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Griffith DM. Antiracism and Health Equity Science: Overcoming Scientific Obstacles to Health Equity. Public Health Rep 2024; 139:288-293. [PMID: 38504480 PMCID: PMC11037222 DOI: 10.1177/00333549241236089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Affiliation(s)
- Derek M. Griffith
- Center for Men’s Health Equity, Georgetown University, Washington, DC, USA
- Racial Justice Institute, Georgetown University, Washington, DC, USA
- Department of Health Management and Policy, School of Health, Georgetown University, Washington, DC, USA
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Loeb S, Sanchez Nolasco T, Byrne N, Allen L, Langford AT, Ravenell J, Gomez SL, Washington SL, Borno HT, Griffith DM, Criner N. Representation Matters: Trust in Digital Health Information Among Black Patients With Prostate Cancer. J Urol 2024; 211:376-383. [PMID: 38329047 DOI: 10.1097/ju.0000000000003822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/08/2023] [Indexed: 02/09/2024]
Abstract
PURPOSE Although the majority of US adults obtain health information on the internet, the quality of information about prostate cancer is highly variable. Black adults are underrepresented in online content about prostate cancer despite a higher incidence of and mortality from the disease. The goal of this study was to explore the perspectives of Black patients with prostate cancer on the importance of racial representation in online content and other factors influencing trust. MATERIALS AND METHODS We conducted 7 virtual focus groups with Black patients with prostate cancer in 2022 and 2023. Participants completed an intake questionnaire with demographics followed by a group discussion, including feedback on purposefully selected online content. Transcripts were independently analyzed by 2 investigators experienced in qualitative research using a constant comparative method. RESULTS Most participants use online sources to look for prostate cancer information. Racial representation is an important factor affecting trust in the content. A lack of Black representation has consequences, including misperceptions about a lower risk of prostate cancer and discouraging further information-seeking. Other key themes affecting trust in online content included the importance of a reputable source of information, professional website structure, and soliciting money. CONCLUSIONS Underrepresentation of Black adults in prostate cancer content has the potential to worsen health disparities. Optimal online communications should include racially diverse representation and evidence-based information in a professional format from reputable sources without financial conflict.
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Affiliation(s)
- Stacy Loeb
- Department of Urology, New York University School of Medicine, New York, New York
- Department of Population Health, New York University School of Medicine, New York, New York
- Department of Surgery/Urology, Manhattan Veterans Affairs, New York, New York
| | - Tatiana Sanchez Nolasco
- Department of Urology, New York University School of Medicine, New York, New York
- Department of Population Health, New York University School of Medicine, New York, New York
| | - Nataliya Byrne
- Department of Urology, New York University School of Medicine, New York, New York
- Department of Population Health, New York University School of Medicine, New York, New York
| | - Laura Allen
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California
| | - Aisha T Langford
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan
| | - Joseph Ravenell
- Department of Population Health, New York University School of Medicine, New York, New York
| | - Scarlett Lin Gomez
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California
| | - Samuel L Washington
- Department of Urology, University of California San Francisco, San Francisco, California
| | - Hala T Borno
- Department of Medical Oncology, University of California San Francisco, San Francisco, California
- Trial Library Inc, San Francisco, California
| | - Derek M Griffith
- Department of Health Management and Policy, Racial Justice Institute and Center for Men's Health Equity, Georgetown University, Washington, Disctrict of Columbia
| | - Nickole Criner
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California
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Loeb S, Sanchez Nolasco T, Byrne N, Allen L, Langford AT, Ravenell JE, Gomez SL, Washington SL, Borno HT, Griffith DM, Criner N. Qualitative Study on Internet Use and Care Impact for Black Men With Prostate Cancer. Health Educ Behav 2024:10901981241228226. [PMID: 38366884 DOI: 10.1177/10901981241228226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Black men have a greater risk of prostate cancer as well as worse quality of life and more decisional regret after prostate cancer treatment compared to non-Hispanic White men. Furthermore, patients with prostate cancer who primarily obtain information on the internet have significantly more decisional regret compared to other information sources. Our objective was to explore the perspectives of Black patients on the use and impact of the internet for their prostate cancer care. In 2022-2023, we conducted seven virtual focus groups with Black patients with prostate cancer (n = 22). Transcripts were independently analyzed by two experienced researchers using a constant comparative method. Online sources were commonly used by participants throughout their cancer journey, although informational needs varied over time. Patient factors affected use (e.g., physical health and experience with the internet), and family members played an active role in online information-seeking. The internet was used before and after visits to the doctor. Key topics that participants searched for online included nutrition and lifestyle, treatment options, and prostate cancer in Black men. Men reported many downstream benefits with internet use including feeling more empowered in decision-making, reducing anxiety about treatment and providing greater accountability for research. However, they also reported negative impacts such as feeling overwhelmed or discouraged sorting through the information to identify high-quality content that is personally relevant, as well as increased anxiety or loss of sleep from overuse. In summary, online sources have the potential to positively impact the cancer journey by reinforcing or supplementing information from health care providers, but can be harmful if the information is poor quality, not representative, or the internet is overused.
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Affiliation(s)
- Stacy Loeb
- New York University Langone Health, New York, NY, USA
- Manhattan Veterans Affairs, New York, NY, USA
| | | | | | - Laura Allen
- University of California San Francisco, San Francisco, CA, USA
| | | | | | | | | | - Hala T Borno
- University of California San Francisco, San Francisco, CA, USA
- Trial Library Inc., San Francisco, CA, USA
| | - Derek M Griffith
- Department of Health Management and Policy, Racial Justice Institute and Center for Men's Health Equity, Georgetown University, Washington, DC, USA
| | - Nickole Criner
- University of California San Francisco, San Francisco, CA, USA
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Wippold GM, Garcia KA, Frary SG, Griffith DM. Community Health Worker Interventions for Men: A Scoping Review Using the RE-AIM Framework. Health Educ Behav 2024; 51:128-143. [PMID: 37350223 DOI: 10.1177/10901981231179498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
INTRODUCTION Community health workers (CHWs) are health promotion specialists who are trusted members of the community served and have a close understanding of the community's needs and values. CHWs are a cost-effective and scalable workforce to promote health among men through tailored approaches. The purpose of the present review was to use the RE-AIM Framework to assess design, implementation, and outcomes of CHW-implemented health promotion efforts tailored for men to provide recommendations for future efforts. METHODS The protocol was pre-registered with PROSPERO. The primary inclusion criteria were that the interventions were (a) implemented at least partially by CHWs, (b) conducted only among men, and (c) designed to improve a health-related outcome. PubMed, EMBASE, PsycINFO, CINAHL, Web of Science, and Global Index Medicus were searched using a librarian-generated search strategy. In all, 1,437 articles were uploaded to Rayyan and two reviewers blindly reviewed each article for inclusion. A total of 24 articles met the inclusion criteria. RESULTS Most interventions (a) targeted men under 50 years, (b) were conducted among a subset of underserved men, (c) improved health outcomes, (d) community-based and informed, (e) atheoretical, and (f) had satisfactory retention rates. The roles and responsibilities of CHWs were varied. Attention was given to training of CHWs, but limited attention was given to how/if the CHWs were supervised. DISCUSSION CHW-implemented interventions can improve health outcomes among men. Opportunities exist to build on past interventions, such as addressing mental health and incorporating prosocial aspects of masculinity. The results have implications for designing similar interventions.
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Adsul P, Shelton RC, Oh A, Moise N, Iwelunmor J, Griffith DM. Challenges and Opportunities for Paving the Road to Global Health Equity Through Implementation Science. Annu Rev Public Health 2024; 45. [PMID: 38166498 DOI: 10.1146/annurev-publhealth-060922-034822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Implementation science focuses on enhancing the widespread uptake of evidence-based interventions into routine practice to improve population health. However, optimizing implementation science to promote health equity in domestic and global resource-limited settings requires considering historical and sociopolitical processes (e.g., colonization, structural racism) and centering in local sociocultural and indigenous cultures and values. This review weaves together principles of decolonization and antiracism to inform critical and reflexive perspectives on partnerships that incorporate a focus on implementation science, with the goal of making progress toward global health equity. From an implementation science perspective, we synthesize examples of public health evidence-based interventions, strategies, and outcomes applied in global settings that are promising for health equity, alongside a critical examination of partnerships, context, and frameworks operationalized in these studies. We conclude with key future directions to optimize the application of implementation science with a justice orientation to promote global health equity. Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Prajakta Adsul
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA;
- Cancer Control and Population Science Research Program, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA
| | - Rachel C Shelton
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - April Oh
- National Cancer Institute, Rockville, Maryland, USA
| | - Nathalie Moise
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, USA
| | - Juliet Iwelunmor
- Division of Infectious Diseases, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
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Griffith DM, Jaeger EC, Pennings JS, Semlow AR, Ellison JM, Alexander LR. Tailor Made: A Pilot Virtual Weight Loss Intervention Individually Tailored for African American Men. Health Promot Pract 2023:15248399231213347. [PMID: 38050903 DOI: 10.1177/15248399231213347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
This study tests the acceptability and feasibility of the first virtual weight loss study individually tailored for middle-aged African American men. Tailor Made is a 3-month randomized controlled pilot of a weight loss intervention that included 58 overweight or obese African American men (mean age of 50.4; SD = 7.9). Control group participants received a Fitbit activity tracker and Bluetooth-enabled scale and copies of the self-led Tailor Made curriculum. Intervention group participants received the same Fitbit, Bluetooth-enabled scale, and curriculum and also participated in weekly, 45-minute virtual small group, professional-led education sessions using the Tailor Made curriculum and received three SMS text messages weekly: (a) a message individually tailored on African American Manhood that links men's values, goals, and motivation to health-promoting behavior; (b) a goal-tracking message to monitor physical activity, healthier eating, and lifestyle changes; and (c) a reminder 24 hours before their session. Participation rates in weekly small group sessions, randomization, and attendance at the assessments suggest that Tailor Made was feasible and acceptable. Only among intervention group participants, we found a small and significant decrease in BMI between baseline and final. In addition, active minutes of physical activity decreased for the control group while active minutes for the intervention group remained steady throughout the intervention. In sum, we demonstrated that a virtual, individually tailored weight loss intervention is feasible and acceptable to African American men. Participants valued the convenience of a virtual intervention, but there were a number of ways we may be able to enhance the potential benefits of this approach.
