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Wippold GM, Jowers T, Garcia KA, Frary SG, Murphy H, Brown S, Carr B, Jeter O, Johnson K, Williams TL. Understanding and Promoting Preventive Health Service Use Among Black Men: Community-Driven and Informed Insights. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01864-3. [PMID: 38017346 DOI: 10.1007/s40615-023-01864-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/30/2023]
Abstract
Black men experience high rates of adverse health that can be prevented or mitigated by the regular use of preventive health services. Efforts are urgently needed to promote this type of health service use among Black men. The U.S. Preventive Services Task Force and the Institute of Medicine indicate that such efforts must align with Black men's values, perspectives, and preferences. However, little guidance exists on how to align these efforts for Black men. The present qualitative study was developed to understand factors associated with preventive health service use among Black men and community-informed strategies to promote preventive health service use among these men. An approach rooted in community-based participatory research and ecological theory was used. A core leadership team consisting of five Black men from the area guided the project's development, implementation, and evaluation. The core leadership team conducted 22 interviews with Black men from their communities. Four themes emerged from these interviews: (1) holistic well-being challenges faced by Black men: interaction of mental, physical, and societal forces; (2) the interplay of financial, informational, and gendered barriers/facilitators to using preventative health services among Black men; (3) the importance of shared identity in peer health education about preventive health service use; and (4) the need for community-centered initiatives to improve preventive health service use among Black men that prioritize accessibility and information. Findings of the present study can be used to tailor preventive health service use efforts for Black men. Such efforts have the potential to promote health and mitigate health disparities.
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Affiliation(s)
- Guillermo M Wippold
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, 29208, USA.
| | - Terri Jowers
- Aiken Center, Aiken, SC, USA
- South Carolina Community Health Workers Association, Columbia, SC, USA
| | - Kaylyn A Garcia
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, 29208, USA
| | - Sarah Grace Frary
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, 29208, USA
| | | | - Steven Brown
- Dreams Imagination and Gift Development, Simpsonville, SC, USA
| | | | - Orion Jeter
- Free Medical Clinic of Aiken County, Aiken, SC, USA
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Pesantes MA, Ferrazza I, Miranda JJ. "I want to be there for my children": fatherhood, diabetes and temporality among Peruvian men. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1207028. [PMID: 37899791 PMCID: PMC10603236 DOI: 10.3389/fcdhc.2023.1207028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/21/2023] [Indexed: 10/31/2023]
Abstract
Introduction Living with a chronic condition is a challenging experience, as it can disrupt your capacity to function and fulfill social roles such as being a father. Fatherhood constitutes an important component of masculinity that has not received significant attention in studies aimed at understanding the role of gender norms in health-related behaviors. Fatherhood refers to the set of social expectations placed on men to provide, protect, and care for those considered his children. Our paper aims to show the importance of understanding men's perspectives around fatherhood and its relevance for staying healthy. Methods In-depth semi-structured interviews with men living with Type 2 diabetes in Peru to explore their experiences with diabetes management. Results Eighteen Peruvian men, diagnosed with Type 2 diabetes for at least one year and with ages between 27 and 59 years old were interviewed. They had an average of three children each and were all insured under the national insurance plan aimed at low-income groups in Peru. Their accounts described their concern of not being able to fulfill their roles as fathers as a result of their condition. They mentioned the importance of being physically and emotionally present in the lives of their children, taking care of them, and being an example. These concerns varied depending on the age of their children: those with younger children were more preoccupied with ensuring they stayed healthy. Temporality provides a relevant analytical approach to understand the interplay of fatherhood and motivation for diabetes management. Discussion Our study advances the research around the intersection between health and gender norms and argues that a more nuanced understanding of the construction of masculinity and the relevance of fatherhood in the lives of men could be useful to design and identify better health promotion strategies tailored to men with diabetes.
