Health-seeking Behaviors in Formerly Incarcerated Black Men

项目摘要/摘要

PROJECT SUMMARY/ ABSTRACT Incarceration is a social determinant of health that disproportionately impacts Black men in the United States (US), contributing to the significant disparate health outcomes experienced by this population. Nearly 40% of incarcerated men in the US are Black, despite the fact that Black men make up only 13% of the nation’s male population. Over the life course, Black men are exposed to health harming social and environmental factors, including physical and emotional trauma, socioeconomic disadvantage, and racial discrimination, which contribute to the negative health outcomes they experience, including mental health symptoms. These same social and environmental factors are also associated with an increased likelihood of incarceration, which is an often-traumatic experience that furthers health harms, disadvantages, and discrimination upon release from incarceration. The cumulative impact of these circumstances leaves formerly incarcerated Black men especially at risk for mental health symptoms and diminished health-related quality of life. Although there have been studies describing contributors to mental health symptoms in formerly incarcerated Black men, there is a significant gap in current knowledge regarding how these men recognize and address their own health needs. This mixed method (QUAL + quan) study aims to investigate how incarceration history influences mental health symptom severity, health-related quality of life, health-seeking behaviors, and engagement in health care. This will be accomplished by (1) examining participants’ experiences with mental health symptoms to identify salient contextual factors that impact mental health, health-related quality of life, and health-seeking behaviors (2) examining experiences and perceptions of health-seeking for mental health symptoms post- incarceration to illuminate how participants address their mental health needs within the social-structural context of incarceration history and (3) describing how incarceration history shapes pathways to engagement in mental health care. Understanding health-seeking behaviors and pathways to engagement in mental health care among formerly incarcerated Black men is an essential step in the development of targeted interventions that promote health-seeking behaviors and minimize barriers to care. The aims of this study are well aligned with the National Institute of Nursing Research’s Notice of Special Interest in the priority areas of social determinants of health, health disparities and health equity. This study is integrated in a fellowship training plan that will prepare the applicant for an independent research career focused on advancing health equity by improving the mental health symptoms and health-related quality of life in trauma-exposed and marginalized populations. Training will primarily take place at the University of Pennsylvania and incorporate didactic and experiential learning, mentored research, and career development activities.