title: Telephone-delivered behavioral intervention among blacks with sleep apnea and metabolic syndrome: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  The study is registered at clinicaltrials.gov NCT01946659 (February 2013).
authors.affiliation: 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. natasha.williams2@nyumc.org.
authors.forename: Natasha J
authors.initials: NJ
authors.lastname: Williams
authors.forename: Girardin
authors.initials: G
authors.lastname: Jean-Louis
authors.forename: Clinton D
authors.initials: CD
authors.lastname: Brown
authors.forename: Samy I
authors.initials: SI
authors.lastname: McFarlane
authors.forename: Carla
authors.initials: C
authors.lastname: Boutin-Foster
authors.forename: Gbenga
authors.initials: G
authors.lastname: Ogedegbe
mesh_terms: D000328:Adult; D044383:Black People / Q000208:ethnology* / Q000523:psychology; D045422:Continuous Positive Airway Pressure / Q000523:psychology*; D054521:Cultural Competency; D005500:Follow-Up Studies; D006266:Health Education / Q000379:methods; D006801:Humans; D015994:Incidence; D008037:Linguistics; D024821:Metabolic Syndrome / Q000208:ethnology* / Q000523:psychology; D009042:Motivation; D010349:Patient Compliance / Q000208:ethnology* / Q000523:psychology; D015995:Prevalence; D012107:Research Design; D020181:Sleep Apnea, Obstructive / Q000208:ethnology* / Q000523:psychology / Q000628:therapy*; D013689:Telephone