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Affiliation(s)
- M. Amalia Pesantes
- Department of Anthropology and Archaeology, Dickinson College, Carlisle, PA, United States
- Universidad Peruana Cayetano Heredia, CRONICAS Centro de Excelencia en Enfermedades Crónicas, Lima, Peru
| | - Isabella Ferrazza
- Department of Anthropology and Archaeology, Dickinson College, Carlisle, PA, United States
| | - J. Jaime Miranda
- Universidad Peruana Cayetano Heredia, CRONICAS Centro de Excelencia en Enfermedades Crónicas, Lima, Peru
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
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Wippold GM, Frary SG. Predictors of Health-Related Quality of Life Among African American Men. J Racial Ethn Health Disparities 2022; 9:2131-2138. [PMID: 34533780 PMCID: PMC8926934 DOI: 10.1007/s40615-021-01151-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 12/29/2022]
Abstract
African American men have the lowest life expectancy of any ethnic gender group in the USA. Furthermore, these men endorse having a lower health-related quality of life (HRQoL) than any other group. There have been recent calls from national organizations to improve HRQoL-a multidimensional indicator of health strongly associated with mortality and morbidity. Following these calls, there have been widespread efforts implemented to improve HRQoL among the US population, though no known effort has been implemented that is tailored to the unique experiences of African American men. Health promotion efforts that are not tailored to the unique preferences and experiences of these men are likely to produce limited results. Formative research conducted among African American men is needed in order to design and implement an effective HRQoL-promoting intervention for African American men. The present study constitutes such formative research and was conducted with a sample of 211 African American men. Hierarchical regressions were performed to understand the role of literature-derived predictors of HRQoL among these men. Results found that depression, stress, and physical activity were found to be significant predictors of HRQoL among these men. This is the first known study to examine predictors of HRQoL among African American men-a group that disproportionately experiences health disparities and low HRQoL, though for who few successful health promotions exist. The findings from this study have implications for those seeking to design and implement HRQoL-promoting interventions among African American men.
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Affiliation(s)
- Guillermo M Wippold
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, 29208, USA.
| | - Sarah Grace Frary
- Department of Psychology, University of South Carolina, 1512 Pendleton Avenue, Barnwell College, Mailbox 38, Columbia, SC, 29208, USA
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Wallace BH, Chard S, Roth EG. The Graying of the Cool Pose: Examining Active Care Strategies Among Older African-American Men With Type 2 Diabetes Mellitus. J Gerontol B Psychol Sci Soc Sci 2022; 77:2016-2025. [PMID: 35552416 PMCID: PMC9683491 DOI: 10.1093/geronb/gbac071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES The influence of masculinity norms on disparate health outcomes has been established in the literature. What is less understood are the specific ways in which African-American men "do health" by engaging in strategies promoting positive health outcomes. This article reframes what has been previously examined through a health deficit perspective by reporting the experiences and positive health maintenance strategies of older, African-American men with type 2 diabetes mellitus (diabetes). METHODS We employed an intersectional framework to thematically analyze qualitative interviews with African-American male participants (N = 15) in our National Institute on Aging-funded study of diabetes among older adults in Baltimore. Interviews consisted of a modified version of the McGill Illness Narrative Interview, which included discussions of diabetes experiences and self-management strategies. RESULTS The majority of African-American men in our study link their successful diabetes management to purposeful self-care activities, despite structural and personal limitations. These activities include proactively seeking diabetes education, healthy eating, medication management, and engaging in supportive relationships. DISCUSSION Active pursuit of a healthy lifestyle often requires redefining Black manhood, defying negative gender stereotypes of what it means to be a Black male. Results are described in the context of the "Cool Pose," a framework for understanding how African-American men and boys cope with systemic racial oppression and the unachievable dominant standards of masculinity in the United States. The results suggest that this framework may be less applicable for older African-American men who promote well-being in the wake of chronic disease as they age.
