The value of decentralized clinical trials: Inclusion, accessibility, and innovation.

In this Review, we explore the transformative potential of decentralized clinical trials (DCTs) in addressing the limitations of traditional randomized controlled trials (RCTs). We highlight the merits of DCTs fostering greater inclusivity, efficiency, and adaptability. We emphasize the challenges of RCTs, including limited participant diversity and logistical barriers, geographical constraints, and mistrust in research institutions, showing how DCTs are preferred in addressing these challenges by utilizing remote digital technologies and community providers to enable broader, more inclusive participation.

Photovoice for leveraging traditional, complementary, and integrative medicine amongst black adults to improve sleep health and overall health.

Introduction: Average adults are recommended to have 7-8 h of sleep. However insufficient sleep (IS defined as <7 h/nightly) is associated with increased risk of chronic diseases such as cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Traditional, complementary, and integrative medicine (TCIM), a burgeoning area of research and practice, leverages both modern and traditional approaches to improve health.

The Transnational Mental Health Burden of Haiti's Alleged Collapse: Preliminary Findings from the Haitian Well-Being Study.

Background: Transnational drug trafficking, political unrest, gang violence, and paramilitarism, which are pervasive in Haiti, have resulted in a mental health crisis for the broader Haitian community. This study explores the mental well-being of Haitians in Haiti and the United States by identifying barriers and facilitators to mental health through the lived experiences of men and women.

Method: Four Focus group discussions conducted in April and November 2023 engaged 28 participants (20 women and eight men) aged between 23 and 60 years from locations in Haiti (Port-au-Prince, Cite Soleil, Cayes, Cap-Haitien, Saint-Marc) and the United States.

Effectiveness of peer-delivered sleep health education and social support in increasing OSA evaluation among at-risk blacks.

To assess the effectiveness of culturally and linguistically tailored, peer-delivered obstructive sleep apnea education and of social support to increase adherence to physician-recommended obstructive sleep apnea evaluation among blacks. In a two-arm randomised controlled trial, we ascertained the effectiveness of peer-delivered obstructive sleep apnea education in increasing obstructive sleep apnea evaluation among 319 blacks at risk of obstructive sleep apnea (intervention = 159 and control = 160); their average age was 47 ± 12.9 years, and 41% were male.

Type 2 diabetes and health-related quality of life among older Medicare beneficiaries: The mediating role of sleep.

Objective: To examine mediating effects of sleep quality and duration on the association between T2D and QoL among Medicare beneficiaries 65+.

Methods: Data from the Medicare Health Outcome Survey (2015-2020) were used. The outcome was QoL (physical and mental health component-summary scores [PCS and MCS]) measured by the Veterans-Rand-12.

Depression, Sleep Health & Sociodemographic Correlates in a Nationwide Survey: Implications for Depression Treatment During the COVID-19.

Purpose: The COVID-19 pandemic has had a profound impact on mental health worldwide, with depression and sleep problems among the most common issues experienced by many individuals. Depression can lead to sleep problems, which can increase the risk of developing depressive symptoms. However, it is unclear which United States (US) sub-population was most affected by depression and sleep problems during the pandemic.

Precision Recruitment and Engagement of Individuals at Risk for Diabetes and Hypertension in Clinical Trials (PREDHICT): A Randomized Trial for an E-Persuasive Mobile Application to Inform Decision Making about Clinical Trials.

The primary objective of this randomized trial was to test the effectiveness of the PREDHiCT digital application, which provides educational and supportive navigation to increase willingness to participate in a future clinical trial. The second objective was to test whether PREDHiCT increased clinical trial literacy or enhanced psychological facilitators of clinical trial participation, such as altruism. To test these two objectives, we conducted a 1-month remote decentralized trial with 100 participants who either have a personal or family history of cardiometabolic health conditions, such as hypertension, diabetes, and obesity.

The effects of social support and support types on continuous positive airway pressure use after 1month of therapy among adults with obstructive sleep apnea.

Background: The relationship between perceived social support and continuous positive airway pressure remains understudied among individuals with obstructive sleep apnea. The aim of this prospective cohort study was to determine if baseline perceived social support and subtypes predict regular continuous positive airway pressure use after 1month of therapy.

Methods: Adults with obstructive sleep apnea initiating continuous positive airway pressure therapy were recruited from sleep clinics in New York City.

Association of Birthplace for Sleep Duration, Sleep Quality, and Sleep Disorder Symptoms, at the US-Mexico Border.

Objectives: The present study investigated the roles birthplace and acculturation play in sleep estimates among Hispanic/Latino population at the US-Mexico border.

