Afiya lives in the rural Sylhet region of Bangladesh. For two days, her youngest daughter, Rubina, has been complaining of fatigue and has felt warm to the touch. Taking the child to the nearest clinic would cost Afiya a day's lost wages, round-trip bus fare, and clinic fees of Taka 200 (U.S. $3). Instead, Afiya and her husband use the family's mobile phone to dial "7-8-9," the Healthline hotline service set up by TRCL, Ltd., a telemedicine firm, and GrameenPhone, the country's largest mobile network operator. The family quickly reaches Dr. Quadri at Healthline's call center in Dhaka. After asking a few questions, Dr. Quadri tells her to give Rubina small regular doses of paracetamol, available at neighborhood shops. For the threeminute call, Afiya pays only Taka 15 (U.S. $0.21) from her family's GrameenPhone prepaid talk-time balance.Afiya is not the only person seeking basic medical advice and information by calling a health hotline. Telephone-based nurse triage, primary care, and health information have been offered in developed countries since the late 1990's, and

Purpose of Review In this current review, we describe the benefits of community-based and "precision and personalized population health" (P3H) approaches to assessing and addressing sleep health problems and sleep-related cardiovascular diseases (CVD) among vulnerable populations such as racial/ethnic minorities, the elderly, and the socioeconomically disadvantaged. Recent Findings Very few sleep health programs utilize a community-based or P3H approach, which may account for low estimates of sleep health problems, related CVD outcomes, and inadequate healthcare infrastructure to address sleep-related health outcomes at the community and population level. We describe community-based and P3H approaches and programs as solutions to accurately capture estimates of sleep health and reduce burden of sleep health problems and corollary CVD outcomes at the level of the community and population. Specifically, we describe seven critical steps needed to successfully implement a community-based and P3H approach to address sleep health problems. Summary Community-based and P3H approaches are effective strategies to assessing and addressing sleep health problems and related health conditions. KeywordsSleep . Sleep health . Community . Personalized . Health disparities . Cardiovascular disease This article is part of the Topical Collection on Sleep and Hypertension

No abstract

No abstract

Introduction Adherence to OSA assessment and treatment is low among racial/ethnic minorities, particularly among blacks. Navigating patients along the continuum of care from assessment to treatment adherence requires motivation, social support, and self-efficacy. Previous studies indicate that community health educators can provide motivation, social support, and skills to patients to better navigate the complex OSA care continuum. However, recruiting, training, and implementing sleep health educators in clinical or research settings is complex. For the current study, we describe how we recruit, train, and implement sleep health educators in research and clinical settings and assess what makes a sleep health educator successful. Methods We recruited and trained twenty-five self-identified black sleep health educators for a randomized clinical trial (R01MD007716) focused on increasing OSA assessment and treatment adherence among blacks. During recruitment, we assessed key personality attributes that translate to being an effective sleep health educator, via behavioral and personality surveys, focused groups, and process forms filled out by educators. Sleep health educators underwent an 8-week training program on sleep health and motivational interviewing. In order to be certified, sleep health educators had to pass a written and scenario-based assessment. During the implementation phase of the trial, we assessed how many interviews each health educator conducted and whether individual characteristics were related to how many interviews. Results Of the trained educators, 80% were female, ranging from 25 to 58 years old. They all completed at least high school. All educators rated the program highly and were very satisfied with dispensing tailored sleep health education. Educators who displayed the highest knowledge about sleep health, provided frequent emotional and strategic support, committed to helping their assigned participants, and who rated their rapport highly with their assigned participants were most effective in getting their participant to adhere to OSA assessment and treatment. Conclusion Sleep health educators can be vital to increasing OSA assessment and treatment adherence among blacks. In order to ensure success, sleep health educators must undergo a thorough recruitment, training, and implementation and dissemination process. Support K01HL135452, R01MD007716, R01HL142066, K01HL135452,and K07AG052685