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Affiliation(s)
- Brandy Harris Wallace
- Address correspondence to: Brandy Harris Wallace, PhD, UMBC, Center for Aging Studies, PUP, 1000 Hilltop Circle, Baltimore, MD 21250, USA. E-mail:
| | - Sarah Chard
- UMBC, Center for Aging Studies, PUP, Baltimore, Maryland, USA,UMBC, Sociology and Anthropology Department, PUP, Baltimore, Maryland, USA
| | - Erin G Roth
- UMBC, Center for Aging Studies, PUP, Baltimore, Maryland, USA
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Ramasawmy M, Poole L, Thorlu-Bangura Z, Chauhan A, Murali M, Jagpal P, Bijral M, Prashar J, G-Medhin A, Murray E, Stevenson F, Blandford A, Potts HWW, Khunti K, Hanif W, Gill P, Sajid M, Patel K, Sood H, Bhala N, Modha S, Mistry M, Patel V, Ali SN, Ala A, Banerjee A. Frameworks for implementation, uptake and use of digital health interventions in ethnic minority populations: a scoping review using cardiometabolic disease as a case study. (Preprint). JMIR Cardio 2022; 6:e37360. [PMID: 35969455 PMCID: PMC9412726 DOI: 10.2196/37360] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/17/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background Digital health interventions have become increasingly common across health care, both before and during the COVID-19 pandemic. Health inequalities, particularly with respect to ethnicity, may not be considered in frameworks that address the implementation of digital health interventions. We considered frameworks to include any models, theories, or taxonomies that describe or predict implementation, uptake, and use of digital health interventions. Objective We aimed to assess how health inequalities are addressed in frameworks relevant to the implementation, uptake, and use of digital health interventions; health and ethnic inequalities; and interventions for cardiometabolic disease. Methods SCOPUS, PubMed, EMBASE, Google Scholar, and gray literature were searched to identify papers on frameworks relevant to the implementation, uptake, and use of digital health interventions; ethnically or culturally diverse populations and health inequalities; and interventions for cardiometabolic disease. We assessed the extent to which frameworks address health inequalities, specifically ethnic inequalities; explored how they were addressed; and developed recommendations for good practice. Results Of 58 relevant papers, 22 (38%) included frameworks that referred to health inequalities. Inequalities were conceptualized as society-level, system-level, intervention-level, and individual. Only 5 frameworks considered all levels. Three frameworks considered how digital health interventions might interact with or exacerbate existing health inequalities, and 3 considered the process of health technology implementation, uptake, and use and suggested opportunities to improve equity in digital health. When ethnicity was considered, it was often within the broader concepts of social determinants of health. Only 3 frameworks explicitly addressed ethnicity: one focused on culturally tailoring digital health interventions, and 2 were applied to management of cardiometabolic disease. Conclusions Existing frameworks evaluate implementation, uptake, and use of digital health interventions, but to consider factors related to ethnicity, it is necessary to look across frameworks. We have developed a visual guide of the key constructs across the 4 potential levels of action for digital health inequalities, which can be used to support future research and inform digital health policies.
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Affiliation(s)
- Mel Ramasawmy
- Institute of Health Informatics, University College London, London, United Kingdom
| | - Lydia Poole
- Institute of Health Informatics, University College London, London, United Kingdom
| | | | - Aneesha Chauhan
- Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Mayur Murali
- Division of Anaesthetics, Pain Medicine, and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Parbir Jagpal
- School of Pharmacy, University of Birmingham, Birmingham, United Kingdom
| | - Mehar Bijral
- University College London Medical School, University College London, London, United Kingdom
| | - Jai Prashar
- University College London Medical School, University College London, London, United Kingdom
| | - Abigail G-Medhin
- Department of Population Health Sciences, King's College London, London, United Kingdom
| | - Elizabeth Murray
- eHealth Unit, Research Department of Primary Care and Population Health, University College London Medical School, London, United Kingdom
| | - Fiona Stevenson
- eHealth Unit, Research Department of Primary Care and Population Health, University College London Medical School, London, United Kingdom
| | - Ann Blandford
- University College London Interaction Centre, University College London, London, United Kingdom
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom
| | - Wasim Hanif
- Department of Diabetes and Institute of Translational Medicine, University Hospital Birmingham, Birmingham, United Kingdom
| | - Paramjit Gill
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Madiha Sajid
- Patient and Public Involvement Representative, DISC Study (UK), United Kingdom
| | - Kiran Patel
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- University Hospitals Coventry and Warwickshire, Coventry, United Kingdom
| | - Harpreet Sood