Measures: Data were collected in 2016, from  = 100 adults of Mexican descent from the city of Nogales, AZ, at the US-Mexico border. Sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index categorized as none, mild, moderate, and severe, and Multivariable Apnea Prediction Index (MAP) categorized as never, infrequently, and frequently.

Discrimination Predicts Suboptimal Adherence to CPAP Treatment and Mediates Black-White Differences in Use.

Background: Although racial and ethnic differences in CPAP adherence for OSA are widely established, no studies have examined the influence of perceived racial discrimination on CPAP usage, to our knowledge.

Research Question: (1) Do Black adults with OSA report experiencing greater amounts of discrimination than non-Hispanic White adults? (2) Is discrimination associated with poorer CPAP adherence over time, independent of self-identified race? (3) Does discrimination mediate the relationship between self-identified Black race and CPAP usage?

Study Design And Methods: In this prospective study, Black and non-Hispanic White adults with OSA initiating CPAP were enrolled from two sleep centers and completed questionnaires including sociodemographics, perceived discrimination, daytime sleepiness, insomnia symptoms, and depressive symptoms. Perceived discrimination was measured using the Everyday Discrimination Scale (EDS).

Association of Hospice Agency Location and Neighborhood Socioeconomic Disadvantage in the U.S.

Background: Despite the growing increase in the utilization of hospice in the U.S, disparities exist in the utilization of hospice. Accumulating evidence has shown that neighborhood characteristics have an impact on availability of hospice agencies.

Health Disparities Research Curricula and Training Development: Recommendations From a National Institute of Neurological Disorders and Stroke Workgroup.

The national mandate to improve health equity in the United Sates is advancing. Racial and ethnic disparities in various aspects of health care have been clearly delineated, and sources of such disparities have been identified. However, implementing solution-focused interventions to eradicate such disparities, thereby achieving health equity in all US communities, has remained a daunting challenge, and no area more so, than with neurologic diseases.

Bringing Health Care Equity to Diverse and Underserved Populations in Sleep Medicine and Research Through a Digital Health Equity Framework.

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.

Ethical and Policy Implications of Racial and Ethnic Healthcare Disparities in Sleep Health.

Despite efforts in recent years, including in policy and research, to address health disparities in the United States, many of those disparities continue to fester in marginalized racial/ethnic populations. Understanding sleep health disparities is critical in understanding the health and wellness of these groups. Using obstructive sleep apnea (OSA) in Black populations as a focus, this paper presents the role of race and ethnicity in the clinical understanding of sleep health-related issues by medical practitioners and the implications of the lack of clear policies or best practices to guide medical practitioners' attempts to meet sleep-related needs of marginalized racial/ethnic populations.

Comparisons of Sleep, Demographics, and Health-Related Variables in Older Long and Average Duration Sleepers.

 Long sleep duration is associated with many health risks, particularly in older adults, but little is known about other characteristics associated with long sleep duration.  Across 5 sites, adults aged 60-80 years who reported sleeping 8-9 h ("long sleepers", n = 95) or 6-7.25 h ("average sleepers", n = 103) were assessed for two weeks using actigraphy and sleep diary.

Strategies to Engage Blacks in Sleep Medicine: Lessons Learned from Three Studies Applying Community-Based Participatory Research Principles.

Introduction: Awareness, assessment and treatment of sleep apnea are disproportionately lower among Blacks, compared to other racial/ethnic groups. To address this health disparity gap, communication strategies that connect Blacks to OSA education, detection and treatment adherence interventions are needed. Strategies that engage individuals through communication technologies, community-level social network support, and medical providers in clinical settings are also needed.

Mind-Body Intervention for Dysfunctional Breathing in Chronic Obstructive Pulmonary Disease: Feasibility Study and Lessons Learned.

Dysfunctional breathing behaviors are prevalent in chronic obstructive pulmonary disease (COPD). Although these behaviors contribute to dyspnea, abnormal carbon dioxide (CO) levels, and COPD exacerbations, they are modifiable. Current dyspnea treatments for COPD are suboptimal, because they do not adequately address dysfunctional breathing behaviors and anxiety together.

The Mediating Role of Inflammation in the Relationship Between α-Synuclein and Cognitive Functioning.

Accumulating evidence suggests that α-synuclein plays a role in the pathophysiology of Alzheimer's disease (AD). This study examined whether α-synuclein level in cerebrospinal fluid (CSF) was associated with cognitive functioning among older adults. We also explored whether this relationship was mediated by proinflammatory cytokines TNF-α and IL-6, along with sIL-6R and vascular endothelial growth factor (VEGF).