1
|
Blanc J, Hahn K, Oliveira B, Phillips R, Duthely LM, Francois L, Carrasco M, Moore J, Sternberg CA, Jean-Louis G, Seixas AA. Bringing Health Care Equity to Diverse and Underserved Populations in Sleep Medicine and Research Through a Digital Health Equity Framework. Sleep Med Clin 2023; 18:255-267. [PMID: 37532367 PMCID: PMC10300114 DOI: 10.1016/j.jsmc.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
Individuals from minoritized groups are less likely to receive sleep medicine care and be the focus of sleep research. Several barriers may explain under-representation and low participation. The coronavirus disease 2019 (COVID-19) pandemic highlighted a digital divide that exacerbated disproportionate sleep health outcomes and access to sleep medicine and research opportunities among minoritized groups. The authors' team developed a digital health equity and inclusion model and revamped its culturally-tailored community outreach program to advance sleep health equity among minoritized groups. This article describes how the authors implemented their digital sleep health equity and inclusion model during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Judite Blanc
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Center for Translational Sleep and Circadian Sciences (TSCS), Clinical Research Building, 14th Floor 1120 Northwest 14th Street, Room 1448, Miami, FL 33136, USA
| | - Kaitlyn Hahn
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine
| | - Bruno Oliveira
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 Northwest 14th Street, 14th Floor, Suite 1451A, Miami, FL 33136, USA
| | - Ro'Mya Phillips
- Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, USA
| | - Lunthita M Duthely
- Obstetrics, Gynecology & Reproductive Sciences, Department of Public Health Sciences, University of Miami Miller School of Medicine, Don Soffer Clinical Research Center 1162
| | - Laura Francois
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine
| | - Mary Carrasco
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine; Department of Informatics and Health Data Science, The Media and Innovation Lab, 1120 Northwest 14th Street, Room 1452, Miami, FL 33136, USA
| | - Jesse Moore
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine; Department of Informatics and Health Data Science, The Media and Innovation Lab, 1120 Northwest 14th Street, Room 1452, Miami, FL 33136, USA
| | - Candice A Sternberg
- Department of Infectious Diseases, University of Miami Miller School of Medicine, Clinical Research Building, 1120 Northwest 14th Street #858, Miami, FL 33136, USA
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, CRB, Translational Sleep and Circadian Sciences (TSCS), 14th Floor 1120 Northwest 14th Street, Room 1449, Miami, FL 33136, USA
| | - Azizi A Seixas
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Center for Translational Sleep and Circadian Sciences (TSCS), Clinical Research Building, 14th Floor 1120 Northwest 14th Street, Room 1448, Miami, FL 33136, USA; Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine; Department of Informatics and Health Data Science, The Media and Innovation Lab, 1120 Northwest 14th Street, Room 1452, Miami, FL 33136, USA.
| |
Collapse
|
2
|
Jean-Louis G, Grandner MA, Seixas AA. Social determinants and health disparities affecting sleep. Lancet Neurol 2022; 21:864-865. [DOI: 10.1016/s1474-4422(22)00347-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 08/22/2022] [Indexed: 10/14/2022]
|
3
|
Johnson DA, Ohanele C, Alcántara C, Jackson CL. The Need for Social and Environmental Determinants of Health Research to Understand and Intervene on Racial/Ethnic Disparities in Obstructive Sleep Apnea. Clin Chest Med 2022; 43:199-216. [PMID: 35659019 DOI: 10.1016/j.ccm.2022.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Obstructive sleep apnea (OSA), a sleep-disordered breathing (SDB) disorder, affects at least 25 million adults in the United States and is associated with increased risk for hypertension, diabetes, and cardiovascular disease (CVD). Racial/ethnic minorities have a disproportionate burden of OSA along with the health sequelae associated with this condition. Despite supporting evidence of racial/ethnic disparities, few studies have investigated SDB including OSA among minoritized racial/ethnic groups. In this scoping review of the literature, the authors summarize current findings related to racial/ethnic disparities in OSA, identified social and environmental determinants of health, treatment inequities, and promising evidence-based interventions and conclude with future research directions.
Collapse
Affiliation(s)
- Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, CNR Room 3025, Atlanta, GA 30322, USA.