- Health Education England, London, United Kingdom
- Hurley Group Practice, London, United Kingdom
| | - Neeraj Bhala
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Shivali Modha
- Patient and Public Involvement Representative, DISC Study (UK), United Kingdom
| | - Manoj Mistry
- Patient and Public Involvement Representative, DISC Study (UK), United Kingdom
| | - Vinod Patel
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Sarah N Ali
- Department of Diabetes and Endocrinology, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Aftab Ala
- Department of Access and Medicine, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, United Kingdom
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Turner CD, Lindsay R, Heisler M. Peer Coaching to Improve Diabetes Self-Management Among Low-Income Black Veteran Men: A Mixed Methods Assessment of Enrollment and Engagement. Ann Fam Med 2021; 19:532-539. [PMID: 34750128 PMCID: PMC8575516 DOI: 10.1370/afm.2742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 05/06/2021] [Accepted: 06/03/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE We undertook a study to ascertain patient characteristics associated with enrollment and engagement in a type 2 diabetes peer health coaching program at an urban health care facility serving predominantly Black veteran men, to improve the targeting of such programs. METHODS A total of 149 patients declined enrollment in a randomized controlled trial but provided sociodemographic, clinical, and psychosocial information. A total of 290 patients enrolled and were randomized to 2 peer coaching programs; they provided sociodemographic, clinical, and survey data, and were analyzed according to their level of program engagement (167 engaged, 123 did not engage) irrespective of randomization group. Qualitative interviews were conducted with 14 engaged participants. RESULTS Patients who enrolled were more likely to be Black men, have higher levels of education, have higher baseline hemoglobin A1c levels, describe their diabetes self-management as "fair" or "poor," and agree they "find it easy to get close to others" (P <.05 for each). At the program's end, patients who had engaged were more likely than those who had not to describe their peer coaches as being supportive of their autonomy (mean score, 85.4 vs 70.7; P <.001). The importance of coaches being encouraging, supportive, and having common ground/shared experiences with participants also emerged as key themes in interviews with engaged participants. CONCLUSION Individuals with greatest perceived need were more likely to enroll in our trial of peer coaching, but the only factor associated with engagement was finding one's coach to support autonomy. Our findings reinforce the importance of training and ensuring fidelity of peer coaches to autonomy-supportive communication styles for participant engagement. In tailoring peer support programs for Black men, future research should elucidate which shared characteristics between participant and peer coach are most important for engagement and improved outcomes.Visual abstract.
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Affiliation(s)
- Cassie D Turner
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan .,Center for Clinical Management Research, Ann Arbor Veterans' Affairs (VA) Healthcare System, Ann Arbor, Michigan
| | - Rebecca Lindsay
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.,Center for Clinical Management Research, Ann Arbor Veterans' Affairs (VA) Healthcare System, Ann Arbor, Michigan
| | - Michele Heisler
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.,Center for Clinical Management Research, Ann Arbor Veterans' Affairs (VA) Healthcare System, Ann Arbor, Michigan.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
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Hurt TR, Francis SL, Seawell AH, Krisco MP, Flynn MH, O'Connor MC, Rudolph CS, Hill A. Revising Diabetes Programming for Black Men and Their Families. Glob Qual Nurs Res 2020; 7:2333393620960183. [PMID: 33088849 PMCID: PMC7545759 DOI: 10.1177/2333393620960183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 08/25/2020] [Accepted: 08/31/2020] [Indexed: 12/20/2022] Open
Abstract
Type-2 diabetes has increased 160% for African American males in the United States. This two-part study's purpose was to apply social marketing theory to understand the Type-2 diabetes education needs of men in Iowa. Study One was a preference assessment of Type-2 diabetes education strategies. Four African American men participated in a series of four focus groups and indicated that they were interested in diabetes prevention programming with their families but not in having it labeled as diabetes education. Participating men would rather increase their physical activity as opposed to tracking their food intake. As a follow-up to this study, nine other African American males took part in Study Two, which used cooking demonstrations and recipe taste-testing with the men to examine their relationship to food in the context of managing their Type-2 diabetes. The findings of both studies, which provided insight into these African American men's lifestyle as related to their Type-2 diabetes, could be useful for nursing professionals who have a critical role in navigating cultural, gender, and family norms while developing care plans, offering patient education, and promoting quality of life.