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Affiliation(s)
| | | | - Jacquelyn S Pennings
- Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt University, Nashville, TN, USA
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Baker P, Leon N, Colvin CJ, Griffith DM. Health policies must consider gender, including men. Lancet Glob Health 2023; 11:e1847-e1848. [PMID: 37973331 DOI: 10.1016/s2214-109x(23)00428-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Peter Baker
- Global Action on Men's Health, London SE1 4YR, UK.
| | - Natalie Leon
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Christopher J Colvin
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Derek M Griffith
- Global Action on Men's Health, London SE1 4YR, UK; Center for Men's Health Equity, Racial Justice Institute, Georgetown University, Washington, DC, USA
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Griffith DM, Jaeger EC, Pepperman P, Chustz KA, Frazier D, Wilson A, Brown HL. Fathers' Perspectives on Fatherhood and Paternal Involvement During Pregnancy and Childbirth. Health Educ Behav 2023; 50:802-809. [PMID: 37787463 DOI: 10.1177/10901981231199710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
There is limited research that specifically explores paternal involvement during pregnancy and childbirth. To address this gap, we completed a series of focus groups with fathers to examine social, cultural, and environmental factors that influence behaviors among new fathers while also providing community perspectives on men's experiences seeking care pre- and postdelivery. We used a phenomenological thematic approach to analyze data from 10 focus groups from five of the six Alliance for Innovation on Maternal Health-Community Care Initiative pilot sites collected between November 2021 and April 2022. The average age of fathers was 33.9 years (range = 24-61 years). The majority (86.25%) of men were African American, and approximately one sixth of focus group participants (16.25%) were Hispanic or Latino. Four key themes emerged: the importance and meaning of fatherhood, accessibility during pregnancy and childbirth, engagement during pregnancy and childbirth, and responsibility of fathers during pregnancy and childbirth. These fathers not only understood and embraced the awesome responsibility they had for their unborn child, but they also recognized and were invested in being present, accessible, engaged, and responsible to the pregnant woman during the pregnancy. Practitioners and policy makers should work to engage fathers as early in the pregnancy as possible; monitor father's mental health and financial stress; provide resources to educate fathers on maternal health, pregnancy, and childbirth; and emphasize fathers' rights, roles, and responsibilities.
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Affiliation(s)
| | | | | | | | | | - Amber Wilson
- National Healthy Start Association, Washington, DC, USA
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Griffith DM, Efird CR, Baskin ML, Webb Hooper M, Davis RE, Resnicow K. Cultural Sensitivity and Cultural Tailoring: Lessons Learned and Refinements After Two Decades of Incorporating Culture in Health Communication Research. Annu Rev Public Health 2023; 45. [PMID: 37931182 DOI: 10.1146/annurev-publhealth-060722-031158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
In this article, we examine progress and challenges in designing, implementing, and evaluating culturally sensitive behavioral interventions by tailoring health communication to groups or individuals. After defining common tailoring constructs (i.e., culture, race, and ethnicity), cultural sensitivity, and cultural tailoring, we examine when it is useful to culturally tailor and address cultural sensitivity in health communication by group tailoring or individual tailoring and when tailoring health communication may not be necessary or appropriate for achieving behavior change. After reviewing selected approaches to cultural tailoring, we critique the quality of research in this domain with a focus on the internal validity of empirical findings. Then we explore the ways in which cultural sensitivity, group targeting, and individual tailoring have incorporated culture in health promotion and health communication. We conclude by articulating yet unanswered questions and suggesting future directions to move the field forward. Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Derek M Griffith
- Center for Men's Health Equity, Racial Justice Institute, Georgetown University, Washington, DC, USA;
- Racial Justice Institute, Georgetown University, Washington, DC, USA
- Department of Health Management and Policy, School of Health, Georgetown University, Washington, DC, USA
| | - Caroline R Efird
- Racial Justice Institute, Georgetown University, Washington, DC, USA
| | - Monica L Baskin
- Division of Hematology/Oncology, School of Medicine; and Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Monica Webb Hooper
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Rachel E Davis
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Ken Resnicow
- Department of Health Behavior and Health Education, School of Public Health; and Community Outreach and Health Disparities Research, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
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Valdez LA, Jaeger EC, Garcia DO, Griffith DM. Breaking Down Machismo: Shifting Definitions and Embodiments of Latino Manhood in Middle-Aged Latino Men. Am J Mens Health 2023; 17:15579883231195118. [PMID: 37694827 PMCID: PMC10496479 DOI: 10.1177/15579883231195118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/12/2023] [Accepted: 07/17/2023] [Indexed: 09/12/2023] Open
Abstract
There is a notable gap in empirical research regarding how Latino men define and demonstrate machismo, masculinity, and manhood as well as the behavioral consequences associated with these concepts. In our study, we employed a phenomenological thematic approach to analyze 20 semi-structured individual interviews conducted with Latino men residing in South Florida. Our primary objectives were twofold: to examine (1) how do Latino men ages 35 to 60 years describe what it means to be a man and (2) what are the attributes that these men seek to show others that demonstrate their character, cultural values, and gender identity. Findings suggest that Latino men understood expectations associated with machismo and explained that fulfillment of their role as provider, protector, and head of the family was important to their perception of self. While some participants reported a desire to embody characteristics associated with traditional machismo, others strived to demonstrate character, familism, and respect and to provide financial and other instrumental support to their families. Participants reported that their transition into middle age was accompanied by a shift in their perspectives on gender roles, moving away from rigid patriarchal views. Exposure to a more fluid and flexible approach to manhood offered relief from the pressures associated with inflexible manifestations of machismo, which can have negative social, behavioral, and physical health implications. The implications of our research extend to the conceptualization of gender ideals, highlighting the need to incorporate intersectionality, role strain, precarious manhood, and culturally specific notions of manhood as foundational elements in this discourse.
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Affiliation(s)
- Luis A. Valdez
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Emily C. Jaeger
- Center for Men’s Health Equity, Georgetown University, Washington, DC, USA
| | - David O. Garcia
- Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Derek M. Griffith
- Center for Men’s Health Equity, Georgetown University, Washington, DC, USA
- Department of Health Management and Policy, School of Health, Georgetown University, Washington, DC, USA
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Boden-Albala B, Rebello V, Drum E, Gutierrez D, Smith WR, Whitmer RA, Griffith DM. Use of Community-Engaged Research Approaches in Clinical Interventions for Neurologic Disorders in the United States: A Scoping Review and Future Directions for Improving Health Equity Research. Neurology 2023; 101:S27-S46. [PMID: 37580148 DOI: 10.1212/wnl.0000000000207563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 05/09/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Evidence suggests a significant prevalence of race and ethnic disparities in the United States among people with neurologic conditions including stroke, Alzheimer disease and related dementia (ADRD), Parkinson disease (PD), epilepsy, spinal cord injury (SCI), and traumatic brain injury (TBI). Recent neurologic research has begun the paradigm shift from observational health disparities research to intervention research in an effort to narrow the disparities gap. There is an evidence base that suggests that community engagement is a necessary component of health equity. While the increase in disparities focused neurologic interventions is encouraging, it remains unclear whether and how community-engaged practices are integrated into intervention design and implementation. The purpose of this scoping review was to identify and synthesize intervention studies that have actively engaged with the community in the design and implementation of interventions to reduce disparities in neurologic conditions and to describe the common community engagement processes used. METHODS Two databases, PubMed and CINAHL, were searched to identify eligible empirical studies within the United States whose focus was on neurologic interventions addressing disparities and using community engagement practices. RESULTS We identified 392 disparity-focused interventions in stroke, ADRD, PD, epilepsy, SCI, and TBI, of which 53 studies incorporated community engagement practices: 32 stroke studies, 15 ADRD, 2 epilepsy studies, 2 PD studies, 1 SCI study, and 1 TBI study. Most of the interventions were designed as randomized controlled trials and were programmatic in nature. The interventions used a variety of community engagement practices: community partners (42%), culturally tailored materials and mobile health (40%), community health workers (32%), faith-based organizations and local businesses (28%), focus groups/health need assessments (25%), community advisory boards (19%), personnel recruited from the community/champions (19%), and caregiver/social support (15%). DISCUSSION Our scoping review reports that the proportion of neurologic intervention studies incorporating community engagement practices is limited and that the practices used within those studies are varied. The major practices used included collaboration with community partners and utilization of culturally tailored materials. We also found inconsistent reporting and dissemination of results from studies that implemented community engagement measures in their interventions. Future directions include involving the community in research early and continuously, building curricula that address challenges to community engagement, prioritizing the inclusion of community engagement reporting in peer-reviewed journals, and prioritizing and incentivizing research of subpopulations that experience disparities in neurologic conditions.
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Affiliation(s)
- Bernadette Boden-Albala
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC.
| | - Vida Rebello
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC
| | - Emily Drum
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC
| | - Desiree Gutierrez
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC
| | - Wally R Smith
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC
| | - Rachel A Whitmer
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC
| | - Derek M Griffith
- From the Department of Health, Society and Behavior (B.B.-A., V.R., E.D., D.G.), Department of Epidemiology and Biostatistics (B.B.-A.), Program in Public Health, and Department of Neurology (B.B.-A.), School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California, Irvine; Division of General Internal Medicine (W.R.S.), Department of Medicine, Virginia Commonwealth University, Richmond; Departments of Public Health Sciences (R.A.W.), and Neurology (R.A.W.), and Division of Epidemiology (R.A.W.), University of California, Davis; Center for Men's Health Equity (D.M.G.), Racial Justice Institute (D.M.G.), and Department of Health Systems Administration (D.M.G.), School of Nursing and Health Sciences, Georgetown University, Washington, DC
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Griffith DM, Towfighi A, Manson SM, Littlejohn EL, Skolarus LE. Determinants of Inequities in Neurologic Disease, Health, and Well-being: The NINDS Social Determinants of Health Framework. Neurology 2023; 101:S75-S81. [PMID: 37580154 PMCID: PMC10605947 DOI: 10.1212/wnl.0000000000207566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 05/09/2023] [Indexed: 08/16/2023] Open
Abstract
A National Institute of Neurological Disorders and Stroke working group developed the Determinants of Inequities in Neurological Disease, Health, and Well-being framework. Our goal was to guide and inspire a new generation of neurologic research that pushes the field to design and test new approaches in pursuit of health equity, population health, and social justice. We seek to expand the lens of those looking to reduce or eliminate racial, socioeconomic status, and other inequities in neurologic disease, health, and well-being to improve our collective ability to create research, programs, and policies that lead to larger, more impactful, and more sustainable change in neurologic disease patterns. In this context, we outline a framework that includes and highlights "upstream" factors in the hopes of enhancing the focus of research, programmatic, and policy efforts to reduce and eliminate inequities in neurologic health and well-being. We explicitly discuss racism and other structural factors to clarify that social determinants are not natural and unchangeable. Populations with a disproportionate burden of neurologic disease are not inherently deficient, despite what some approaches to framing health inequities imply. The framework is presented linearly, but the pathways linking the determinants of neurologic disease, health, and well-being are far more complex than those demonstrated by the arrows included in the figure. The framework highlights the different levels and scale of causation, including the structural and intermediary social determinants and their impact on neurologic health. We offer this framework to refine efforts to contextualize the interpretation of neurologic research findings and suggest new avenues for their application. We illustrate how behavioral and biological factors occur in a social and economic context, factors that have been understudied as points of intervention to reduce inequities in neurologic disease. Considering social and structural determinants of health provides promising new opportunities to achieve neurologic health equity, reach social justice, and improve our science. Extending our work in this fashion is not simply about health equity or social justice but to fundamentally improve the quality of neurologic research by enhancing underlying theory and improving study design and implementation.
