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.

The Black Men’s Health Forum: Improving Health Knowledge and Willingness to Participate in Research

“…In this study, participant health knowledge was assessed in the areas of prostate cancer, heart disease, diabetes, and mental health. Both groups of participants had significant increases in knowledge in all areas of health, excluding AA men in the area of heart disease (Okoro et al, 2020). Offering culturally tailored, community-based health education interventions is a public health approach that enables clinicians and researchers to reach a broader proportion of AA men, especially considering that mistrust of health care systems is commonly cited as a reason for lack of involvement in research and health systems among AAs (Hoyo et al, 2003; Scharff et al, 2010).…”

“…Women may positively impact health behaviors by influencing diet; monitoring health behaviors; providing motivation, support, and encouragement; and being a source for health information (Allen et al, 2013;Felder et al, 2019;Okoro et al, 2018Okoro et al, , 2020. Previous community-based health education interventions have been successful in engaging AA men (Graham et al, 2018;Joseph et al, 2022;Okoro et al, 2020). A total of 245 men completed the Men of Color Health Awareness (MOCHA) project from 2011 to 2015, a project that aimed to improve men's overall health, including physical, mental, emotional, and spiritual health (Graham et al, 2018).…”

“…Examples of community-based interventions may include activities such as health programs, health fairs, and mobile clinics held in the community that focus on a population of interest. Communal spaces (e.g., community centers, churches, and other community spaces) versus health care settings may yield greater participant engagement (Okoro et al, 2020). Interdisciplinary stakeholders such as community members, faith-based leaders, policymakers, and health researchers may be involved in these health education efforts (Mitic, 2012).…”

“…A total of 245 men completed the Men of Color Health Awareness (MOCHA) project from 2011 to 2015, a project that aimed to improve men’s overall health, including physical, mental, emotional, and spiritual health (Graham et al, 2018). Similarly, Okoro et al (2020) and Joseph et al (2022) engaged 29 and 74 AA men, respectively, in health education intervention to address health disparities found among AA men. Not only were these interventions successful in engaging AA men in community settings, but the interventions also provided a health space for AA men, improved health knowledge, and increased access to health care.…”

“…In addition, female peers and relatives may facilitate healthy behaviors among AA men. Women may positively impact health behaviors by influencing diet; monitoring health behaviors; providing motivation, support, and encouragement; and being a source for health information (Allen et al, 2013;Felder et al, 2019;Okoro et al, 2018Okoro et al, , 2020. Previous community-based health education interventions have been successful in engaging AA men (Graham et al, 2018;Joseph et al, 2022;Okoro et al, 2020).…”