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Willie-Tyndale D, McKoy Davis J, Holder-Nevins D, Mitchell-Fearon K, James K, Waldron NK, Eldemire-Shearer D. Predictors of Health Service Utilization Among Older Men in Jamaica. J Gerontol B Psychol Sci Soc Sci 2020; 74:999-1006. [PMID: 29304226 DOI: 10.1093/geronb/gbx168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 11/20/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To determine the relative influence of sociodemographic, socioeconomic, psychosocial, and health variables on health service utilization in the last 12 months. METHODS Data were analyzed for 1,412 men ≥60 years old from a 2012 nationally representative community-based survey in Jamaica. Associations between six health service utilization variables and several explanatory variables were explored. Logistic regression models were used to identify independent predictors of each utilization measure and determine the strengths of associations. RESULTS More than 75% reported having health visits and blood pressure checks. Blood sugar (69.6%) and cholesterol (63.1%) checks were less common, and having a prostate check (35.1%) was the least utilized service. Adjusted models confirmed that the presence of chronic diseases and health insurance most strongly predicted utilization. A daughter or son as the main source of financial support (vs self) doubled or tripled, respectively, the odds of routine doctors' visits. Compared with primary or lower education, tertiary education doubled [2.37 (1.12, 4.95)] the odds of a blood pressure check. Regular attendance at club/society/religious organizations' meetings increased the odds of having a prostate check by 45%. DISCUSSION Although need and financial resources most strongly influenced health service utilization, psychosocial variables may be particularly influential for underutilized services.
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Affiliation(s)
- Douladel Willie-Tyndale
- Mona Ageing and Wellness Centre, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Julian McKoy Davis
- Mona Ageing and Wellness Centre, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Desmalee Holder-Nevins
- Department of Community Health and Psychiatry, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Kathryn Mitchell-Fearon
- Department of Community Health and Psychiatry, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Kenneth James
- Department of Community Health and Psychiatry, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Norman K Waldron
- Mona Ageing and Wellness Centre, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Denise Eldemire-Shearer
- Mona Ageing and Wellness Centre, The University of the West Indies, Mona Campus, Kingston, Jamaica
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Sinclair KA, Pritchard D, McElfish PA. An intersectional mixed methods approach to Native Hawaiian and Pacific Islander men's health. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2019; 10:268-281. [PMID: 32864038 PMCID: PMC7453840 DOI: 10.1037/aap0000156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
We used a convergent parallel design to explore NHPI men's multi-level perspectives of the factors that influence healthy eating, physical activity, and weight, to elicit recommendations for lifestyle interventions, and to understand the intersection of masculinity and health from a social constructionist perspective. From June to December 2017, NHPI men 18 years and older were recruited to participate in a survey and focus groups. The survey included demographic questions and questions about physical and cultural activities men engage in, perceived social support for lifestyle behaviors, dietary behaviors, masculine characteristics and values important to NHPI men. The Kessler Psychological Distress Scale was used to assess psychological distress. Focus groups were audio recorded and transcribed for a thematic analysis. Descriptive statistics were computed for survey data. We conducted eight focus groups with 89 NHPI men (50% Samoan, 20% Native Hawaiian, 30% Marshallese). The mean age of participants was 39 years, 43% reported some college or college graduate, 64% were currently married, and 63% were working full time. Ninety percent of men scored 20 or higher on the K10 scale indicating mild to severe psychological distress. Men described food as a major part of their culture and their identity. Men's roles were defined as provider and protector, with little attention is paid to their own health. Our study found that hegemonic, or traditional masculinity and social norms may encourage some men to put their health at risk but may also be used to motivate healthy behaviors.
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Affiliation(s)
- Kàimi A Sinclair
- Initiative for Research and Education to Advance Community Health (IREACH), College of Nursing, Washington State University, Seattle, Washington, USA
| | - Dan Pritchard
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, Washington, USA
| | - Pearl A McElfish
- Office of Community Health and Research, University of Arkansas for Medical Sciences, Fayetteville, Arkansas, USA; College of Medicine, University of Arkansas for Medical Sciences, Fayetteville, Arkansas, USA
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Routh B, Hurt T, Winham D, Lanningham-Foster L. Family Legacy of Diabetes-Related Behaviors: An Exploration of the Experiences of African American Parents and Adult Children. Glob Qual Nurs Res 2019; 6:2333393619852343. [PMID: 31192273 PMCID: PMC6542120 DOI: 10.1177/2333393619852343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 04/18/2019] [Accepted: 04/29/2019] [Indexed: 12/16/2022] Open
Abstract
African Americans are at higher risk of developing type 2 diabetes mellitus (T2DM), and this risk may be influenced by familial experiences and cultural norms throughout the life course. This led us to conduct this study of 20 African American families with strong histories of T2DM to explore familial complexities that prevent or help manage diabetic symptoms. Experiences were analyzed inductively through individual family profiles created using content-analytic summaries. When profiles were further analyzed for emerging and theoretically informed data patterns, two themes emerged: (a) family interactions characterized by T2DM-related actions and communication patterns, and (b) intergenerational patterns of openness characterized by variations in approach within generational cohort and parental gender. Through inquiries related to intergenerational experiences with T2DM, nursing and health care professionals may be better able to tailor and promote success for prevention and management of behaviors among high-risk African Americans.
