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Culturally Responsive Health Promotion to Address Health Disparities in African American Men: A Program Impact Evaluation.

ABSTRACT: African American (AA) men continue to experience worse health outcomes compared to men of other races/ethnicities. Community-based interventions are known to be effective in health promotion and disease prevention. The program objectives were to (a) increase knowledge and risk awareness of targeted conditions, (b) change health-care-seeking attitudes toward regular primary care among AA men, and (c) improve their lifestyle-related health behaviors by leveraging the influence of women in their lives. The community-engaged educational intervention targeted both men and women and included eight 90-min sessions per cohort. Topics included prostate cancer, cardiovascular disease, diabetes, mental health, health-care access, and healthy lifestyle. Sessions were both didactic and interactive. A pre-/post-intervention questionnaire assessed knowledge. Interviews were conducted with male participants and a focus group discussion (FGD) with women to assess program impact. Interview and FGD transcripts were analyzed for themes and recommendations. Major themes were-increased knowledge/awareness of risk associated with chronic conditions, change in health-care-seeking attitudes, increased self-efficacy to engage the health-care system, and lifestyle changes. Other impacts reported were building community/social support, a safe and enabling learning environment, and enhanced community health status overall. Recommendations included having extended, more in-depth sessions, targeting the younger generation, smaller cohort sizes, and more community-based health programming. Community-engaged health promotion using a cohort model as well as including women can be effective in increasing knowledge, enhancing self-efficacy, and providing the much-needed social support. These can influence health-related behaviors and thus contribute to improving health outcomes for AA men.

SUBMITTER: Okoro ON

PROVIDER: S-EPMC7450466 | biostudies-literature | 2020 Jul-Aug

REPOSITORIES: biostudies-literature

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Culturally Responsive Health Promotion to Address Health Disparities in African American Men: A Program Impact Evaluation.

Okoro Olihe N ON Nelson Chantele S CS Witherspoon Stephan P SP Witherspoon Salaam F SF Simmons Glenn E GE

American journal of men's health 20200701 4

African American (AA) men continue to experience worse health outcomes compared to men of other races/ethnicities. Community-based interventions are known to be effective in health promotion and disease prevention. The program objectives were to (a) increase knowledge and risk awareness of targeted conditions, (b) change health-care-seeking attitudes toward regular primary care among AA men, and (c) improve their lifestyle-related health behaviors by leveraging the influence of women in their li ...[more]

PMID: 32840146

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Project description:African American men (AA) carry unequal burdens of several conditions including cancer, diabetes, hypertension, and HIV. Engagement of diverse populations including AA men in research and health promotion practice is vital to examining the health disparities that continue to plague many racially and ethnically diverse communities. To date, there is little research on best practices that indicate locations, community areas and settings to engage AA men in research and health promotion. Traditionally, the AA church has been a key area to engage AA men and women. However, changing tides in attendance of AA parishioners require additional information to identify areas where AAs, particularly, AA men congregate. The AA barbershop has been identified as a place of social cohesion, cultural immersion and solidarity for AA men but specific sub-populations of AA men may be underrepresented. To further investigate additional locales where AA men congregate, this study engaged AA barbers and clients in several urban community barbershops in Chicago, Illinois. 127 AA men over age 18y/o receiving grooming services in 25 Chicago area barbershops across 14 predominantly AA communities were consented and recruited for a quantitative survey study. The self-administered surveys were completed in ~15 min and $10 compensation was provided to men. Descriptive statistics were reported for demographic variables and for frequency of responses for locations to find AA men of specific age ranges for health promotion and screening activities. Outside of the traditionally used churches or barbershops, the top recommended recruitment sites by age were: 18-29y/o- city park or a recreational center; 30-39y/o- gym, bars or the street; 40-49y/o- various stores, especially home improvement stores, and the mall; and 50y/o+- fast food restaurants in the mornings, such as McDonalds, and individual's homes. The study participants also reported that locations where AA men congregate vary by age. Findings from this study illustrate that AA barbers and barbershops remain a key stakeholder in health promotion among AA men. The findings also demonstrate the need for additional research to examine best practices for identifying locations where diverse groups of AA men that vary by age and sexual orientation may congregate in order to support increased health promotion among AA men.