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Affiliation(s)
- Derek M Griffith
- From the Department of Health Management and Policy, School of Health, Georgetown University (D.M.G.), Washington, DC; Department of Neurology (A.T.), Keck School of Medicine of the University of Southern California, Los Angeles; University of Colorado Anschutz Medical Campus (S.M.M.), Aurora; National Institute of Neurological Disorders and Stroke (E.L.L.), NIH, Bethesda, MD; and Davee Department of Neurology, Northwestern University, Feinberg School of Medicine (L.E.S.), Chicago, IL.
| | - Amytis Towfighi
- From the Department of Health Management and Policy, School of Health, Georgetown University (D.M.G.), Washington, DC; Department of Neurology (A.T.), Keck School of Medicine of the University of Southern California, Los Angeles; University of Colorado Anschutz Medical Campus (S.M.M.), Aurora; National Institute of Neurological Disorders and Stroke (E.L.L.), NIH, Bethesda, MD; and Davee Department of Neurology, Northwestern University, Feinberg School of Medicine (L.E.S.), Chicago, IL
| | - Spero M Manson
- From the Department of Health Management and Policy, School of Health, Georgetown University (D.M.G.), Washington, DC; Department of Neurology (A.T.), Keck School of Medicine of the University of Southern California, Los Angeles; University of Colorado Anschutz Medical Campus (S.M.M.), Aurora; National Institute of Neurological Disorders and Stroke (E.L.L.), NIH, Bethesda, MD; and Davee Department of Neurology, Northwestern University, Feinberg School of Medicine (L.E.S.), Chicago, IL
| | - Erica L Littlejohn
- From the Department of Health Management and Policy, School of Health, Georgetown University (D.M.G.), Washington, DC; Department of Neurology (A.T.), Keck School of Medicine of the University of Southern California, Los Angeles; University of Colorado Anschutz Medical Campus (S.M.M.), Aurora; National Institute of Neurological Disorders and Stroke (E.L.L.), NIH, Bethesda, MD; and Davee Department of Neurology, Northwestern University, Feinberg School of Medicine (L.E.S.), Chicago, IL
| | - Lesli E Skolarus
- From the Department of Health Management and Policy, School of Health, Georgetown University (D.M.G.), Washington, DC; Department of Neurology (A.T.), Keck School of Medicine of the University of Southern California, Los Angeles; University of Colorado Anschutz Medical Campus (S.M.M.), Aurora; National Institute of Neurological Disorders and Stroke (E.L.L.), NIH, Bethesda, MD; and Davee Department of Neurology, Northwestern University, Feinberg School of Medicine (L.E.S.), Chicago, IL
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Abstract
The 10 articles in the Preventing Chronic Disease (PCD) special collection on health equity highlight that a commitment to self-reflection, cultural humility, and lifelong learning are foundations of health equity science and that the field is interdependent with the perspectives and context of communities.Three themes - place, perspective, and partnership - emerged from the PCD special collection. The articles embody the principles outlined in the Healthy People definition of health equity and CDC's CORE Health Equity Science and Intervention Strategy. They highlight the critical role that context, qualitative methods, and community-based participatory research play in efforts to achieve health equity. However, the science of achieving health equity is rooted in antiracism principles; the "inner work" of learning, unlearning, relearning, and co-learning; and the efforts to equip communities to act, research, and intervene for themselves. Without these added critical structural lenses, health equity science will continue to fail to achieve its goal.
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Affiliation(s)
- Derek M Griffith
- Racial Justice Institute, Center for Men's Health Equity, Georgetown University, Washington, DC
- Georgetown University, 300 Reservoir Rd NW, Washington, DC 20057
| | - Dawn Satterfield
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Keon L Gilbert
- Brookings Institution, Washington, DC
- Department of Behavioral Science and Health Education, Institute for Healing Justice and Equity, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri
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Loeb S, Ravenell JE, Gomez SL, Borno HT, Siu K, Sanchez Nolasco T, Byrne N, Wilson G, Griffith DM, Crocker R, Sherman R, Washington SL, Langford AT. The Effect of Racial Concordance on Patient Trust in Online Videos About Prostate Cancer: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2324395. [PMID: 37466938 DOI: 10.1001/jamanetworkopen.2023.24395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Importance Black men have a higher risk of prostate cancer compared with White men, but Black adults are underrepresented in online content about prostate cancer. Across racial groups, the internet is a popular source of health information; Black adults are more likely to trust online health information, yet have more medical mistrust than White adults. Objective To evaluate the association between racial representation in online content about prostate cancer and trust in the content and identify factors that influence trust. Design, Setting, and Participants A randomized clinical trial was conducted from August 18, 2021, to January 7, 2022, consisting of a 1-time online survey. Participants included US men and women aged 40 years and older. Data were analyzed from January 2022 to June 2023. Interventions Participants were randomized to watch the same video script about either prostate cancer screening or clinical trials presented by 1 of 4 speakers: a Black physician, a Black patient, a White physician, or a White patient, followed by a questionnaire. Main Outcomes and Measures The primary outcome was a published scale for trust in the information. χ2 tests and multivariable logistic regression were used to compare trust according to the video's speaker and topic. Results Among 2904 participants, 1801 (62%) were men, and the median (IQR) age was 59 (47-69) years. Among 1703 Black adults, a greater proportion had high trust in videos with Black speakers vs White speakers (72.7% vs 64.3%; adjusted odds ratio [aOR], 1.62; 95% CI, 1.28-2.05; P < .001); less trust with patient vs physician presenter (64.6% vs 72.5%; aOR, 0.63; 95% CI, 0.49-0.80; P < .001) and about clinical trials vs screening (66.3% vs 70.7%; aOR, 0.78; 95% CI, 0.62-0.99; P = .04). Among White adults, a lower proportion had high trust in videos featuring a patient vs physician (72.0% vs 78.6%; aOR, 0.71; 95% CI, 0.54-0.95; P = .02) and clinical trials vs screening (71.4% vs 79.1%; aOR, 0.57; 95% CI, 0.42-0.76; P < .001), but no difference for Black vs White presenters (76.8% vs 73.7%; aOR, 1.11; 95% CI, 0.83-1.48; P = .49). Conclusions and Relevance In this randomized clinical trial, prostate cancer information was considered more trustworthy when delivered by a physician, but racial concordance was significantly associated with trust only among Black adults. These results highlight the importance of physician participation and increasing racial diversity in public dissemination of health information and an ongoing need for public education about clinical trials. Trial Registration ClinicalTrials.gov Identifier: NCT05886751.
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Affiliation(s)
- Stacy Loeb
- Department of Urology, New York University Langone Health, New York
- Department of Population Health, New York University Langone Health, New York
- Department of Surgery/Urology, Manhattan Veterans Affairs, New York, New York
| | - Joseph E Ravenell
- Department of Population Health, New York University Langone Health, New York
| | - Scarlett Lin Gomez
- Department of Urology and Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco
| | - Hala T Borno
- Department of Urology and Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco
- Trial Library, Inc., San Francisco, California
| | - Katherine Siu
- Department of Urology, New York University Langone Health, New York
- Department of Population Health, New York University Langone Health, New York
| | - Tatiana Sanchez Nolasco
- Department of Urology, New York University Langone Health, New York
- Department of Population Health, New York University Langone Health, New York
| | - Nataliya Byrne
- Department of Urology, New York University Langone Health, New York
- Department of Population Health, New York University Langone Health, New York
| | | | | | - Rob Crocker
- Stakeholder Advisory Board, New York, New York
| | | | - Samuel L Washington
- Department of Urology and Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco
| | - Aisha T Langford
- Department of Population Health, New York University Langone Health, New York
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Griffith DM, Pennings JS, Jaeger EC. Mighty Men: A Pilot Test of the Feasibility and Acceptability of a Faith-Based, Individually Tailored, Cluster-Randomized Weight Loss Trial for Middle-Aged and Older African American Men. Am J Mens Health 2023; 17:15579883231193235. [PMID: 37608590 PMCID: PMC10467204 DOI: 10.1177/15579883231193235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/06/2023] [Accepted: 07/17/2023] [Indexed: 08/24/2023] Open
Abstract
Two in five African American men have obesity, but they are underrepresented in community-based weight loss interventions. This pilot effectiveness trial examines the acceptability and feasibility of the first weight loss study for African American men that includes randomization and individual tailoring. Using a community-based, cluster-randomized, longitudinal parallel group design, four churches were randomized to a control condition or a weight loss condition. Each church received physical activity equipment, a coordinator, and small group physical activity sessions. A total of 71 African American men (mean age: 58.5) enrolled and received a Fitbit, Bluetooth-enabled scale, a t-shirt, gift cards for participation, and 45 min of small group physical activity led by a certified personal trainer. Men in the weight loss condition also received 45 min of health education and individually tailored SMS text messages. Multiple metrics suggest that Mighty Men was feasible, yet the acceptability of the intervention components was mixed. Participants in both the weight loss and control conditions lost weight between zero and 6 months (p < .001), but body fat (p = .005) and visceral fat percentage (p = .001) of men in the weight loss condition decreased while men in the control condition did not (p < .05). An increase in physical activity was seen among men in the weight loss condition (p = .030) but not among men in the control condition (p < .05). It is acceptable and feasible to conduct a 6-month weight loss intervention with African American men that includes randomization and individually tailored text messages.
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Affiliation(s)
- Derek M. Griffith
- Center for Men’s Health Equity, Georgetown University, Washington, DC, USA
- Racial Justice Institute, Georgetown University, Washington, DC, USA
- Department of Health Management and Policy, School of Health, Georgetown University, Washington, DC, USA
| | - Jacquelyn S. Pennings
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Emily C. Jaeger
- Center for Men’s Health Equity, Georgetown University, Washington, DC, USA
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16
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Cho A, Mendenhall E, Griffith DM. Power, place, and access: Why history is at the center of black D.C. residents of wards 7 and 8 decisions to receive the COVID-19 vaccine. SSM Qual Res Health 2023; 3:100270. [PMID: 37073370 PMCID: PMC10101486 DOI: 10.1016/j.ssmqr.2023.100270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 02/26/2023] [Accepted: 04/08/2023] [Indexed: 04/20/2023]
Abstract
Vaccines have played an essential role in curbing case and mortality rates due to SARS-CoV-2 in the United Sates. Still, many communities display high rates of unwillingness or inability to get a COVID-19 vaccine, limiting overall vaccination efforts and contributing to viral spread. Black Americans have expressed skepticism towards vaccines because of limited access to the technology, mistrust in its safety and efficacy, and a lack of confidence in the healthcare authorities that distribute it. This article investigates how Black residents of Wards 7 and 8 in Washington, D.C. thought about COVID-19 vaccination and why or why not they decided to vaccinate. These Wards' vaccination rates were markedly lower than those from Wards 1-6, which have substantially higher populations of White residents, affluence, access, and resources. This study involved 31 interviews with Ward 7 and 8 residents recruited through snowball sampling. We found that residents navigated the dual perceived risks of coronavirus infection and vaccination through three key frames: their relationship to their place or location, their desires to maintain autonomy over their health, and their abilities to access COVID-19 vaccines. This case study advances knowledge of vaccine utilization among marginalized communities, and how this phenomenon varies depending on local social, cultural, and political dynamics. Moreover, this research has implications for vaccine rollout efforts and the D.C. health system, as it reveals gaps in confidence and care that undermine health outcomes for Black residents.
