Reducing sleep health disparities was recognized as a priority area for intervention by the National Institutes of Health. Sleep apnea, which disproportionately affects minorities, is an important preventable and treatable disease that should be targeted as it is associated with increased cardiovascular risk and disease outcomes, including obesity, diabetes, hypertension, stroke, cardiac arrhythmia, and chronic heart failure. Evidence from previous research suggests that most minorities are unaware of general sleep problems, such as sleep apnea symptoms and the negative effects on cardiovascular disease. Only 26% of minorities participating in the investigators prior research followed up on recommended sleep apnea screening, although 39% were at high risk for sleep apnea. While few followed the physician's recommendations, 90% of those assessed received a sleep apnea diagnosis. The investigators research will assess the effectiveness of peer-based sleep health education and social support in increasing sleep apnea screening and treatment rates among minorities with sleep apnea risk. Participants will receive quality-controlled and culturally tailored peer education using a sleep health education manual. They will each receive up to 4 sessions promoting sleep apnea screening during a 6-month period. Those with a diagnosis will receive 2 additional sessions promoting sleep apnea treatment adherence, in conjunction with telephone interventions. The investigators research will also assess the rate of sleep apnea among minorities using home recordings. The long-term goal of the investigators study is to apply this intervention in community-based settings (barbershops, beauty salons, churches, and health centers), thereby linking community health promotion to the healthcare system.

Brief Title

Peer-Enhanced Education to Reduce Sleep Ethnic Disparities

Official Title

Tailored Peer-Based Sleep Health Education and Social Support Among Blacks With Obstructive Sleep Apnea

Brief Summary

Reducing sleep health disparities was recognized as a priority area for intervention by the<br /> National Institutes of Health. Sleep apnea, which disproportionately affects minorities, is<br /> an important preventable and treatable disease that should be targeted as it is associated<br /> with increased cardiovascular risk and disease outcomes, including obesity, diabetes,<br /> hypertension, stroke, cardiac arrhythmia, and chronic heart failure. Evidence from previous<br /> research suggests that most minorities are unaware of general sleep problems, such as sleep<br /> apnea symptoms and the negative effects on cardiovascular disease. Only 26% of minorities<br /> participating in the investigators prior research followed up on recommended sleep apnea<br /> screening, although 39% were at high risk for sleep apnea. While few followed the physician's<br /> recommendations, 90% of those assessed received a sleep apnea diagnosis. The investigators<br /> research will assess the effectiveness of peer-based sleep health education and social<br /> support in increasing sleep apnea screening and treatment rates among minorities with sleep<br /> apnea risk. Participants will receive quality-controlled and culturally tailored peer<br /> education using a sleep health education manual. They will each receive up to 4 sessions<br /> promoting sleep apnea screening during a 6-month period. Those with a diagnosis will receive<br /> 2 additional sessions promoting sleep apnea treatment adherence, in conjunction with<br /> telephone interventions. The investigators research will also assess the rate of sleep apnea<br /> among minorities using home recordings. The long-term goal of the investigators study is to<br /> apply this intervention in community-based settings (barbershops, beauty salons, churches,<br /> and health centers), thereby linking community health promotion to the healthcare system.

Detailed Description

Primary Aim: To ascertain effectiveness of tailored, peer-based sleep health education and
social support in increasing adherence rates to recommended OSA evaluation and treatment
among blacks at risk for OSA.

Secondary Aim: To ascertain the rate of OSA among black men and women at the community level
using home-based sleep recordings in accordance with criteria from the American Academy of
Sleep Medicine.

Hypotheses: Among blacks at risk for OSA, those randomized to receive peer-based sleep health
education and social support, compared with those randomized to the attention-control group,
will have:

- Greater adherence to physician-recommended OSA evaluation using home sleep recordings.

- Greater adherence to OSA treatment using telemetry (CPAP use [>4 hrs. a night for 70% of
the nights]).

- Individual-level factors (OSA knowledge, OSA self-efficacy, and past evaluation
behavior) and contextual level factors (i.e., trust/rapport with peer educators, family
network, and socioeconomic position) will mediate effects of peer education on adherence
to OSA evaluation and recommended treatment.

Outcome Measures

Outcome measures are the tests that investigators perform to prove whether or not a treatment being tested in a clinical trial is having any effect.