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Affiliation(s)
| | - Tera Hurt
- Iowa State University, Ames, Iowa, USA
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Abstract
PURPOSE OF REVIEW This article discusses the state of type 2 diabetes (T2D) self-management research on non-Hispanic Black men with a focus on their knowledge of diabetes, factors that impact T2D self-management and intervention research that specifically targets non-Hispanic Black men with T2D. RECENT FINDINGS Studies on T2D knowledge and barriers and facilitators to T2D self-management in non-Hispanic Black men are limited to small qualitative focus group and in-depth interviews. To date, few T2D interventions for non-Hispanic Black men have been developed and tested. Research shows that non-Hispanic Black men's knowledge of T2D may be less than optimal compared to non-Hispanic white men. Factors that influence T2D self-management in non-Hispanic Black men include gender-related values and beliefs, and a range of other psychosocial (e.g., social support) and structural (e.g., access to health care) factors. Interventions with gender-specific programming may show promise. More studies with larger sample sizes and longitudinal designs are needed to develop programming to effectively target this at-risk population.
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Affiliation(s)
- Jaclynn M Hawkins
- School of Social Work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI, 48109, USA.
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Hurt TR, Seawell AH, Cutrona C, O'Connor MC, Camp RD, Duran R, Elderts R, Green C, Hara V, Pattee J. Black Women's Recommendations for Developing Effective Type 2 Diabetes Programming. Glob Qual Nurs Res 2017; 4:2333393617715335. [PMID: 28804746 PMCID: PMC5484429 DOI: 10.1177/2333393617715335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 05/13/2017] [Accepted: 05/22/2017] [Indexed: 01/28/2023] Open
Abstract
The purpose of this study was to learn from 29 Black women how to develop effective Type 2 diabetes programming. Three focus groups were held in Des Moines, Iowa, during fall 2012. Results highlighted themes related to diabetes knowledge, diabetes management and prevention, physical activity, diet, and diabetes management programming. Opinions were shared as to whether family members should be included in programs for supporting those diagnosed with diabetes. These results provided guidance and ideas to scholars and health care professionals aiming to improve effectiveness of diabetes programs for Black women and families.
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Abstract
Hispanic Americans are the fastest growing minority group in the United States. They face a distinct set of health challenges, resulting in persistent health disparities. Chronic disease self-management programs hold promise in addressing individual-level, behavioral risks factors, such as dietary habits and physical activity patterns. In light of the unique barriers Hispanic men face, including low participation in evidence-based health intervention research, this article argues for a gendered perspective when approaching Hispanic men’s physical and mental health needs. Through the analysis of data collected from male-only focus groups ( N = 3, n = 15) with Hispanic Americans in west central Florida, this study identified that masculine identity is influenced by chronic disease and comorbid depression status. Diagnosis with a chronic disease and/or depression is accompanied by lifestyle adaptations, activity restrictions, and changes in income and health care demands that can undermine traditional notions of Hispanic masculinity. Consequently, masculine identity is associated with self-management strategies in complex ways. Public health interventions aimed at addressing comorbid chronic disease and depression among Hispanic men must take into consideration the role of gender identity and relevant conceptualizations of masculinity in order to better serve this underserved and understudied population.
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Reynolds GL, Fisher DG, Dyo M, Huckabay LM. Using the Bem and Klein Grid Scores to Predict Health Services Usage by Men. Behav Med 2016; 42:143-9. [PMID: 27337618 PMCID: PMC4979744 DOI: 10.1080/08964289.2016.1154003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We examined the association between scores on the Bem Sex Roles Inventory (BSRI), Klein Sexual Orientation Grid, and utilization of hospital inpatient services, emergency departments, and outpatient clinic visits in the past 12 months among 53 men (mean age 39 years). The femininity subscale score on the BSRI, ever having had gonorrhea and age were the three variables identified in a multivariate linear regression significantly predicting use of total health services. This supports the hypothesis that sex roles can assist our understanding of men's use of health services.