| | - Chidinma Ohanele
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, CNR Room 3025, Atlanta, GA 30322, USA
| | - Carmela Alcántara
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, Room 917, New York, NY 10027, USA
| | - Chandra L Jackson
- Epidemiology Branch, Social and Environmental Determinants of Health Equity, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Drive, Room A327, Research Triangle Park, 27709 Post: P.O. Box 12233, Mail Drop A3-05, NC 27709, USA; Intramural Program, Department of Health and Human Services, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| |
Collapse
|
4
|
Honaker SM, Gopalkrishnan A, Brann M, Wiehe S, Clark AA, Chung A. “It made all the difference”: a qualitative study of parental experiences with pediatric obstructive sleep apnea detection. J Clin Sleep Med 2022; 18:1921-1931. [PMID: 35499142 PMCID: PMC9340584 DOI: 10.5664/jcsm.10024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To assess parental experience of their child's obstructive sleep apnea (OSA) detection process and inform the development of interventions and health communication strategies to improve OSA detection. METHODS Semistructured interviews were conducted with 30 parents of children (ages 3-14) who snored and were referred for an overnight polysomnogram (PSG). Parents (60.0% Black race, 93.3% mothers) described how their child was referred for PSG and their perceptions and feelings throughout the detection process. Parents also completed an OSA knowledge measure. Interview data were analyzed using a descriptive approach and thematic analysis was conducted using the NVivo 12 software system. RESULTS Twenty-one themes were identified across 5 categories (first steps; PSG facilitators and barriers; health information; health care experiences; parent experiences). Respondents experienced multiple pathways to OSA detection, with more than half of referrals initiated by parental concerns (vs. screening efforts). Parents reported a willingness to take any necessary steps to help their child. Both barriers and facilitators to completing a PSG were described. Parents observed both nighttime and daytime symptoms related to OSA in their child but often did not connect the symptoms to each other until later in the process. Participants had varying degrees of OSA knowledge, with a mean knowledge score of 56% correct (range 10%-90% correct). CONCLUSIONS Parental experiences highlight aspects of the health care system that are both effective and ineffective in detecting children with OSA. Implications include a need for strategies to promote timely detection and to provide parents with accurate information about pediatric OSA. CITATION Honaker SM, Gopalkrishnan A, Brann M, Wiehe S, Clark AA, Chung A. "It made all the difference": a qualitative study of parental experiences ith pediatric obstructive sleep apnea detection. J Clin Sleep Med. 2022;18(8):1921-1931.
Collapse
Affiliation(s)
- Sarah M. Honaker
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Akila Gopalkrishnan
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch
| | - Maria Brann
- Department of Communication Studies, Indiana University Purdue University Indianapolis
| | - Sarah Wiehe
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Ann A. Clark
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Alicia Chung
- Center for Early Childhood Health and Development, Department of Population Health, New York University Grossman School of Medicine
| |
Collapse
|
5
|
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]
|
6
|
Seixas AA, Olaye IM, Wall SP, Dunn P. Optimizing Healthcare Through Digital Health and Wellness Solutions to Meet the Needs of Patients With Chronic Disease During the COVID-19 Era. Front Public Health 2021; 9:667654. [PMID: 34322469 PMCID: PMC8311288 DOI: 10.3389/fpubh.2021.667654] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 05/21/2021] [Indexed: 01/07/2023] Open
Abstract
The COVID-19 pandemic exposed and exacerbated longstanding inefficiencies and deficiencies in chronic disease management and treatment in the United States, such as a fragmented healthcare experience and system, narrowly focused services, limited resources beyond office visits, expensive yet low quality care, and poor access to comprehensive prevention and non-pharmacological resources. It is feared that the addition of COVID-19 survivors to the pool of chronic disease patients will burden an already precarious healthcare system struggling to meet the needs of chronic disease patients. Digital health and telemedicine solutions, which exploded during the pandemic, may address many inefficiencies and deficiencies in chronic disease management, such as increasing access to care. However, these solutions are not panaceas as they are replete with several limitations, such as low uptake, poor engagement, and low long-term use. To fully optimize digital health and telemedicine solutions, we argue for the gamification of digital health and telemedicine solutions through a pantheoretical framework—one that uses personalized, contextualized, and behavioral science algorithms, data, evidence, and theories to ground treatments.
Collapse
Affiliation(s)
- Azizi A Seixas
- Department of Population Health, Department of Psychiatry, New York University (NYU) Grossman School of Medicine, New York, NY, United States
| | - Iredia M Olaye
- Department of Medicine Division of Clinical Epidemiology and Evaluative Sciences Research, Weill Cornell Medical College, New York, NY, United States
| | - Stephen P Wall
- Department of Emergency Medicine, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Pat Dunn
- American Heart Association, Center for Health Technology and Innovation, New York, NY, United States
| |
Collapse
|
7
|
Sleep deprivation: time to intervene. Sleep Med 2021; 86:116-117. [PMID: 33820713 DOI: 10.1016/j.sleep.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
8
|
Experimental sleep loss, racial bias, and the decision criterion to shoot in the Police Officer's Dilemma task. Sci Rep 2020; 10:20581. [PMID: 33239735 PMCID: PMC7688945 DOI: 10.1038/s41598-020-77522-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/12/2020] [Indexed: 12/03/2022] Open
Abstract
Violent behavior, police brutality, and racial discrimination are currently at the forefront of society’s attention, and they should be. We investigated whether mild sleep loss—as typical for many adults throughout the work week—could aggravate the socio-emotional-cognitive processes contributing to violence and discrimination. In a sample of 40 healthy young adults, we either experimentally restricted participants’ sleep for four nights (6.2 h/night) or let participants obtain normal sleep (7.7 h/night)—and then had them complete the Police Officer’s Dilemma Task. In this computerized task, the participant must rapidly decide to shoot or not shoot at White and Black men who either are or are not holding a gun. Results showed significant racial biases, including more and quicker shooting of Black targets compared to White targets. Furthermore, signal detection analyses demonstrated that mild sleep restriction changed participants’ decision criterion, increasing the tendency to shoot, even when controlling for psychomotor vigilance, fluid intelligence, and self-reported desirability to behave in a socially acceptable manner. The increased tendency to shoot was also observed in participants who reported believing that they had adapted to the sleep loss. Future experimental research using trained police officers will help establish the generalizability of these laboratory effects. Importantly, sleep loss is modifiable via organization-level changes (e.g., shift scheduling, light entrainment) and individual-level interventions (e.g., sleep hygiene education, incentives for behavioral change), suggesting that if sleep loss is corrected, it could save lives—including Black lives.
Collapse
|