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Affiliation(s)
- Allison Cho
- Edmund A Walsh School of Foreign Service, Georgetown University, 3700 O St. NW, Washington, DC, 20057, USA
| | - Emily Mendenhall
- Edmund A Walsh School of Foreign Service, Georgetown University, 3700 O St. NW, Washington, DC, 20057, USA
| | - Derek M Griffith
- Racial Justice Institute and School of Health, Georgetown University, 3700 O St. NW, Washington, DC, 20057, USA
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17
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White A, Connell R, Griffith DM, Baker P. Defining "Men's Health". IJMSCH 2023. [DOI: 10.22374/ijmsch.v6i1.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
A definition is required for men’s health that captures current thinking around men and their health and well-being globally. A new definition of men’s health should reflect greater complexity than that has existed in previously accepted, over-simplistic definitions of what constitutes “men’s health.” In addition, the most com-monly used definitions in the field that originated from the westernised countries of the Global North do not seem to be inclusive of the heterogeneity among a significant proportion of the world’s population. Definitions are important as they help drive academic endeavour, practice and policy; they also help shape organisations working in men’s health and, as such, they need to be as broad as possible. This paper outlines the limitationsand conceptual concerns in the current definitions and argues for a more inclusive definition.
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18
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Cleary A, Griffith DM, Oliffe JL, Rice S. Editorial: Men, mental health, and suicide. Front Sociol 2023; 7:1123319. [PMID: 36726599 PMCID: PMC9885186 DOI: 10.3389/fsoc.2022.1123319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 12/28/2022] [Indexed: 06/18/2023]
Affiliation(s)
- Anne Cleary
- UCD Geary Institute for Public Policy and Department of Sociology, University College Dublin, Dublin, Ireland
| | - Derek M. Griffith
- Department of Health Management and Policy, School of Health and Centre for Men's Health Equity, Georgetown University, Washington, DC, United States
| | - John Lindsey Oliffe
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
- Department of Nursing, The University of Melbourne, Melbourne, VIC, Australia
| | - Simon Rice
- Faculty of Medicine, Dentistry and Health Science based at Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
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19
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Griffith DM. Abstract IA014: Precision public health approaches to health equity. Cancer Prev Res (Phila) 2023. [DOI: 10.1158/1940-6215.precprev22-ia014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Abstract
Since President Barack Obama announced the “Precision Medicine Initiative” during his state of the union address in January 2015, the sciences of precision medicine and health equity have largely grown in parallel, though there have been some efforts to bring the two together. As research on health equity has evolved to name and consider structural racism, the penultimate goal of research in this area also as moved from efforts to identify and describe gaps between racial and ethnic groups to characterizing the context creates and perpetuates racial inequities and how best to mitigate them. In this presentation, I will briefly describe how syndemics, intersectionality, and individual tailoring may complement downstream efforts to characterize epigenetic and genomic efforts to develop biomedical interventions to achieve healthcare equity and health equity. After noting how the principles of precision medicine may be applied more broadly than the most common way it is operationalized through genomic medicine, I argue that that creating racial justice in health will require defining health equity more clearly and precisely. Consequently, I utilize the example of Black men and the context of COVID-19 to highlight how more precisely defining the structural context of the population of interest by using tools such as intersectionality and syndemics is fundamental to achieving equity. I highlight how achieving health equity will require creating, resisting, undoing, and mitigating structural racism and note what that means for cancer research. Precision medicine may help to mitigate the health effects of structural racism, and it will remain an important tool to promote population health; however, efforts to achieve health equity and racial justice will require interventions that change the contexts and conditions that create, exacerbate, and perpetuate structural inequities and the racial inequities in health outcomes that they produce and maintain.
Citation Format: Derek M. Griffith. Precision public health approaches to health equity. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr IA014.
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20
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Everson NS, Klein WMP, Lee SS, Selove R, Sanderson M, Blot WJ, Tyndale RF, King S, Gilliam K, Kundu S, Steinwandel M, Sternlieb SJ, Andersen SW, Friedman DL, Connors E, Fadden MK, Freiberg MS, Wells QS, Canedo J, Young RP, Scott RJ, Umeukeje EM, Griffith DM, Tindle HA. Dispositional optimism and optimistic bias: Associations with cessation motivation, confidence, and attitudes. Health Psychol 2022; 41:621-629. [PMID: 35901400 PMCID: PMC9830640 DOI: 10.1037/hea0001184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To test whether 2 conceptually overlapping constructs, dispositional optimism (generalized positive expectations) and optimistic bias (inaccurately low risk perceptions), may have different implications for smoking treatment engagement. METHOD Predominantly Black, low-income Southern Community Cohort study smokers (n = 880) self-reported dispositional optimism and pessimism (Life Orientation Test-Revised subscales: 0 = neutral, 12 = high optimism/pessimism), comparative lung cancer risk (Low/Average/High), and information to calculate objective lung cancer risk (Low/Med/High). Perceived risk was categorized as accurate (perceived = objective), optimistically-biased (perceived < objective), or pessimistically-biased (perceived > objective). One-way ANOVAs tested associations between dispositional optimism/pessimism and perceived risk accuracy. Multivariable logistic regressions tested independent associations of optimism/pessimism and perceived risk accuracy with cessation motivation (Low/High), confidence (Low/High), and precision treatment attitudes (Favorable/Unfavorable), controlling for sociodemographics and nicotine dependence. RESULTS Mean dispositional optimism/pessimism scores were 8.41 (SD = 2.59) and 5.65 (SD = 3.02), respectively. Perceived lung cancer risk was 38% accurate, 27% optimistically-biased, and 35% pessimistically-biased. Accuracy was unrelated to dispositional optimism (F(2, 641) = 1.23, p = .29), though optimistically-biased (vs. pessimistically-biased) smokers had higher dispositional pessimism (F(2, 628) = 3.17, p = .043). Dispositional optimism was associated with higher confidence (Adjusted odds ratio [AOR] = 1.71, 95% CI [1.42, 2.06], p < .001) and favorable precision treatment attitudes (AOR = 1.66, 95% CI [1.37, 2.01], p < .001). Optimistically-biased (vs. accurate) risk perception was associated with lower motivation (AOR = .64, 95% CI [.42, .98], p = .041) and less favorable precision treatment attitudes (AOR = .59, 95% CI [.38, .94], p = .029). CONCLUSIONS Dispositional optimism and lung cancer risk perception accuracy were unrelated. Dispositional optimism was associated with favorable engagement-related outcomes and optimistically-biased risk perception with unfavorable outcomes, reinforcing the distinctiveness of these constructs and their implications for smoking treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Nicole Senft Everson
- Vanderbilt University Medical Center, Nashville, TN, USA
- Behavioral Research Program, National Cancer Institute, Bethesda, MD, USA
| | | | - Scott S. Lee
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | - Rachel F. Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Departments of Pharmacology and Toxicology, and Psychiatry, University of Toronto, ON, CA
| | - Stephen King
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Karen Gilliam
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Suman Kundu
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Shaneda Warren Andersen
- Vanderbilt University Medical Center, Nashville, TN, USA
- University of Wisconsin-Madison; Carbone Cancer Center, Madison, WI, USA
| | | | - Erin Connors
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Matthew S. Freiberg
- Vanderbilt University Medical Center, Nashville, TN, USA
- Geriatric Research Education and Clinical Centers (GRECC), Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Quinn S. Wells
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Juan Canedo
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | - Derek M. Griffith
- Georgetown University, Departments of Health Services Administration and Oncology, Washington, DC, USA
| | - Hilary A. Tindle
- Vanderbilt University Medical Center, Nashville, TN, USA
- Geriatric Research Education and Clinical Centers (GRECC), Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA
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21
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Griffith DM, Jaeger EC, Semlow AR, Ellison JM, Bergner EM, Stewart EC. Individually Tailoring Messages to Promote African American Men's Health. Health Commun 2022; 37:1147-1156. [PMID: 33899604 PMCID: PMC8542646 DOI: 10.1080/10410236.2021.1913837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In this paper, we describe our approach to individualizing messages to promote the health of middle-aged and older heterosexual, cisgender African American men. After arguing the importance of being population specific, we describe the process we use to increase the salience of health messages for this population by operationalizing the identity concepts of centrality and contextualization. We also present a measure of African American manhood and discuss how manhood is congruent with qualitative research that describes how African American men view their values, identities, goals, and aspirations in ways that can be utilized to create more meaningful and impactful messages to promote and maintain health behaviors. Our tailoring strategy uses an intersectional approach that considers how the centrality of racial identity and manhood and the salience of religiosity, spirituality, and role strains may help to increase the impact of health messages. We highlight the need to consider how the context of health behavior and the meaning ascribed to certain behaviors are gendered, not only from a man's perspective, but also how his social networks, behavioral context, and the dynamic sociopolitical climate may consider gendered ideals in ways that shape behavior. We close by discussing the need to apply this approach to other populations of men, women, and those who are non-gender binary because this strategy builds from the population of interest and incorporates factors that they deem central and salient to their identities and behaviors. These factors are important to consider in interventions using health messages to pursue health equity.
