Recruiting Low-Income African American Men in Mental Health Research: A Community-Based Participatory Research Feasibility Study

Men's mental health - Conceptualization, effects, and coping

Men are predisposed to suffer with unaddressed depression and anxiety. This study sought to empower men, in three urban, racially/ethnically diverse, underserved, and impoverished neighborhoods, for mental health self-care by capturing their perceptions of depression and anxiety. Using community-based participatory research, in the context of long-term partnerships between a department of nursing and these neighborhoods, the researchers recruited 50 men aged 23-83 years. Data were collected via six homogeneous, zoom-based focus groups composed of Black, Hispanic, and White men, respectively. The men identified themes pertaining to the conceptualization and devastating effects of depression and anxiety as well as coping strategies employed to mitigate the symptoms.

Men's Depression and Anxiety: Contributing Factors and Barriers to Intervention

BACKGROUND

Urban, ethnically/racially diverse, impoverished men are predisposed to experience unaddressed depression and anxiety. The overlap of these factors creates significant mental health inequity.

AIMS

This study sought to capture men's impressions of the factors that contributed to their experience of depression and anxiety as well as barriers that they experienced in pursuing intervention.

METHODS

Using community-based participatory research, in the context of long-term partnerships between a department of nursing and three urban, racially/ethnically diverse, and impoverished neighborhoods, the researchers recruited 50 men ages 23-83 years. Data were collected via six homogeneous, Zoom-based focus groups composed of Black, Hispanic, and White men, respectively.

RESULTS

The men identified multiple themes pertaining to modifiable and non-modifiable contributing factors that played a role in their development of depression and anxiety as well as barriers related to stigma, resource issues, and a lack of knowledge of mental illness that they faced when seeking intervention.

CONCLUSIONS

Understanding men's perspectives on the contributing factors and barriers to mental health intervention can provide an evidence base with which to address mental health inequity via tailored care, policy, and research agendas.

Strategies for Recruiting Young African American Men for Primary Stroke Prevention Research

BACKGROUND

African American (AA) men bear a disproportionate burden of cardiovascular disease and stroke but are often underrepresented in research.

OBJECTIVE

This article describes the development and evaluation of a recruitment plan to reach young AA men for the Stroke Counseling for Risk Reduction in Men project.

METHODS

The plan was developed from researchers' previous experiences and a literature review, and used to recruit AA men, ages 20 to 35 years, for focus groups about stroke and Stroke Counseling for Risk Reduction.

RESULTS

Screening survey respondents (N = 81) were reached mostly by word of mouth (42%) and social media (28%). Focus group participants (N = 32) recommended appropriate incentives and social media to recruit young AA men for research. They also suggested learning about the study from a friend, colleague, or study participant could motivate participation.

CONCLUSION

The plan was successful in reaching and enrolling an adequate sample. Findings and recommendations highlight the importance of social networks and trusted sources.

An evaluation of the feasibility and acceptability of sister circles as an anxiety intervention for pregnant Black women

BACKGROUND

Black women and their infants face heightened health risks during pregnancy, labor, and delivery that, for many, cost them their lives. Such health risks during this critical period are linked to increased rates of anxiety among Black pregnant and postpartum women. Black women also endure racism when seeking support from mental health and healthcare providers, which further contributes to pregnancy and postpartum-related anxiety. Evidence on sister circles has demonstrated that this indigenous form of healing may provide Black pregnant and postpartum women with the support and skills needed to cope with stressors associated with mental and physical health concerns and racism.

OBJECTIVE

Our study aimed to evaluate the feasibility and acceptability of the Birthing Beautiful Babies Sisters Offering Support, a sister circle cognitive behavioral therapy-based stress and anxiety intervention for Black pregnant and postpartum women.

DESIGN

Our study employed a mixed-methods framework.

METHODS

Descriptive analyses, paired samples t-test, and open and selective coding were conducted. We utilized the following measures: Penn State Worry Questionnaire-Abbreviated, Kessler Psychological Distress Scale, Pregnancy-Related Anxiety Scale, focus booklet, and focus group discussion.

