Williams Natasha J, Jean-Louis Girardin, Brown Clinton D, McFarlane Samy I, Boutin-Foster Carla, Ogedegbe Gbenga
Center for Healthful Behavior Change, Division of Health and Behavior, Department of Population Health, New York University Langone Medical Center, New York University School of Medicine, 227 East 30th St, 10016 New York, NY, USA.
Trials. 2014 Jun 12;15:225. doi: 10.1186/1745-6215-15-225.
Lack of adherence to recommended treatment for obstructive sleep apnea remains an ongoing public health challenge. Despite evidence that continuous positive airway pressure (CPAP) is effective and improves overall quality of life, adherence with the use of CPAP in certain racial/ethnic groups, especially blacks, is suboptimal. Evidence indicates that the incidence and prevalence of obstructive sleep apnea are higher among blacks, relative to whites, and blacks are less likely to adhere to recommended treatment compared with other racial/ethnic groups.
Using a two-arm randomized controlled design, this study will evaluate the effectiveness of a culturally and linguistically tailored telephone-delivered intervention to promote adherence to physician-recommended sleep apnea assessment and treatment among blacks with metabolic syndrome, versus an attention-control arm. The intervention is designed to foster adherence to recommended sleep apnea care using the stages-of-change model. The intervention will be delivered entirely over the telephone. Participants in the intervention arm will receive 10 phone calls to address challenges and barriers to recommended care. Outcomes will be assessed at baseline, and at 6- and 12-months post-randomization.
This tailored behavioral intervention will improve adherence to sleep apnea assessment and treatment among blacks with metabolic syndrome. We expect to demonstrate that this intervention modality is feasible in terms of time and cost and can be replicated in populations with similar racial/ethnic backgrounds.
The study is registered at clinicaltrials.gov NCT01946659 (February 2013).
对阻塞性睡眠呼吸暂停推荐治疗方案的依从性不足仍是一个持续存在的公共卫生挑战。尽管有证据表明持续气道正压通气（CPAP）有效且能改善整体生活质量，但在某些种族/族裔群体中，尤其是黑人，CPAP的使用依从性并不理想。有证据表明，相对于白人，阻塞性睡眠呼吸暂停在黑人中的发病率和患病率更高，而且与其他种族/族裔群体相比，黑人更不太可能坚持推荐的治疗方案。
本研究采用双臂随机对照设计，将评估一种针对文化和语言进行调整的电话干预措施的有效性，该干预旨在促进患有代谢综合征的黑人坚持医生推荐的睡眠呼吸暂停评估和治疗，对照组为注意力控制组。该干预旨在利用行为改变阶段模型促进对推荐的睡眠呼吸暂停护理的依从性。干预将完全通过电话进行。干预组的参与者将接到10个电话，以应对推荐护理中的挑战和障碍。将在基线以及随机分组后的6个月和12个月评估结果。
这种针对性的行为干预将提高患有代谢综合征的黑人对睡眠呼吸暂停评估和治疗的依从性。我们期望证明这种干预方式在时间和成本方面是可行的，并且可以在具有相似种族/族裔背景的人群中复制。
该研究已在clinicaltrials.gov注册，注册号为NCT01946659（2013年2月）。
