PROMOTING UPTAKE OF A USUAL SOURCE OF CARE AMONG AFRICAN AMERICAN MEN

描述（由申请人提供）：与大多数其他人口和种族群体相比，非洲裔美国男性的健康状况不成比例地较差。例如，与所有其他男性相比，非洲裔美国男性患不受控制的高血压的发病率较高，心脏病的死亡率较高，大多数主要癌症的发病率较高。他们比大多数其他种族和族裔群体的男女平均早死5至10年。造成这些差异的一个公认因素是缺乏通常的保健来源。拥有一个通常的提供者对非洲裔美国男性的健康特别有益，因为一贯的提供者可以建立信任，提供定期的预防性护理，并在长期的基础上更好地管理护理，以改善结果。然而，旨在促进非裔美国人男子通常护理来源的公共卫生干预措施尚未得到广泛传播。在公共卫生运动中成功地使用的一种方法是健康营销，以影响人口中的不同亚群体。健康营销方法是一种多步骤的研究策略，通过该策略，构成给定人群的个体（例如，非裔美国男性）被有意义地分类为不同的亚组，其成员共享与某个标准相关的一系列特征（例如，有一个通常的护理来源）。使用这一策略，为健康促进干预措施中每个确定的亚组定制健康传播。拟议的研究的目标是（a）应用健康营销策略，以确定和表征独特的亚组的非洲裔美国人男子就有一个通常的来源的照顾，和（B）探讨偏好的消息内容和沟通渠道，将是最有效的促进摄取的一个通常的来源，这些人之间的照顾。该项目的研究计划包括两个阶段。首先，统计分类技术将用于根据选定的预测变量（例如，医学上的不信任，男性气质的各个方面）以及与拥有常规护理来源相关的行为。第二，焦点小组将形成从男性在确定的亚组，以更好地了解相关因素与非洲裔美国男子有一个通常的护理来源，并探讨偏好的健康通信方法，可能是最翔实和激励不同的亚组。使用这种健康营销方法，在未来的健康促进干预中，可以为每个特定的亚组定制健康传播。拟议的研究结果将提高未来量身定制的干预措施的成功率，这些干预措施旨在增加弱势非洲裔美国男性对常规医疗保健来源的吸收。 公共卫生相关性：非裔美国人男性比大多数其他人口和种族群体更不可能获得通常的医疗保健来源。拥有通常的护理提供者或护理地点对非裔美国男性的健康很重要，因为持续的连续性可以增加信任、改善预防性护理的接受以及更好的健康相关结果。该项目的目的是确定和表征独特的亚组的非洲裔美国人的男人谁没有一个通常的护理来源，并探讨分组内的信息内容和沟通渠道，这将是最有效的促进摄取这些人之间的一个通常的护理来源的偏好。

DESCRIPTION (provided by applicant): 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.