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Affiliation(s)
- Derek M. Griffith
- Center for Research on Men’s Health, Vanderbilt University, Nashville, TN
- Department of Medicine Health & Society, Vanderbilt University, Nashville, TN
| | | | - Andrea R. Semlow
- Center for Research on Men’s Health, Vanderbilt University, Nashville, TN
| | | | - Erin M. Bergner
- Center for Research on Men’s Health, Vanderbilt University, Nashville, TN
| | - Elizabeth C. Stewart
- Center for Research on Men’s Health, Vanderbilt University, Nashville, TN
- Meharry Medical College, Nashville, TN
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22
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Griffith DM, Umeukeje EM. Navigating to Kidney Health Equity. J Am Soc Nephrol 2022; 33:1242-1244. [PMID: 35728885 PMCID: PMC9257807 DOI: 10.1681/asn.2022040421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Derek M Griffith
- Racial Justice Institute and Departments of Health Systems Administration and Oncology, Georgetown University, Washington, DC
| | - Ebele M Umeukeje
- Vanderbilt Center for Kidney Disease and Division of Nephrology, Vanderbilt University Medical Center, Nashville, Tennessee
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23
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Griffith DM. "Healthy masculinities are mosaics": Commentary on Di Bianca and Mahalik (2022). Am Psychol 2022; 77:333-335. [PMID: 35587399 PMCID: PMC9351610 DOI: 10.1037/amp0000974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this commentary on "A Relational-Cultural Framework for Promoting Healthy Masculinities" (Di Bianca & Mahalik, 2022), I suggest that healthy masculinities may benefit from considering other factors than hegemonic masculinity. Borrowing the concept of mosaic masculinities, I argue that many men do not view hegemonic masculinity as an aspirational ideal. They create other ideals for themselves by using elements of hegemonic masculinity that they value and that they can attain. Some men may create mosaics of ideals that they use as north stars to guide who they would like to be and how they would like others to view them. To illustrate this point, I cite and discuss research on African American men's masculinities, and use the concept of intersectionality to discuss why and how this approach to promoting healthy masculinities may be advantageous. I argue that integrating the concept of manhood would also add important texture to the ideals that men have. This alternative perspective also is relationally constructed and it centers a more heterogeneous array of cultural factors that give masculinities meaning and that shape the implications of masculinities for health and well-being. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Kuzmichev A, Harada NM, Griffith DM, Powell KM, Dean HD. Public Health Reports in 2021: Impact Factor Increase and New Article Collections on Racism and COVID-19. Public Health Rep 2022; 137:397-407. [PMID: 35435072 PMCID: PMC9109544 DOI: 10.1177/00333549221091785] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Andrey Kuzmichev
- Public Health Reports,
Office of the Surgeon General, US Department of Health and Human Services,
Washington, DC, USA
| | - Noelle M. Harada
- Public Health Reports,
Office of the Surgeon General, US Department of Health and Human Services,
Washington, DC, USA
| | - Derek M. Griffith
- Racial Justice Institute, Center for
Men’s Health Equity, Department of Health Systems Administration, Georgetown
University, Washington, DC, USA
| | - Krista M. Powell
- CDR, US Public Health Service, US
Department of Veterans Affairs, Atlanta, GA, USA
| | - Hazel D. Dean
- Public Health Reports,
Office of the Surgeon General, US Department of Health and Human Services,
Washington, DC, USA
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King CJ, Buckley BO, Maheshwari R, Griffith DM. Race, Place, And Structural Racism: A Review Of Health And History In Washington, D.C. Health Aff (Millwood) 2022; 41:273-280. [PMID: 35130070 DOI: 10.1377/hlthaff.2021.01805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Recent events have amplified the debilitating effects of systemic racism on the health of the United States. In an effort to improve population health and dismantle more than 400 years of racial injustice, retrospective examinations of policies, practices, and events that have sustained and continue to undergird racial hierarchy are necessary. In this historical review we feature Washington, D.C.-a city with a legacy of Black plurality. We begin with an overview of contemporary place-based health and socioeconomic disparities. To express the etiology of the trends and uncover opportunities to undo the damage, we reflect on the national landscape as well as on policies and events that socially, economically, and politically disenfranchised Black residents, yielding stark differences in health outcomes among Washington, D.C., populations. In the spirit of atonement in policy and practice, we hope that this approach will inspire policy makers and practitioners in communities across the nation to conduct similar examinations.
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Desta R, Blumrosen C, Laferriere HE, Saluja A, Bruce MA, Elasy TA, Griffith DM, Norris KC, Cavanaugh KL, Umeukeje EM. Interventions Incorporating Therapeutic Alliance to Improve Medication Adherence in Black Patients with Diabetes, Hypertension and Kidney Disease: A Systematic Review. Patient Prefer Adherence 2022; 16:3095-3110. [PMID: 36404799 PMCID: PMC9673796 DOI: 10.2147/ppa.s371162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/11/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Black Americans have a disproportionately increased risk of diabetes, hypertension, and kidney disease, and higher associated morbidity, mortality, and hospitalization rates than their White peers. Structural racism amplifies these disparities, and negatively impacts self-care including medication adherence, critical to chronic disease management. Systematic evidence of successful interventions to improve medication adherence in Black patients with diabetes, hypertension, and kidney disease is lacking. Knowledge of the impact of therapeutic alliance, ie, the unique relationship between patients and providers, which optimizes outcomes especially for minority populations, is unclear. The role and application of behavioral theories in successful development of medication adherence interventions specific to this context also remains unclear. OBJECTIVE To evaluate the existing evidence on the salience of a therapeutic alliance in effective interventions to improve medication adherence in Black patients with diabetes, hypertension, or kidney disease. DATA SOURCES Medline (via PubMed), EMBASE (OvidSP), Cumulative Index of Nursing and Allied Health Literature (CINAHL) (EBSCOhost), and PsycINFO (ProQuest) databases. REVIEW METHODS Only randomized clinical trials and pre/post intervention studies published in English between 2009 and 2022 with a proportion of Black patients greater than 25% were included. Narrative synthesis was done. RESULTS Eleven intervention studies met the study criteria and eight of those studies had all-Black samples. Medication adherence outcome measures were heterogenous. Five out of six studies which effectively improved medication adherence, incorporated therapeutic alliance. Seven studies informed by behavioral theories led to significant improvement in medication adherence. DISCUSSION/CONCLUSION Study findings suggest that therapeutic alliance-based interventions are effective in improving medication adherence in Black patients with diabetes and hypertension. Further research to test the efficacy of therapeutic alliance-based interventions to improve medication adherence in Black patients should ideally incorporate cultural adaptation, theoretical framework, face-to-face delivery mode, and convenient locations.
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Affiliation(s)
- Russom Desta
- Department of Medicine, University of Washington Medical Center, Seattle, WA, USA
| | - Charlotte Blumrosen
- Department of Medicine and Pediatrics, University of Rochester Medical Center, New York, NY, USA
| | | | - Aades Saluja
- Vanderbilt Center for Kidney Disease, Nashville, TN, USA
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marino A Bruce
- Department of Behavioral and Social Sciences, University of Houston, Tilman J. Fertitta Family College of Medicine, Houston, TX, USA
| | - Tom A Elasy
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Derek M Griffith
- Department of Health Management & Policy, School of Health, Georgetown University, Washington, DC, USA
- Center for Men’s Health Equity, Racial Justice Institute, Georgetown University, Washington, DC, USA
| | - Keith C Norris
- Division of General Internal Medicine & Health Services Research, UCLA, Los Angeles, CA, USA
| | - Kerri L Cavanaugh
- Vanderbilt Center for Kidney Disease, Nashville, TN, USA
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ebele M Umeukeje
- Vanderbilt Center for Kidney Disease, Nashville, TN, USA
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
- Correspondence: Ebele M Umeukeje, Division of Nephrology, Vanderbilt University Medical Center, 1161 21 Avenue MCN S-3223, Nashville, TN, USA, Tel +1 615 936-3283, Fax +1 615 875-5626, Email
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Shelton RC, Adsul P, Oh A, Moise N, Griffith DM. Application of an antiracism lens in the field of implementation science (IS): Recommendations for reframing implementation research with a focus on justice and racial equity. Implementation Research and Practice 2021; 2:26334895211049482. [PMID: 37089985 PMCID: PMC9978668 DOI: 10.1177/26334895211049482] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Despite the promise of implementation science (IS) to reduce health inequities, critical gaps and opportunities remain in the field to promote health equity. Prioritizing racial equity and antiracism approaches is critical in these efforts, so that IS does not inadvertently exacerbate disparities based on the selection of frameworks, methods, interventions, and strategies that do not reflect consideration of structural racism and its impacts. Methods Grounded in extant research on structural racism and antiracism, we discuss the importance of advancing understanding of how structural racism as a system shapes racial health inequities and inequitable implementation of evidence-based interventions among racially and ethnically diverse communities. We outline recommendations for explicitly applying an antiracism lens to address structural racism and its manifests through IS. An anti-racism lens provides a framework to guide efforts to confront, address, and eradicate racism and racial privilege by helping people identify racism as a root cause of health inequities and critically examine how it is embedded in policies, structures, and systems that differentially affect racially and ethnically diverse populations. Results We provide guidance for the application of an antiracism lens in the field of IS, focusing on select core elements in implementation research, including: (1) stakeholder engagement; (2) conceptual frameworks and models; (3) development, selection, adaptation of EBIs; (4) evaluation approaches; and (5) implementation strategies. We highlight the need for foundational grounding in antiracism frameworks among implementation scientists to facilitate ongoing self-reflection, accountability, and attention to racial equity, and provide questions to guide such reflection and consideration. Conclusion We conclude with a reflection on how this is a critical time for IS to prioritize focus on justice, racial equity, and real-world equitable impact. Moving IS towards making consideration of health equity and an antiracism lens foundational is central to strengthening the field and enhancing its impact. Plain language abstract There are important gaps and opportunities that exist in promoting health equity through implementation science. Historically, the commonly used frameworks, measures, interventions, strategies, and approaches in the field have not been explicitly focused on equity, nor do they consider the role of structural racism in shaping health and inequitable delivery of evidence-based practices/programs. This work seeks to build off of the long history of research on structural racism and health, and seeks to provide guidance on how to apply an antiracism lens to select core elements of implementation research. We highlight important opportunities for the field to reflect and consider applying an antiracism approach in: 1) stakeholder/community engagement; 2) use of conceptual frameworks; 3) development, selection and adaptation of evidence-based interventions; 4) evaluation approaches; 5) implementation strategies (e.g., how to deliver evidence-based practices, programs, policies); and 6) how researchers conduct their research, with a focus on racial equity. This is an important time for the field of implementation science to prioritize a foundational focus on justice, equity, and real-world impact through the application of an anti-racism lens in their work.