Project description:BackgroundHealth promotion efforts among African American men have been met with significant challenges and have produced limited results. Interventions that do not align with the values, perspectives, and preferences of African American men often produce less effective results. Research among African American men has provided compelling evidence that these men prefer informal networks of health support. Recent successful health promotion efforts among these men have benefited from peer-to-peer models of implementation. To date, no known scoping or systematic review of peer-to-peer health promotion interventions among African American men has been conducted. The goal of this scoping review is to understand the extent of, design, implementation, and use of peer-to-peer interventions to promote health, improve quality of life, and prevent disease among African American men.MethodsA review of the literature will be performed in PubMED, EMBASE, PsycInfo, CINAHL, and Web of Science. The development of this protocol was guided by the work of Arksey and O'Malley and the PICOS statement. Reporting will be guided by the PRISMA-ScR checklist. Eligible studies include those testing the effects of a peer-to-peer health promotion intervention targeting African American men. A comparison group will not be required. For the purposes of the current review, "peers" will be limited to other African American men. An initial screening of the titles and abstracts of potentially eligible studies will be completed by two independent reviewers. The full text of records that appear to meet the eligibility criteria will be accessed and further screened. Data will then be extracted and collected using a custom Microsoft Excel spreadsheet. Extracted data will include authors' name and publication year, target health issue(s), design of the intervention, components of the intervention, peer-led components of the intervention, peer role, length and type of training for peer leaders, intervention duration, frequency of the intervention, study design and number of participants, and main outcomes. Finally, results will be presented in table format and summarized in text format.DiscussionResults will have implications for the design, implementation, and evaluation of health promotion interventions among African American men.Systematic review registrationPROSPERO CRD42020198664.

Project description:The incidence and mortality rates of prostate cancer are significantly higher in African-American men when compared to European-American men. We tested the hypothesis that differences in tumor biology contribute to this survival health disparity. Using microarray technology, we obtained gene expression profiles of primary prostate tumors resected from 33 African-American and 36 European-American patients. These tumors were matched on clinical parameters. We also evaluated 18 non-tumor prostate tissues from 7 African-American and 11 European-American patients. The resulting datasets were analyzed for expression differences on the gene and pathway level comparing African-American with European-American patients. Our analysis revealed a significant number of genes, e.g., 162 transcripts at a false-discovery rate less than 5%, to be differently expressed between African-American and European-American patients. Using a disease association analysis, we identified a common relationship of these transcripts with autoimmunity and inflammation. These findings were corroborated on the pathway level with numerous differently expressed genes clustering in immune response, stress response, cytokine signaling, and chemotaxis pathways. Furthermore, a two-gene tumor signature was identified that accurately differentiated between African-American and European-American patients. This finding was confirmed in a blinded analysis of a second sample set. In conclusion, the gene expression profiles of prostate tumors indicate prominent differences in tumor immunobiology between African-American and European-American men. The profiles portray the existence of a distinct tumor microenvironment in these two patient groups. Experiment Overall Design: A total of 69 fresh-frozen prostate tumors were obtained from the NCI Cooperative Prostate Cancer Tissue Resource (CPCTR) and the Department of Pathology at the University of Maryland (UMD). All tumors were resected adenocarcinomas that had not received any therapy prior to prostatectomy. The macro-dissected CPCTR tumor specimens (n = 59) were reviewed by a CPCTR-associated pathologist, who confirmed the presence of tumor in the specimens. These tissues were collected between 2002 and 2004 at four different sites, with each site providing tissues from both African-American and European-American patients. Information on race/ethnicity (33 African-Americans and 36 European-Americans) was either extracted from medical records (CPCTR) or obtained through an epidemiological questionnaire in which race/ethnicity was self-reported (UMD). Only one patient, a European-American, was also Hispanic. Surrounding non-tumor prostate tissue was collected from 18 of the recruited patients in this study. Of those, 7 were African-American men and 11 were European-American men. We also isolated total RNA from 10 needle biopsy specimens collected from patients at the National Naval Medical Center (one African-American and 9 European-Americans) that did not have prostate cancer. From those, we prepared two RNA pools, each representing 5 patients. Clinicopathological characteristics of the patients, including age at prostatectomy, histology, Gleason score, pathological stage, PSA at diagnosis, tumor size, extraprostatic extension, margin involvement, and seminal vesicle invasion were obtained from CPCTR. For UMD cases, this information was extracted from the medical and pathology records, if available. Written informed consent was obtained from all donors. Tissue collection and study design were approved by the institutional review boards of the participating institutions.

Dataset Information

Culturally Responsive Health Promotion to Address Health Disparities in African American Men: A Program Impact Evaluation.

Publications

Culturally Responsive Health Promotion to Address Health Disparities in African American Men: A Program Impact Evaluation.

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