African American men experience disproportionately poorer health outcomes compared to most other demographic and racial groups. For example, compared to all other males, African American men have a higher incidence of uncontrolled hypertension, higher death rate from heart disease, and a higher incidence of most of the major cancers. They die on average 5 to 10 years earlier than men and women of most other racial and ethnic groups. One factor recognized as a contributor to these disparities is lack of a usual source of health care. Having a usual provider is particularly beneficial to the health of African American men because consistent providers can establish trust, provide regular preventive care, and better manage care on a long- term basis for improved outcomes. Yet public health interventions aimed at promoting a usual source of care among African American men have not been widely disseminated. One approach that has been used successfully in public health campaigns to influence different subgroups within a population is health marketing. The health marketing approach is a multi-step research strategy by which individuals comprising a given population (e.g., African American men) are meaningfully classified into distinct subgroups whose members share a constellation of characteristics relevant to a criterion (e.g., having a usual source of care). Using this strategy, health communications are custom tailored for each identified subgroup in a health- promoting intervention. The goals of the proposed study are (a) to apply health marketing strategies to identify and characterize distinctive subgroups of African American men with respect to having a usual source of care, and (b) to explore preferences within subgroups for message content and communication channels that will be most effective in promoting uptake of a usual source of care among these men. The research plan of the project consists of two phases. First, statistical classification techniques will be used to identiy specific subgroups of African American men according to relationships between selected predictor variables (e.g., medical mistrust, various facets of masculinity) and behaviors related to having a usual source of care. Second, focus groups will be formed from men in the identified subgroups in order to better understand factors associated with African American men's having a usual source of care and to explore preferences for health communications approaches that might be most informative and motivating within the different subgroups. Using this health marketing approach, health communications can then be custom tailored for each particular subgroup in a future health-promoting intervention. Results of the proposed study will enhance the success of future tailored interventions designed to increase the uptake of a usual source of healthcare among vulnerable African American men.

Public Health Relevance

African American men are less likely than most other demographic and racial groups to have a usual source of health care. Having a usual provider or site of care is important to the health of African American men because sustained continuity can result in increased trust, improved receipt of preventive care, and better health-related outcomes. This project aims to identify and characterize distinctive subgroups of African American men who do not have a usual source of care, and to explore preferences within subgroups for message content and communication channels that will be most effective in promoting uptake of a usual source of care among these men.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21HL113751-01A1
Application #
8383902
Study Section
Health Disparities and Equity Promotion Study Section (HDEP)
Program Officer
Pratt, Charlotte
Project Start
2012-07-01
Project End
2014-06-30
Budget Start
2012-07-01
Budget End
2013-06-30
Support Year
1
Fiscal Year
2012
Total Cost
$228,000
Indirect Cost
$78,000
Name
Washington University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Ristvedt, Stephen L (2014) The evolution of gender. JAMA Psychiatry 71:13-4