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Affiliation(s)
- Rachel C. Shelton
- Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, USA
| | - Prajakta Adsul
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, USA
| | - April Oh
- Division of Cancer Control and Population Sciences, Implementation Science Team, National Cancer Institute, Rockville, USA
| | - Nathalie Moise
- Department of Medicine, Columbia University Irving Medical Center, New York, USA
| | - Derek M. Griffith
- Georgetown University, Racial Justice Institute, Washington, USA
- Georgetown University, Center for Men’s Health Equity, Washington, USA
- Department of Health Systems Administration at the School of Nursing & Health Studies, Georgetown University, Washington, USA
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Semlow AR, Ellison JM, Jaeger EC, Griffith DM. Healthy Men 2030: Setting Men's Health Goals as a Tool to Improve the Nation's Health and Achieve Health Equity. Health Educ Behav 2021; 48:393-396. [PMID: 34254545 DOI: 10.1177/10901981211025465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Andrea R Semlow
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | - Jennifer M Ellison
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | - Emily C Jaeger
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | - Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
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Griffith DM, Holliday CS, Enyia OK, Ellison JM, Jaeger EC. Using Syndemics and Intersectionality to Explain the Disproportionate COVID-19 Mortality Among Black Men. Public Health Rep 2021; 136:523-531. [PMID: 34161180 DOI: 10.1177/00333549211026799] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Derek M Griffith
- Racial Justice Institute, Center for Men's Health Equity, Georgetown University, Washington, DC, USA.,Health Systems Administration, School of Nursing & Health Studies, Washington, DC, USA.,5718 Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | | | - Okechuku K Enyia
- 233231 Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Jennifer M Ellison
- 5718 Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | - Emily C Jaeger
- 5718 Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
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Morgan R, Baker P, Griffith DM, Klein SL, Logie CH, Mwiine AA, Scheim AI, Shapiro JR, Smith J, Wenham C, White A. Beyond a Zero-Sum Game: How Does the Impact of COVID-19 Vary by Gender? Front Sociol 2021; 6:650729. [PMID: 34212026 PMCID: PMC8239350 DOI: 10.3389/fsoc.2021.650729] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 05/24/2021] [Indexed: 06/13/2023]
Abstract
Epidemics and pandemics, like COVID-19, are not gender neutral. Much of the current work on gender, sex, and COVID-19, however, has seemed implicitly or explicitly to be attempting to demonstrate that either men or women have been hardest hit, treating differences between women and men as though it is not important to understand how each group is affected by the virus. This approach often leaves out the effect on gender and sexual minorities entirely. Believing that a more nuanced approach is needed now and for the future, we brought together a group of gender experts to answer the question: how are people of different genders impacted by COVID-19 and why? Individuals working in women's, men's, and LGBTQ health and wellbeing wrote sections to lay out the different ways that women, men, and gender and sexual minorities are affected by COVID-19. We demonstrate that there is not one group "most affected," but that many groups are affected, and we need to move beyond a zero-sum game and engage in ways to mutually identify and support marginalized groups.
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Affiliation(s)
- Rosemary Morgan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Peter Baker
- Global Action on Men’s Health, London, United Kingdom
| | - Derek M Griffith
- Founder and Director of the Center for Research on Men’s Health and Professor of Medicine, Health and Society, Vanderbilt University, Nashville, TN, United States
| | - Sabra L. Klein
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- W. Harry Feinstone Department of Molecular Microbiology and Immunology and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Carmen H Logie
- Factor-Inwentash Faculty of Social Work, Canada and Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, ON, Canada
| | - Amon Ashaba Mwiine
- School of Women and Gender Studies, Makerere University, Kampala, Uganda
| | - Ayden I Scheim
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Janna R. Shapiro
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Julia Smith
- Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Clare Wenham
- Department of Health Policy, London School of Economics and Political Science, Leeds, United Kingdom
| | - Alan White
- Emeritus Professor of Men’s Health, Leeds Beckett University, Leeds, United Kingdom
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Pierce LJ, Rebeiro P, Brantley M, Fields EL, Jenkins CA, Griffith DM, Conserve D, Shepherd B, Wester C, Ahonkhai AA. Who Is Not Linking to HIV Care in Tennessee - the Benefits of an Intersectional Approach. J Racial Ethn Health Disparities 2021; 9:849-855. [PMID: 33876409 PMCID: PMC8523577 DOI: 10.1007/s40615-021-01023-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/17/2021] [Accepted: 03/14/2021] [Indexed: 11/21/2022]
Abstract
Introduction Guided by an intersectional approach, we assessed the association between social categories (individual and combined) on time to linkage to HIV care in Tennessee. Methods Tennessee residents diagnosed with HIV from 2012-2016 were included in the analysis (n=3750). Linkage was defined by the first CD4 or HIV RNA test date after HIV diagnosis. We used Cox proportional hazards models to assess the association of time to linkage with individual-level variables. We modeled interactions between race, age, gender, and HIV acquisition risk factor (RF), to understand how these variables jointly influence linkage to care. Results Age, race, and gender/RF weAima A. Ahonkhaire strong individual (p < 0.001 for each) and joint predictors of time to linkage to HIV care (p < 0.001 for interaction). Older individuals were more likely to link to care (aHR comparing 40 vs. 30 years, 1.20, 95%CI 1.11-1.29). Blacks were less likely to link to care than Whites (aHR= 0.73, 95% CI: 0.67-0.79). Men who have sex with men (MSM) (aHR = 1.18, 95%CI: 1.03-1.34) and heterosexually active females (females) (aHR = 1.32, 95%CI: 1.14-1.53) were more likely to link to care than heterosexually active males. The three-way interaction between age, race, and gender/RF showed that Black males overall and young, heterosexually active Black males in particular were least likely to establish care. Conclusions Racial disparities persist in establishing HIV care in Tennessee, but data highlighting the combined influence of age, race, gender, and sexual orientation suggest that heterosexually active Black males should be an important focus of targeted interventions for linkage to HIV care. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-021-01023-6.
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Affiliation(s)
- Leslie J Pierce
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, 2525 West End Ave, Suite 750, Nashville, TN, 37203, USA
| | - Peter Rebeiro
- Department of Medicine, Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA.,Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | | | - Errol L Fields
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Cathy A Jenkins
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | - Donaldson Conserve
- Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, SC, USA
| | - Bryan Shepherd
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | | | - Aima A Ahonkhai
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, 2525 West End Ave, Suite 750, Nashville, TN, 37203, USA. .,Department of Medicine, Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, USA.
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Griffith DM, Pennings JS, Jaeger EC. African American Manhood and self-rated health: What demographic characteristics, health conditions, and aspects of manhood matter? Psychol Men Masc 2021; 22:250-264. [PMID: 35095345 PMCID: PMC8797163 DOI: 10.1037/men0000343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Few studies have tested what aspects of manhood are associated with health. In this study, we examine how aspects of African American Manhood are related to health. Using cross-sectional data from a criterion sample of 300 African American men 35-73 years old (M = 46.53), we examined how aspects of African American Manhood, demographic characteristics, and health conditions were related to self-rated health. When we controlled for demographics, SES and health conditions, different aspects of manhood were associated with good/excellent health. Across four linear regression models, we found that the Religion and Spirituality factor was the component of African American Manhood most strongly associated with good/excellent self-rated health. The Religion and Spirituality factor was the only aspect of African American Manhood that remained significant when we controlled for SES and health conditions. Neither Reputation, Respectability, nor aspects of role strain remained significantly associated with good/excellent self-rated health when we controlled for SES and health conditions. In analyses examining the relationship between lower odds of good/excellent self-rated health and aspects of ethnic identity, only Afrocentric subscales that highlight behaviors that demonstrate a connection to Africa (e.g., celebrating Kwanzaa) and greater importance of learning about African culture or spiritual beliefs in Africa remained significant. Finally, we found that African American men who reported a body mass index in the normal range, an income level above $50,000, being employed, and having no chronic conditions were more likely to report good/excellent self-rated health than African American men who reported poor/fair health.
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Affiliation(s)
- Derek M. Griffith
- Center for Research on Men’s Health, Vanderbilt University, Nashville, TN
- Department of Medicine Health & Society, Vanderbilt University, Nashville, TN
| | - Jacquelyn S. Pennings
- Center for Research on Men’s Health, Vanderbilt University, Nashville, TN
- Department of Medicine Health & Society, Vanderbilt University, Nashville, TN
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
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Griffith DM, Bergner EM, Fair AS, Wilkins CH. Using Mistrust, Distrust, and Low Trust Precisely in Medical Care and Medical Research Advances Health Equity. Am J Prev Med 2021; 60:442-445. [PMID: 33208267 PMCID: PMC7902381 DOI: 10.1016/j.amepre.2020.08.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/29/2020] [Accepted: 08/10/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, Tennessee; Department of Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee.
| | - Erin M Bergner
- Center for Research on Men's Health, Vanderbilt University, Nashville, Tennessee
| | | | - Consuelo H Wilkins
- Office of the Vice President for Health Equity, Vanderbilt University Medical Center, Nashville, Tennessee
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35
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Golestaneh L, Karaboyas A, Cavanaugh K, Umeukeje EM, Johns TS, Thorpe RJ, Bruce MA, Griffith DM, Melamed ML, Norris KC. The Role of Place in Disparities Affecting Black Men Receiving Hemodialysis. Kidney Int Rep 2021; 6:357-365. [PMID: 33615061 PMCID: PMC7879205 DOI: 10.1016/j.ekir.2020.10.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/21/2020] [Accepted: 10/13/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Black men are over-represented in the end stage kidney disease population and are at disproportionate risk of unfavorable outcomes. There is a paucity of investigation to elucidate the mediators of this risk. This study attempts to identify residential community attributes as a possible contributor. METHODS A post-hoc analysis of prospectively collected data from a cohort of Black men enrolled in the US Dialysis Outcomes and Practice Patterns Study (DOPPS), 2010--2015, linked to the American Community Survey, by dialysis facility zip codes was undertaken. The exposure variable was the dialysis facility community composition as defined by percent Black residents. Negative binomial regression was used to estimate incidence rate ratio (IRR) of hospitalization (first outcome) for Black men in crude and adjusted models. Similarly, Cox proportional hazards modeling was used to estimate mortality (second outcome) for Black men by type of community. RESULTS A total of 702 Black men receiving chronic hemodialysis were included in the study. Black men receiving hemodialysis in communities with greater proportions of Black residents had lower Charlson scores and fewer comorbidities, but a higher rate of hypertension. They had equivalent adherence to dialysis treatments, but a lower rate of arteriovenous fistula use and fewer dialysis minutes prescribed. Black men receiving dialysis in communities with a greater proportion of Black residents (per 10% increase) had higher adjusted hospitalization rates (IRR 1.09, 95% confidence interval [CI] 1.00-1.19) and mortality (hazard ratio [HR] 1.29, 95% CI 1.05-1.59). CONCLUSIONS This study supports the unique role of residential community as a risk factor for Black men with end stage kidney disease, showing higher hospitalization and mortality in those treating in Black versus non-Black communities, despite equivalent adherence and fewer comorbidities.
