our knowledge, this will be the first culturally and linguistically tailored, community-engaged, peer-based sleep health intervention to increase adherence to OSA evaluation and treatment. Our analysis of the BRFSS data revealed several significant social/cultural determinants of sleep deficiency among blacks [113]. They include working more than 40 hours (OR 1.72), caregiving to family/friends (OR 1.23), and lack of emotional support (OR 1.21). This study will provide data to examine effects of contextual factors on sleep behavior of blacks. We propose to achieve a 15% increase in adoption of OSA care, which would have a significant public health impact
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