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

描述（由申请人提供）：与大多数其他人口统计和种族群体相比，非洲裔美国人的健康结果不成比例地差。例如，与所有其他男性相比，非裔美国男性患未控制的高血压的发病率更高，心脏病死亡率更高，大多数主要癌症的发病率更高。他们比大多数其他种族和族裔群体的男性和女性平均早死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。拥有一个固定的提供者对非裔美国人的健康尤其有益，因为始终不变的提供者可以建立信任，提供定期的预防性护理，并在长期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性通常护理来源的公共卫生干预措施尚未广泛传播。在公共卫生运动中成功使用的影响人口中不同亚群体的一种方法是卫生营销。健康营销方法是一种多步骤的研究策略，通过该策略，由特定人群组成的个人（例如，非洲裔美国人）被有意义地划分为不同的亚组，其成员共享与标准相关的一系列特征（例如，拥有通常的护理来源）。利用这一战略，在促进健康的干预措施中为每个确定的亚群体量身定制卫生通信。拟议研究的目标是(a)应用健康营销策略来识别和描述非洲裔美国男性在通常护理来源方面的不同亚群体，以及(b)探索亚群体对信息内容和沟通渠道的偏好，这些信息内容和沟通渠道将最有效地促进这些男性接受通常的护理来源。本项目的研究计划分为两个阶段。首先，将使用统计分类技术，根据选定的预测变量（例如，医疗不信任，男子气概的各个方面）和与拥有常规护理来源相关的行为之间的关系，确定非洲裔美国人的特定亚组。第二，将由确定的子群体中的男性组成焦点小组，以便更好地了解与非洲裔美国人男性拥有通常护理来源相关的因素，并探索对不同子群体中可能最具信息和激励作用的健康交流方法的偏好。使用这种卫生营销方法，就可以在未来的健康促进干预措施中为每个特定的亚群体量身定制卫生传播。拟议研究的结果将提高未来量身定制的干预措施的成功，这些干预措施旨在增加弱势非洲裔美国人对通常医疗保健来源的吸收。

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.