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Affiliation(s)
- Ladan Golestaneh
- Division of Nephrology, Department of Medicine Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Angelo Karaboyas
- Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA
| | - Kerri Cavanaugh
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Tanya S. Johns
- Division of Nephrology, Department of Medicine Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, 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, Maryland, USA
| | - Marino A. Bruce
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Derek M. Griffith
- Center for Research on Men’s Health, Vanderbilt University, Nashville, Tennessee, USA
| | - Michal L. Melamed
- Division of Nephrology, Department of Medicine Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Keith C. Norris
- Division of General Internal Medicine and Nephrology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
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Abstract
Men's health equity is an area of men's health research and practice that combines the literature on men's health with that of health equity. More research is needed that describes how to intervene to promote men's health equity. This introduction to the American Journal of Men's Health special collection on promoting men's health equity was created to feature research that describes aspects of promising interventions that (a) are population-specific approaches that consider the unique biopsychosocial factors that affect the health of socially defined populations of men; or (b) use a comparative approach to close or eliminate gaps between socially defined groups of men and women and among socially meaningful groups of men that are unnecessary, avoidable, considered unfair and unjust, and yet are modifiable. The dozen papers from across the globe included in the special collection are grouped in three areas: conceptual approaches and reviews; formative research; and evaluation findings. The papers represent a diverse array of populations under the umbrella of men's health and a range of strategies to improve men's health from tobacco cessation to microfinance. The collection features a range of alternative masculinities that emerge from original research by the contributors that are used in novel ways in the interventions. This editorial argues that more qualitative research is needed to evaluate the intended and unintended findings from interventions. This editorial also highlights the benefits that men's health equity can gain from embracing dissemination and implementation science as a tool to systematically design, implement, refine, and sustain interventions.
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Affiliation(s)
- Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA.,Department of Medicine, Health and Society, Vanderbilt University, Nashville, TN, USA
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Abstract
Commentary
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Williams MS, Beech BM, Griffith DM, Jr Thorpe RJ. The Association between Hypertension and Race/Ethnicity among Breast Cancer Survivors. J Racial Ethn Health Disparities 2020; 7:1172-1177. [PMID: 32185742 PMCID: PMC8063721 DOI: 10.1007/s40615-020-00741-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 03/05/2020] [Accepted: 03/09/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Hypertension is a significant, modifiable risk factor for cardiovascular disease (CVD). African American women who are diagnosed with early-stage breast cancer have a significantly higher risk of premature death due to CVD. The purpose of this study was to examine the association between hypertension and race/ethnicity among breast cancer survivors using data from the National Health and Nutrition Examination Surveys 1999-2014. METHODS Non-Hispanic African American and non-Hispanic White women who were diagnosed with breast cancer were identified. Hypertension was defined as taking medication to treat hypertension, having a systolic blood pressure ≥ 140, or a diastolic blood pressure ≥ 90. Modified Poisson regression was performed to estimate the prevalence ratios (PR) and corresponding 95% confidence intervals (CI) for race/ethnicity, as it relates to hypertension controlling for potential confounders. RESULTS Of the 524 breast cancer survivors included in our study, 107 (20.4%) were African American and 417 (80.0%) were White. After adjusting for age, marital status, education, annual household income, health insurance, smoking and drinking status, physical inactivity, obesity, and diabetes, African American breast cancer survivors had a 30% higher prevalence of hypertension (PR = 1.30 [95% CI, 1.11-1.52]) than White breast cancer survivors. CONCLUSIONS These results indicate that African American breast cancer survivors have a significantly higher risk of CVD due to hypertension even after controlling for other comorbid conditions such as diabetes and obesity.
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Affiliation(s)
- Michelle S Williams
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
- Cancer Institute, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
| | - Bettina M Beech
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
- Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA
| | - Derek M Griffith
- Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA
- Center for Medicine, Health and Society and Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | - Roland J Jr Thorpe
- Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA
- Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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39
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Griffith DM, Semlow AR, Leventhal M, Sullivan C. The Tennessee Men's Health Report Card: A Model for Men's Health Policy Advocacy and Education. Am J Mens Health 2020; 13:1557988319882586. [PMID: 31631746 PMCID: PMC6804362 DOI: 10.1177/1557988319882586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Tennessee is the only state in the United States that has regularly published a document monitoring men’s health and assessing men’s health disparities. Vanderbilt University, Vanderbilt University Medical Center, the Tennessee Department of Health, Meharry Medical College, Tennessee Men’s Health Network, and health providers and advocates across the state have come together to publish a set of indicators as the Tennessee Men’s Health Report Card (TMHRC). This article describes the origins, structure, development, and lessons learned from publishing report cards in 2010, 2012, 2014, and 2017. The report card highlights statistically significant changes in trends over time, identifies racial, ethnic, age, and geographic differences among men, highlights connections to regional and statewide public health initiatives, and suggests priorities for improving men’s health in Tennessee. State data were compared to Healthy People 2020 Objectives and graded based on the degree of discrepancy between the goal and the current reality for Tennessee men. Over the four iterations of the report card, the TMHRC team has made significant adjustments to the ways they analyze and present the data, utilize grades and graphics, consider the implications of the data for the economic well-being of the state, and disseminate the findings across the state to different stakeholders. It is important to go beyond creating a summary of information; rather, data should be shared in ways that are easily understood, actionable, and applicable to different audiences. It is also critical to highlight promising policy and programmatic initiatives to improve men’s health in the state.
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Affiliation(s)
- Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA.,Center for Medicine, Health and Society, Vanderbilt University, Nashville, TN, USA
| | - Andrea R Semlow
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
| | | | - Clare Sullivan
- Vanderbilt University Medical Center, Nashville, TN, USA
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Blumrosen C, Desta R, Cavanaugh KL, Laferriere HE, Bruce MA, Norris KC, Griffith DM, Umeukeje EM. Interventions Incorporating Therapeutic Alliance to Improve Hemodialysis Treatment Adherence in Black Patients with End-Stage Kidney Disease (ESKD) in the United States: A Systematic Review. Patient Prefer Adherence 2020; 14:1435-1444. [PMID: 32884245 PMCID: PMC7443008 DOI: 10.2147/ppa.s260684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/10/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In the US, Blacks with end-stage kidney disease (ESKD) have a four-fold higher prevalence rate of hemodialysis treatment and higher subsequent rates of hemodialysis treatment nonadherence and hospitalization compared to their White peers. Nonadherence to prescribed dialysis therapy is an underestimated life-threatening behavior, because of its association with increased morbidity and mortality. Few studies have specified and systematically evaluated targeted methods of increasing hemodialysis treatment adherence among Black hemodialysis patients with added focus on therapeutic alliance, a rewarding patient-centered relationship between patients and providers, based on common goals and objectives. This review seeks to evaluate the state of the science to determine the salience of a therapeutic alliance for the development of effective interventions positively impacting hemodialysis treatment adherence among Black patients. METHODS Medline (via PubMed), Embase (OvidSP), Cumulative Index of Nursing and Allied Health Literature (CINAHL; EBSCOhost), and PsycInfo (ProQuest) databases were used to search for abstracts with the keywords "dialysis", "therapeutic alliance", and "treatment adherence and compliance", including all underlying index terms and alternative variations of terms, in order to cover the entire scope of the field. Only randomized clinical trials and pre/postintervention studies published in the previous 10 years (2009-2019) and including a proportion of Black patients >25% were included for review. RESULTS Only three intervention studies met these criteria, for a total aggregated sample of 130 - mean age 58.1 years and 53% female. None of these studies was composed exclusively of Black patients (range 62%-91.3%), nor did they present data specifically for Blacks. Despite the lack of robust data informing strategies to improve hemodialysis adherence among Blacks with ESRD, a limited number of intervention studies have reported positive effects on hemodialysis attendance. DISCUSSION/CONCLUSION Further research is warranted to fill this significant gap in our understanding of theoretically based, therapeutic alliance-enhanced, and culturally tailored hemodialysis treatment-adherence interventions among Blacks.
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Affiliation(s)
| | | | - Kerri L Cavanaugh
- Vanderbilt Center for Kidney Disease, Nashville, TN, USA
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Heather E Laferriere
- Eskind Biomedical Library, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marino A Bruce
- Department of Population Health Science, John D Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Keith C Norris
- Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, CA, USA
| | - Derek M Griffith
- Center for Research on Men’s Health, Vanderbilt University, Nashville, TN, USA
| | - Ebele M Umeukeje
- Vanderbilt Center for Kidney Disease, Nashville, TN, USA
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
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Abstract
Objective One of the fundamental challenges in research on, and the practice of, anti-racism is helping people open their minds to new possibilities and new ways of thinking. Design This commentary illustrates how art can help people unlearn misinformation and narrow ways of thinking while enhancing flexibility that allows people to think creatively about efforts to eliminate or mitigate the health effects of racism. Results Historically, art has been a critical foundation of the history of protest and struggle to achieve equity in the United States and across the globe. Whether music, poems, paintings or other forms of creative expression, art has been at the core of efforts to express emotion, communicate difficult concepts, spur action and change what seems impossible. Art has been particularly important in illustrating and helping to facilitate how people understand what racism is, how it feels to experience privilege or oppression and exploring the implications of policies and practices that affect health indirectly or directly. Yet, art remains underutilized in anti-racism education, training and organizing efforts within public health. This commentary includes several arts-based examples to illustrate how art can facilitate insights, observations and strategies to address racism and achieve health equity. Conclusion Art can be an important tool to facilitate moving past intellectual arguments that seek to explain, justify and excuse racism. Art may be particularly important in efforts to illuminate how racism operates in organizational or institutional contexts and to communicate hope, resilience, and strength amid what seems impossible.
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Affiliation(s)
- Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN
| | - Andrea R Semlow
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN
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42
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Smith JA, Watkins DC, Griffith DM. Fostering Transnational Research Partnerships to Advance Men's Health. Am J Mens Health 2020; 14:1557988320936893. [PMID: 32703077 PMCID: PMC7383705 DOI: 10.1177/1557988320936893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- James A Smith
- Wellbeing & Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Daphne C Watkins
- School of Social Work Vivian A. & James L. Curtis Center for Health Equity Research and Training, University of Michigan, Ann Arbor, MI, USA
| | - Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, USA
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Griffith DM, Sharma G, Holliday CS, Enyia OK, Valliere M, Semlow AR, Stewart EC, Blumenthal RS. Men and COVID-19: A Biopsychosocial Approach to Understanding Sex Differences in Mortality and Recommendations for Practice and Policy Interventions. Prev Chronic Dis 2020; 17:E63. [PMID: 32678061 DOI: 10.5888/pcd17.200247(2020)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Data suggest that more men than women are dying of coronavirus disease 2019 (COVID-19) worldwide, but it is unclear why. A biopsychosocial approach is critical for understanding the disproportionate death rate among men. Biological, psychological, behavioral, and social factors may put men at disproportionate risk of death. We propose a stepwise approach to clinical, public health, and policy interventions to reduce COVID-19-associated morbidity and mortality among men. We also review what health professionals and policy makers can do, and are doing, to address the unique COVID-19-associated needs of men.
