Psychosocial factors that influence men's help-seeking for cancer symptoms: a systematic synthesis of mixed methods research

Masculinity and Race-Related Factors as Barriers to Health Help-Seeking Among African American Men

Men's tendency to delay health help-seeking is largely attributed to masculinity, but findings scarcely focus on African American men who face additional race-related, help-seeking barriers. Building principally on reactance theory, we test a hypothesized model situating racial discrimination, masculinity norms salience (MNS), everyday racism (ERD), racial identity, sense of control (SOC), and depressive symptomatology as key barriers to African American men's health help-seeking. A total of 458 African American men were recruited primarily from US barbershops in the Western and Southern regions. The primary outcome was Barriers to Help-Seeking Scale (BHSS) scores. The hypothesized model was investigated with confirmatory factor and path analysis with tests for measurement invariance. Our model fit was excellent [Formula: see text] CFI = 0.99; TLI = 1.00; RMSEA = 0.00, and 90% CI [0.00, 0.07] and operated equivalently across different age, income, and education strata. Frequent ERD and higher MNS contributed to higher BHHS scores. The relationship between ERD exposure and BHHS scores was partially mediated by diminished SOC and greater depressive symptomatology. Interventions aimed at addressing African American men's health help-seeking should not only address masculinity norms but also threats to sense of control, and negative psychological sequelae induced by everyday racism.

Rural Men's Health, Health Information Seeking, and Gender Identities: A Conceptual Theoretical Review of the Literature

Beginning as early as 2009, recent shifts in Canadian health care delivery indicate that access to health information is essential to promote and maintain a healthy population. It is important to understand how and where various populations, such as underresourced rural populations, access health information so that public health agencies can develop and deliver appropriate information with, for, and in these contexts. There is a paucity of research that specifically examines how rural Canadian men seek health information; therefore, this review aimed to conceptualize this process based on three dynamic key constructs: health patterns of rural Canadians, health information-seeking behaviors, and rural gender identities. This conceptual theoretical literature review included 91 articles at the intersection of these three constructs. Discussion focuses on how residing in a rural region influences men's health and health care access. Health information-seeking behaviors are discussed in terms of social networks and framed with a rural context. Connell's theory of masculinity provides a useful approach to dissecting how rural men's gender identities influence their health attitudes, and how such attitudes are embedded in rural social and cultural norms. Each major construct-health in rural Canada, health information seeking, and rural gender identities-is discussed to highlight how specific embodiments of masculinity may promote and inhibit men's health information-seeking and positive health behaviors.

Characteristics, rates, and trends of melanoma incidence among Hispanics in the USA

PURPOSE

The purpose of this study is to describe the epidemiology of melanoma among Hispanics using data that cover nearly 100 % of the US population.

METHODS

The study used population-based cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology and End Results Program to examine melanoma incidence rates and trends among Hispanics by sex, age, race, histology, anatomic location, stage, and tumor thickness.

RESULTS

From 2008 to 2012, 6,623 cases of melanoma were diagnosed among Hispanics. Rates were higher among males (4.6) than among females (4.0), but females younger than age 55 had higher rates than males. The most common histologic subtype was superficial spreading melanoma (23 %). Melanomas with poorer outcomes, such as nodular (NM) and acral lentiginous melanoma (ALM), were more common among males. Hispanic females had the highest proportion of melanoma on the lower limb and hip (33.7 %), while Hispanic males had the highest proportion on the trunk (29.9 %). Incidence rates for later-stage diagnosis and thicker tumors were significantly higher among Hispanic men than among women. Incidence rates decreased significantly during 2003-2012 (AAPC = -1.4).

CONCLUSIONS

Clinicians and public health practitioners will need to reach the growing Hispanic population in the USA with strategies for primary prevention and early diagnosis of melanoma. Results suggest Hispanics and providers need education to increase awareness about the characteristics of melanoma among Hispanics, including types that occur on non-sun-exposed areas (ALM and NM). Skin cancer prevention and awareness interventions targeting Hispanics should be culturally relevant.

Reinforcing the role of psycho-social oncology in global cancer prevention: applying psycho-oncology research in programmes and practice

Over the past decade, global action to address the emerging crisis in non-communicable diseases (NCDs) has escalated. Central to these efforts has been the support and influence of the World Health Organisation and the United Nations with the 2000 civil societies represented by the Non-Communicable Disease Alliance. In particular this reached expression in the world's first High Level Meeting on NCDs by the United Nations leading to the 2011 Political Declaration urging a coordinated global response to NCDs. Where then does psycho-oncology sit in this global context? Psycho-oncology practitioners and their collective, the International Psycho-Oncology Society (IPOS), have traditionally been situated within a patient focus and context. However, through linkages with community-based and non-government cancer organisations' agencies, psycho-oncology research and practice has played a key role in reducing cancer risk, improving cancer survivorship, and influencing social and cultural change to eliminate disease-related stigma. As a discipline, psycho-oncology has contributed to widespread recognition of patient-centred care in cancer and along with a broad acceptance and endorsement of the IPOS International Standard. However psycho-oncology is less well accepted in nation-state cancer plans and herein lies opportunity. This special issue includes research across the illness continuum from cancer prevention to screening and early detection, and then to tertiary prevention with lifestyle considerations for cancer survivors. Importantly this demonstrates the capacity within psycho-oncology to develop new understandings of cancer as not only a disease but also a context linked to individual, community, and society health and well-being. Copyright © 2015 John Wiley & Sons, Ltd.