RESULTS

Participants reported experiencing moderate levels of worry and distress and low levels of pregnancy-related anxiety prior to the start of the Birthing Beautiful Babies Sisters Offering Support intervention. Eighty women participated in Birthing Beautiful Babies Sisters Offering Support. Eleven focus groups were conducted to assess their experience. Participants reported a perceived increase in their knowledge about panic attacks and stress and ability to manage stressors effectively. They found that all completed activities contributed to their development and application of skills. They reported they enjoyed Birthing Beautiful Babies Sisters Offering Support because of the supportive environment, openness, and emphasis on sisterhood. Participants provided helpful feedback about the structure and flow of the intervention.

CONCLUSION

Limitations of the present study and future directions are discussed.

Critically appraising for antiracism

Racial bias in research impacts a study’s relevancy, validity and reliability, though presently this aspect is not addressed in critical appraisal tools, and consequently appraisers may not take racial bias into account when assessing a paper’s quality. Drawing on Critical Race Theory (CRT) tenets that racism is ubiquitous and race a social construct, this paper discusses concerns regarding racism in research which have been broadly divided into two categories for critical appraisers to consider: the underrepresentation of minoritised ethnic groups in health studies, especially where minoritised populations see higher rates of disease occurrence and; the utilisation of racial/ethnicity data to interpret disparities in outcomes, including speculation of biological race, the misinterpretation of genetic ancestry as race, and the lack of investigation into social determinants of health, including systemic, institutional and interpersonal forms of racism. The injustices exposed in this paper impact the health of minoritised ethnic groups and are therefore a Black Lives Matter issue. They risk resurrecting dangerous theories regarding biological inferiority among minoritised ethnic populations, as well as hindering study findings. The application of CRT frameworks in health science research quality appraisal are discussed in relation to the above themes – using largely UK-based contexts with supporting examples from the US – followed by recommendations for critically appraising for antiracism. Further information to support critically appraising for antiracism can be found via https://www.criticallyappraisingantiracism.org/.

Improving diversity in study participation: Patient perspectives on barriers, racial differences and the role of communities

INTRODUCTION

The lack of racial/ethnic diversity in research potentially limits the generalizability of findings to a broader population, highlighting the need for greater diversity and inclusion in clinical research. Qualitative research (i.e., focus groups) was conducted to identify (i) the potential motivators and barriers to study participation across different races and ethnicities; (ii) preferred delivery of education and information to support healthcare decision-making and the role of the community.

METHODS

Patient focus groups were conducted with 26 participants from the sponsor's Patient Engagement Research Councils selected through subjective sampling. Recruitment prioritized adequate representation across different race/ethnic groups. Participation was voluntary and participants underwent a confidential interview process before selection. Narrative analysis was used to identify themes and draw insights from interactions. Experienced research specialists identified emerging concepts, and these were tested against new observations. The frequency of each concept was examined to understand its importance.

RESULTS

Based on self-selected race/ethnicity, participants were divided into five focus groups (Groups: African American/Black: 2; Hispanic/Latino, Asian American, and white: 1 each) and were asked to share their experiences/opinions regarding the stated objectives. Barriers to study participation included: limited awareness of opportunities to participate in research, fears about changes in standard therapy, breaking cultural norms/stigma, religion-related concerns and mistrust of clinical research. Participants identified the importance of transparency by pharmaceutical companies and other entities to build trust and partnership and cited key roles that communities can play. The perceptions of the African American group regarding diversity/inclusion in research studies appeared to be different from other groups; a lack of trust in healthcare providers, concerns about historical instances of research abuse and the importance of prayer were cited.

CONCLUSION

This study provided insights into barriers to study participation, and also highlighted the need for pharmaceutical companies and other entities to authentically engage in strategies that build trust within communities to enhance recruitment among diverse populations.

PATIENT OR PUBLIC CONTRIBUTION

The data collected in the present study was provided by the participants in the focus groups.