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Affiliation(s)
- Grace L. Reynolds
- Center for Behavioral Research & Services, California State University, Long Beach ,Health Care Administration Department, California State University, Long Beach
| | - Dennis G. Fisher
- Center for Behavioral Research & Services, California State University, Long Beach ,Psychology Department, California State University, Long Beach
| | - Melissa Dyo
- School of Nursing, California State University, Long Beach
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15
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Hurt TR, Seawell AH, O'Connor MC. Developing Effective Diabetes Programming for Black Men. Glob Qual Nurs Res 2015; 2:2333393615610576. [PMID: 28462319 PMCID: PMC5342290 DOI: 10.1177/2333393615610576] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 08/29/2015] [Accepted: 09/04/2015] [Indexed: 12/18/2022] Open
Abstract
The purpose of this study is to obtain feedback from 20 men on developing effective programming to reduce the impact of diabetes (t2dm) among Black men. Three focus groups were convened in Des Moines, Iowa. Men were recruited, all either diagnosed with t2dm (n = 10), pre-diabetic (n = 1), or experienced t2dm through family and friends (n = 9). The results highlighted themes related to t2dm knowledge, masculinity, and behavioral health; gender-centered diabetes management education; and family support and functioning. Men provided recommendations for program format and content, desirable facilitator characteristics, and whether to include spouses/partners, relatives, and friends. These results provide guidance and ideas to nurses wishing to enhance t2dm education and patient outcomes for Black men.
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Seawell AH, Hurt TR, Shirley MC. The Influence of Stress, Gender, and Culture on Type 2 Diabetes Prevention and Management Among Black Men: A Qualitative Analysis. Am J Mens Health 2015; 10:149-56. [PMID: 25862692 DOI: 10.1177/1557988315580132] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study used focus-group methodology to seek understanding about the unique influence of stress, gender, and culture on type 2 diabetes mellitus (t2dm) prevention and management among Black men. Twenty men from Iowa were recruited from a larger longitudinal study on Black families; each of these men participated in one of three focus groups. Ninety-five percent of the men in the sample were Black and all were either diagnosed with t2dm (n = 10), were prediabetic (n = 1), or had experience with t2dm through family and friends (n = 9). Our results revealed the existence of significant stress and some pessimism with respect to perceived ability to prevent and manage t2dm. The participants made it clear that, while their families are primary sources of support for managing stress, including t2dm, they can also be a source of stress, particularly with respect to parenting. Black men had mixed opinions on their relationships with respect to their health care providers; some had positive, long-standing relationships while others reported little or no relationship with their providers. In response to life stress, Black men reported experiencing inadequate and disrupted sleep as well as consuming too much alcohol at times. Some of the participants reported engaging in physical activity to manage their stress. The study concluded that, as researchers develop t2dm prevention and management programs, they should continue to consider the unique role that stress in its various forms, plays in the lives of Black men.
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Whitaker SM, Bowie JV, McCleary R, Gaskin DJ, LaVeist TA, Thorpe RJ. The Association Between Educational Attainment and Diabetes Among Men in the United States. Am J Mens Health 2014; 8:349-56. [PMID: 24429135 DOI: 10.1177/1557988313520034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Few studies have examined the relationship between education and diabetes among men in the United States and whether this relationship differs by race/ethnicity. This study examined whether racial disparities in diabetes existed by educational attainment in 336,746 non-Hispanic White, non-Hispanic Black, and Hispanic men 18 years of age and older in the United States. Logistic regression models were specified to examine the odds of reporting diabetes by educational attainment. Within race/ethnicity, both White and Hispanic men who had less than a high school education (odds ratio [OR] = 1.42, 95% confidence interval [CI] = [1.19, 1.69], and OR = 1.64, 95% CI = [1.22, 2.21], respectively) had consistently higher odds of diabetes than men with a bachelor's degree or higher level of educational attainment. Educational attainment did not appear to be associated with reporting a diagnosis of diabetes in non-Hispanic Black men. Identifying why educational attainment is associated with diabetes outcomes in some racial/ethnic groups but not others is essential for diabetes treatment and management.
