Giving Voice to Black Men: Guidance for Increasing the Likelihood of Having a Usual Source of Care

Black men suffer inequalities in health and health-care outcomes relative to other racial/ethnic groups, requiring well-informed efforts for health promotion. Fewer Black men have a usual source of health care, which may be a contributor to these disparities. Increasing access to and the likelihood of a usual source of care among Black men are important to address health and health-care disparities. In this focus group study, we sought to better understand how Black men think about primary care and usual sources of care. A total of six focus groups were conducted with N = 25 men. Groups were a mix of men with and without a usual source of care. Several themes were identified through analysis of the data regarding factors that contribute to Black men going to the doctor. Themes identified in the data analysis included Lack of Health Insurance as a Barrier to Establishing Usual Source of Care; Family Promoting Health Care Use; Relationship With Doctor, Trust, and Empowerment; Age and Maturity in Health Promotion; and Positive Tone of Messaging. Future research should explore if similar findings are obtained among men in different regions of the United States or between Black men of different backgrounds. Taking a step beyond this research, specifically, future research can also examine the impact of particular health messages/messaging on Black men’s health-care-seeking behaviors.

Threat sensitivity is associated with the healthcare source used most often: doctor's office, emergency room, or none at all

A significant proportion of American adults do not have a regular source of healthcare and the reasons for this shortfall are not fully understood. The objective of this study was to examine the relationship between individual differences in threat sensitivity and healthcare utilization in a survey of 483 African American men. Demographics, psychological characteristics, and health behaviors were assessed. The primary outcomes were: 1) most frequent source of healthcare utilization (doctor's office or clinic vs. emergency room vs. no place), and 2) frequency of healthcare utilization (one or more vs. no healthcare visits in the previous year). Data were analyzed with multivariable logistic regression. Results showed that threat sensitivity, insurance status, and age were associated with the most frequent source of healthcare utilization. Compared to men who most commonly used a doctor's office or clinic, men who tended to use an emergency room had higher levels of threat sensitivity and those with no usual healthcare source had lower levels of threat sensitivity. These findings fit with leading neurobiological theories of personality regarding threat sensitivity. From a pragmatic standpoint, these findings may also lend insight to the tailoring of health marketing messages designed to optimize utilization of healthcare resources.

Patient preference and recall of results of EUS-guided FNA

BACKGROUND

There are no clear guidelines regarding the best way, in terms of timing and setting, to deliver results to patients who undergo EUS-guided FNA (EUS-FNA) of suspected pancreatic masses.

OBJECTIVE

We aimed to study (1) whether patients undergoing EUS-FNA prefer to receive preliminary results immediately after the procedure or at a later date, after final results are known; and (2) to assess the accuracy of patients' recollection of information given to them regarding their FNA diagnosis.

DESIGN

We enrolled patients presenting to our endoscopy center for EUS-FNA of suspected pancreatic masses and obtained data through 4 pilot surveys.

SETTINGS

University-based endoscopy center.

PATIENTS

Sixty patients who were referred for EUS-FNA of suspected pancreatic masses.

RESULTS

A total of 57 of 59 patients (96.6%) wanted preliminary results the same day as the procedure. Twenty-eight of 60 (42.7%) knew they were having a biopsy, and 42 of 60 (70%) knew cancer was suspected. Of those who received preliminary results, 31 of 41 (75%) remembered the diagnosis correctly the next day, and 32 of 38 (84%) remembered the diagnosis correctly 1 week later.

LIMITATIONS

Single-center pilot study.

CONCLUSIONS

The majority of our patients wished to receive preliminary results the same day as the procedure. Although most patients remembered results correctly, 25% of patients did not remember the correct diagnosis the next day. Further work is needed to improve patient's understanding of the reasons for the EUS-FNA and recall of preliminary EUS-FNA results.

The impact of physicians' health beliefs on colorectal cancer screening practices

Primary-care physicians have significant influence on whether or not their patients participate in colorectal cancer screening (CRCS). This study explored the association of physicians' personal health beliefs, medical history, and personal participation in CRCS with their practice patterns regarding CRCS. Perceived personal risk for colorectal cancer (CRC) was associated with compliance with American Cancer Society (ACS) guidelines for CRCS for their patients (P = 0.03). For physicians at low risk for CRC, their perception of the seriousness of CRC was significantly associated with compliance (P = 0.047). For physicians at, at least, average risk for CRC, personal participation in CRCS did not predict whether they recommend CRCS to their patients. Efforts to improve physicians' understanding about their own susceptibility to CRC and the seriousness of CRC may improve their compliance with making recommendations for CRCS to their patients and may improve their participation in CRCS.

Coping and anxiety in women recalled for additional diagnostic procedures following an abnormal screening mammogram

This study characterized women's concurrent and subsequent levels of emotional distress associated with a questionable mammogram screening and relationships between women's coping and psychosocial adjustment. State anxiety was assessed in 98 women 1 day after receiving a mammogram screening (Time 1), after notification of a questionable screening result that necessitated additional testing (Time 2), and after being informed of their breast-cancer-free status (Time 3). Key findings include (a) women reported a significant increase in anxiety following notification of the need to return for follow-up testing; (b) significant and positive associations were found between anxiety and behavioral approach, behavioral avoidance, cognitive approach, and cognitive avoidance coping in cross-sectional analyses; and (c) cognitive avoidance coping was a strong predictor of final levels of state anxiety in women. Findings suggest that cognitive avoidance coping plays an important role in reducing anxiety in women recalled to clarify an initially ambiguous screening procedure.