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Affiliation(s)
- Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, 2301 Vanderbilt Pl, PMB# 401814, Nashville, TN 37240-1814.
| | - Garima Sharma
- Ciccarone Center for Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Okechuku K Enyia
- The George Washington University Milken Institute School of Public Health, Washington, DC
| | | | - Andrea R Semlow
- Center for Research on Men's Health, Vanderbilt University, Nashville, Tennessee
| | - Elizabeth C Stewart
- Center for Research on Men's Health, Vanderbilt University, Nashville, Tennessee
- Meharry Medical College, Nashville, Tennessee
| | - Roger Scott Blumenthal
- Ciccarone Center for Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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44
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Griffith DM, Sharma G, Holliday CS, Enyia OK, Valliere M, Semlow AR, Stewart EC, Blumenthal RS. Men and COVID-19: A Biopsychosocial Approach to Understanding Sex Differences in Mortality and Recommendations for Practice and Policy Interventions. Prev Chronic Dis 2020; 17:E63. [PMID: 32678061 PMCID: PMC7380297 DOI: 10.5888/pcd17.200247] [Citation(s) in RCA: 148] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Data suggest that more men than women are dying of coronavirus disease 2019 (COVID-19) worldwide, but it is unclear why. A biopsychosocial approach is critical for understanding the disproportionate death rate among men. Biological, psychological, behavioral, and social factors may put men at disproportionate risk of death. We propose a stepwise approach to clinical, public health, and policy interventions to reduce COVID-19-associated morbidity and mortality among men. We also review what health professionals and policy makers can do, and are doing, to address the unique COVID-19-associated needs of men.
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Affiliation(s)
- Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, 2301 Vanderbilt Pl, PMB# 401814, Nashville, TN 37240-1814.
| | - Garima Sharma
- Ciccarone Center for Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Okechuku K Enyia
- The George Washington University Milken Institute School of Public Health, Washington, DC
| | | | - Andrea R Semlow
- Center for Research on Men's Health, Vanderbilt University, Nashville, Tennessee
| | - Elizabeth C Stewart
- Center for Research on Men's Health, Vanderbilt University, Nashville, Tennessee.,Meharry Medical College, Nashville, Tennessee
| | - Roger Scott Blumenthal
- Ciccarone Center for Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Valdez LA, Morrill KE, Griffith DM, Lindberg NM, Hooker SP, Garcia DO. Mexican Origin Hispanic Men's Perspectives of Physical Activity-Related Health Behaviors. Am J Mens Health 2020; 13:1557988319834112. [PMID: 30819068 PMCID: PMC6775557 DOI: 10.1177/1557988319834112] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Approximately 83% of Hispanic men of Mexican origin are overweight or obese, which are both associated with increased risk of chronic disease and all-cause mortality. Consequently, men of Mexican origin have some of the highest prevalence rates of obesity-related comorbidities. Physical activity (PA) may be an important strategy for Hispanic men of Mexican origin in reducing incidence and risk factors of lifestyle diseases. The current study engaged Spanish-speaking, Hispanic men of Mexican origin aged 24–64 years with overweight/obesity to examine perspectives of health behaviors related to PA. A total of 14 in-depth semistructured individual interviews were completed between September and November of 2015 and data analyzed using an iterative deductive–inductive thematic assessment strategy. The men suggested that their PA was hindered by (a) work-related energy and time constraints, (b) socioeconomic status (SES) and the need to prioritize work, (c) adaptations to majority population lifestyle norms, and (d) perceived lack of suitable access to PA-promoting spaces. The men provided valuable insight for strategies to improve PA interventions such as (a) accurately accounting for current PA levels of participants, including occupational and transportation PA, (b) considerations of family dynamics that influence PA-based behavior change, and (c) considerations of economic and geographical constraints that can be remediated. To improve effectiveness, future PA-related intervention research with Hispanic men of Mexican origin should consider methods that (a) account for transportation and occupational PA to better tailor PA to individual needs, (b) consider sociocultural and socioeconomic influences, (c) account for social support and accountability, and (d) consider economic and geographical constraints.
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Affiliation(s)
- Luis A Valdez
- 1 School of Public Health and Health Sciences, Department of Health Promotion and Policy, University of Massachusetts, Amherst, MA, USA
| | - Kristin E Morrill
- 2 College of Agriculture & Life Sciences, Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | - Derek M Griffith
- 3 Center for Research on Men's Health, Center for Medicine, Health and Society, Vanderbilt University, Nashville, TN, USA
| | | | - Steven P Hooker
- 5 College of Health and Human Services, San Diego State University, CA, USA
| | - David O Garcia
- 6 Mel and Enid Zuckerman College of Public Health, Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, USA
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46
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Abstract
Ethn Dis. 2020;30(Suppl 1):129-134; doi:10.18865/ed.30.S1.129
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Affiliation(s)
- Derek M Griffith
- Center for Research on Men's Health; Vanderbilt University, Nashville, TN
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47
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Griffith DM, Jaeger EC, Valdez LA, Schaefer Solle N, Garcia DO, Alexander LR. Developing a "Tailor-Made" Precision Lifestyle Medicine Intervention for Weight Control among Middle-aged Latino Men. Ethn Dis 2020; 30:203-210. [PMID: 32269462 PMCID: PMC7138438 DOI: 10.18865/ed.30.s1.203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective To identify what is important to middle-aged Latino men and their personal goals and values as foundations for a future precision lifestyle medicine intervention that is rooted in Self-Determination Theory. Design We used a phenomenological, thematic approach to analyze data from 20 semi-structured, individual interviews with Latino men aged 35-60 years. Setting Community-based settings between November 2017 and May 2018 in South Florida. Participants Latino or Hispanic men who were aged 35-60 years. The mean age of the men was 49.8 years. Results Two key themes emerged: a) the characteristics that these men say define what it means to be a man; and b) the characteristics that these men say define what is important to them. "What defines a man" includes three primary subthemes: a) the attributes, characteristics and behaviors that participants understood to be ideals that a man should embody and the roles he should fulfill; b) lessons learned growing up about what it means to be a man; and c) how Latino men relate to the ideal of machismo. "What defines me" includes the subthemes: a) comparing themselves with the ideal of machismo; b) caring for family and others; and c) supporting and modeling positive behavior for their children. Conclusions We found key candidate mechanisms that may be novel yet critical foundations on which to build a precision lifestyle medicine intervention for Latino men. We identified actionable psychosocial factors that map onto motivational constructs that can shape behaviors that are essential for weight control and be a useful foundation for improving the health of middle-aged Latino men.
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Affiliation(s)
- Derek M Griffith
- Center for Research on Men's Health; Vanderbilt University, Nashville, TN
| | - Emily C Jaeger
- Center for Research on Men's Health; Vanderbilt University, Nashville, TN
| | - Luis A Valdez
- Department of Health Promotion and Policy, University of Massachusetts, Amherst, MA
| | | | - David O Garcia
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ
| | - Leah R Alexander
- School of Graduate Studies and Research, Meharry Medical College, Nashville, TN
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48
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Yeh VM, Bergner EM, Bruce MA, Kripalani S, Mitrani VB, Ogunsola TA, Wilkins CH, Griffith DM. Can Precision Medicine Actually Help People Like Me? African American and Hispanic Perspectives on the Benefits and Barriers of Precision Medicine. Ethn Dis 2020; 30:149-158. [PMID: 32269456 DOI: 10.18865/ed.30.s1.149] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objective To better understand African American and Hispanic perspectives on the potential benefits of precision medicine, along with the potential barriers that may prevent precision medicine from being equally beneficial to all. We also sought to identify if there were differences between African American and Hispanic perspectives. Design Six semi-structured focus groups were conducted between May 2017 and February 2018 to identify benefits and barriers to precision medicine. Three groups occurred in Nashville, TN with African American participants and three groups occurred in Miami, FL with Hispanic participants. Setting At community-based and university sites convenient to community partners and participants. Participants A total of 55 individuals participated (27 in Nashville, 28 in Miami). The majority of participants were women (76.5%) and the mean age of participants was 56.2 years old. Results Both African Americans and Hispanics believed precision medicine has the potential to improve medicine and health outcomes by individualizing care and decreasing medical uncertainty. However, both groups were concerned that inadequacies in health care institutions and socioeconomic barriers would prevent their communities from receiving the full benefits of precision medicine. African Americans were also concerned that the genetic and non-genetic personal information revealed through precision medicine would make African Americans further vulnerable to provider racism and discrimination in and outside of health care. Conclusions While these groups believed precision medicine might yield benefits for health outcomes, they are also skeptical about whether African Americans and Hispanics would actually benefit from precision medicine given current structural limitations and disparities in health care access and quality.
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Affiliation(s)
- Vivian M Yeh
- Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, TN
| | - Erin M Bergner
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN
| | - Marino A Bruce
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN.,Center for Medicine, Health, and Society, Vanderbilt University, Nashville, TN
| | - Sunil Kripalani
- Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, TN.,Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Victoria B Mitrani
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL
| | | | - Consuelo H Wilkins
- Department of Internal Medicine, Meharry Medical College, Nashville, TN.,Meharry-Vanderbilt Alliance, Vanderbilt University Medical Center, Nashville, TN.,Division of Geriatrics, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN.,Center for Medicine, Health, and Society, Vanderbilt University, Nashville, TN
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Smith JA, Watkins DC, Griffith DM. Equity, gender and health: New directions for global men’s health promotion. Health Promot J Austr 2020; 31:161-165. [DOI: 10.1002/hpja.337] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- James A. Smith
- Wellbeing and Preventable Chronic Diseases Division Menzies School of Health Research Darwin Northern Territory Australia
- Vivian A. and James L. Curtis School of Social Work Center for Health Equity Research and Training University of Michigan Ann Arbor MI USA
| | - Daphne C. Watkins
- Vivian A. and James L. Curtis School of Social Work Center for Health Equity Research and Training University of Michigan Ann Arbor MI USA
| | - Derek M. Griffith
- Center for Research in Men’s Health Vanderbilt University Nashville TN USA
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50
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Abstract
According to the American Cancer Society's guidelines on nutrition and physical activity for cancer prevention, weight control, eating practices and physical activity are second only to tobacco use as modifiable determinants of cancer risk. However, no evidence-based interventions have been targeted to African American men or tailored to individual African American men's preferences, needs or identities. The goal of this chapter is to describe the rationale for the components, aims and setting of Mighty Men: A Faith-Based Weight Loss Intervention for African American Men. We begin by discussing the rationale for focusing on weight loss in the context of cancer prevention, and argue that obesity and obesogenic behaviors are important yet modifiable determinants of cancer risk. Next, we briefly review the scarce literature on interventions to promote healthy eating, physical activity and weight loss in our population of interest, and then discuss the rationale for conducting the intervention in faith- based organizations rather than other common settings for recruiting African American men. We conclude with a discussion of the conceptual foundations and components of Mighty Men, and discuss our focus and goals in the context of the larger literature in this area.
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Affiliation(s)
- Derek M Griffith
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, United States; Center for Medicine, Health and Society, Vanderbilt University, Nashville, TN, United States.
| | - Emily C Jaeger
- Center for Research on Men's Health, Vanderbilt University, Nashville, TN, United States
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