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Affiliation(s)
- Shanta M Whitaker
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Janice V Bowie
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rachael McCleary
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Darrell J Gaskin
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas A LaVeist
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roland J Thorpe
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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18
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Jack L, Griffith DM. The health of African American men: implications for research and practice. Am J Mens Health 2013; 7:5S-7S. [PMID: 23708877 PMCID: PMC5178829 DOI: 10.1177/1557988313490190] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
BACKGROUND Factors contributing to patient-reported experiences of diabetes self-management support are not understood well, particularly over time. OBJECTIVES The aim of the study was to identify the contribution of patient characteristics to patient-reported quality of SMS. METHODS Using secondary data from a prospective clinical trial (n = 339) comparing three approaches of providing diabetes self-management support (Group Medical Visits, Automated Telephone Support, and Usual Care) in a diverse, underserved population, the influence of patient characteristics (e.g., age, gender, income, and health status) was examined on Patient Assessment of Chronic Illness Care ratings. RESULTS At baseline, older age (p = .014), being female (p = .038), and having lower income (p = .001) were associated with lower ratings. Income and interactions involving income combined explained 12% of the variance in baseline ratings. Compared with White patients, African American and Asian patients tended to have higher baseline ratings (p = .076 and p = .045, respectively). Race or ethnicity influenced perceptions throughout the trial, explaining 5% of the variance at baseline and 2% of the variance in 1-year changes in Patient Assessment of Chronic Illness Care ratings. As expected, over 1 year, ratings increased more for patients in both intervention groups compared with the control group (p < .001). DISCUSSION Ratings of healthcare quality are influenced by patient characteristics independent of the nature of the care provided. Understanding more precisely how these differences are associated with differences in clinical processes will be particularly important for efforts aiming to integrate patient-reported measures into assessments of healthcare quality during routine clinical care and clinical trials.
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Hooker SP, Wilcox S, Burroughs EL, Rheaume CE, Courtenay W. The potential influence of masculine identity on health-improving behavior in midlife and older African American men. JOURNAL OF MENS HEALTH 2012; 9:79-88. [PMID: 23459337 DOI: 10.1016/j.jomh.2012.02.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To gain a greater understanding of masculinity and its potential influence on health-improving behavior in midlife and older African American (AA) men. METHODS Forty-nine AA men aged 45-88 years completed in-depth interviews to ascertain their perspectives on masculinity, how masculine identity in this population might be influenced by age and physical activity level, or how it might impact health. Taped interviews were transcribed and organized for analysis with common themes identified by multiple researchers. RESULTS Most often cited attributes of someone considered "manly" included a leader of a family/household, provider, strong work ethic, and masculine physique. Terms such as responsible, principled, and man of character also described the typical man. Potential negative and positive influences of manhood on health included avoiding health care appointments and being a good example to children/others, respectively. Themes associated with age-related changes in manhood were acceptance and being more health conscious. Elements associated with how manhood was influenced by AA race included stress and perseverance. CONCLUSIONS Midlife and older AA men in this study primarily expressed views of masculinity that fit the traditional perception of manhood. However, the attributes revealed, such as family provider, responsibility, self-reliance, and perseverance, were viewed as having potential for both negative and positive impacts on health and health-improving behaviors. It will be essential to integrate these prevalent attributes of masculine identity into health promotion interventions such that they facilitate positive behavior change while not competing with gender role norms among this vulnerable group of men.
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Nielsen DS, Brixen K, Huniche L. Men's experiences of living with osteoporosis: focus group interviews. Am J Mens Health 2010; 5:166-76. [PMID: 20798147 DOI: 10.1177/1557988310372800] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Osteoporotic fractures in men are an increasing public health problem. Male osteoporosis is often a low-prioritized issue, however. To examine men's experiences with osteoporosis and how they handle osteoporosis in their everyday lives, the authors collected data from four focus groups with a total of 16 men aged 51 to 82 years diagnosed with osteoporosis. Critical psychology was used as a theoretical framework for the data analysis, which aimed to elicit information about the men's daily lives. The men handled osteoporosis in different ways using different strategies. The authors found patterns that resonated with the social construction of hegemonic masculinity as displayed through the men's fear of weakness and endurance through physical activity, as well as identity construction through active decision making in relation to health. Understanding and implementation of these issues is necessary in the development of preventive, screening, and monitoring strategies, as well as in the clinical care of men with osteoporosis.
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Affiliation(s)
- Dorthe S Nielsen
- Department of Endocrinology, Kloevervaenget 6, 1st Floor, Odense University Hospital and Institute of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark.
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