Objective: One of the fundamental challenges in research on, and the practice of, anti-racism is helping people open their minds to new possibilities and new ways of thinking.Design: This commentary illustrates how art can help people unlearn misinformation and narrow ways of thinking while enhancing flexibility that allows people to think creatively about efforts to eliminate or mitigate the health effects of racism.Results: Historically, art has been a critical foundation of the history of protest and struggle to achieve equity in the United States and across the globe. Whether music, poems, paintings or other forms of creative expression, art has been at the core of efforts to express emotion, communicate difficult concepts, spur action and change what seems impossible. Art has been particularly important in illustrating and helping to facilitate how people understand what racism is, how it feels to experience privilege or oppression and exploring the implications of policies and practices that affect health indirectly or directly. Yet, art remains underutilized in anti-racism education, training and organizing efforts within public health. This commentary includes several arts-based examples to illustrate how art can facilitate insights, observations and strategies to address racism and achieve health equity.Conclusion: Art can be an important tool to facilitate moving past intellectual arguments that seek to explain, justify and excuse racism. Art may be particularly important in efforts to illuminate how racism operates in organizational or institutional contexts and to communicate hope, resilience, and strength amid what seems impossible. Ethn Dis. 2020;30(3):373-380; doi:10.18865/ed.30.3.373
Objective: To examine the factors that influenced African American men's medical help seeking. Method: Thematic analysis of 14 focus groups with 105 older, urban African American men. Results: African American men described normative expectations that they did not go to the doctor and that they were afraid to go, with little explanation. When they did go, men reported that they were particularly uncomfortable with the tone physicians used when talking to them. Providers often made recommendations but offered the men little useful information on how to make lifestyle and behavior changes. Following receipt of care, spouses, medical test results, and men's desire to fulfill social roles were key motivating and instrumental factors in following medical advice. Conclusions: African American men's medical help seeking seemed to be negatively influenced by social norms and patient-provider interactions but positively influenced by spouses and the desire to fulfill social roles.
<p><strong>Objective: </strong>Few studies have focused on how men perceive stress and depression, and even fewer have examined how men of a specific racial or ethnic group describe their experiences of these conditions. African American men tend to define health in ways that are inclusive of their physical health, health behaviors, and mental health, but research has largely failed to explore how men put their health and mental health in social contexts. The objective of this article is to explore how middle-aged and older African American men who self-identify as having depression: 1) differentiate stress from depression; and 2) describe depression. <strong></strong></p><p><strong>Design: </strong>Using data from semi-structured, individual interviews conducted between March and April 2014, we used a phenomenological approach to examine how men describe, experience, and perceive stress and depression. <strong></strong></p><p><strong>Setting: </strong>Nashville, Tennessee. <strong></strong></p><p><strong>Participants: </strong>18 African American men aged 35-76 years who self-reported a previous or current diagnosis of depression. <strong></strong></p><p><strong>Results: </strong>Men talked about the experiences of stress and how many of them viewed chronic stress as expected and depression as a normal part of life. They used phrases like being "slightly depressed" or "I take a light antidepressant" to describe how they feel and what they are doing to feel better. Within these narratives, men had difficulty distinguishing between stress and depression and they primarily explained that depression was the result of external stressors and strains. <strong></strong></p><p><strong>Conclusions: </strong>Men may have difficulty distinguishing between stress and depression and they may frame the causes of depression in ways that decrease their perceived culpability for its causes and limit their perceived control over the causes of depression. <em></em></p><p><em>Ethn Dis. </em>2017;27(4):437-442; doi:10.18865/ ed.27.4.437 </p>
This case study describes the qualitative data collection and analytic strategies used to understand the psychological and social factors that influence the health behaviors of middle-aged and older African American men. In this case study, we provide the conceptual and methodological rationale driving the decision to conduct thematic analyses of semi-structured individual interviews. We discuss the influence of gender, race/ethnicity, and notions of health to promote healthy behavior among this population. Personal characteristics and psychosocial factors, such as gender, age, and personal values, are critical determinants of health to explicate and incorporate in interventions to improve healthy behavior because they shape where health fits among other life goals and priorities. This research builds on a robust line of formative work by the authors and colleagues emerging from the effort to determine how to most effectively motivate middle-aged and older African American men to eat healthier and be more physically active.
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Objective: To identify what is important to middle-aged Latino men and their personal goals and values as foundations for a future precision lifestyle medicine intervention that is rooted in Self-Determination Theory.Design: We used a phenomenological, thematic approach to analyze data from 20 semi-structured, individual interviews with Latino men aged 35-60 years.Setting: Community-based settings between November 2017 and May 2018 in South Florida.Participants: Latino or Hispanic men who were aged 35-60 years. The mean age of the men was 49.8 years.Results: Two key themes emerged: a) the characteristics that these men say define what it means to be a man; and b) the characteristics that these men say define what is important to them. "What defines a man" includes three primary subthemes: a) the attributes, characteristics and behaviors that participants understood to be ideals that a man should embody and the roles he should fulfill; b) lessons learned growing up about what it means to be a man; and c) how Latino men relate to the ideal of machismo. "What defines me" includes the subthemes: a) comparing themselves with the ideal of machismo; b) caring for family and others; and c) supporting and modeling positive behavior for their children.Conclusions: We found key candidate mechanisms that may be novel yet critical foundations on which to build a precision lifestyle medicine intervention for Latino men. We identified actionable psychosocial factors that map onto motivational constructs that can shape behaviors that are essential for weight control and be a useful foundation for improving the health of middle-aged Latino men. Ethn Dis. 2020;30(Suppl 1):203-210; doi:10.18865/ed.30.S1.203
<p>Mentoring has been consistently identified as an important element for career advancement in many biomedical and health professional disciplines and has been found to be critical for success and promotion in academic settings. Early-career faculty from groups underrepresented in biomedical research, however, are less likely to have mentors, and in general, receive less mentoring than their majority-group peers, particularly among those employed in teaching-intensive institutions. This article describes Obesity Health Disparities (OHD) PRIDE, a theoretically and conceptually based research training and mentoring program designed for early-career faculty who trained or are employed at Historically Black Colleges and Universities (HBCUs). <em></em></p><p><em>Ethn Dis. </em>2018;28(2):115-122; doi:10.18865/ed.28.2.115. </p>
Objective: To better understand African American and Hispanic perspectives on the potential benefits of precision medicine, along with the potential barriers that may prevent precision medicine from being equally beneficial to all. We also sought to identify if there were differences between African American and Hispanic perspectives.Design: Six semi-structured focus groups were conducted between May 2017 and February 2018 to identify benefits and barriers to precision medicine. Three groups occurred in Nashville, TN with African American participants and three groups occurred in Miami, FL with Hispanic participants.Setting: At community-based and university sites convenient to community partners and participants.Participants: A total of 55 individuals participated (27 in Nashville, 28 in Miami). The majority of participants were women (76.5%) and the mean age of participants was 56.2 years old.Results: Both African Americans and Hispanics believed precision medicine has the potential to improve medicine and health outcomes by individualizing care and decreasing medical uncertainty. However, both groups were concerned that inadequacies in health care institutions and socioeconomic barriers would prevent their communities from receiving the full benefits of precision medicine. African Americans were also concerned that the genetic and non-genetic personal information revealed through precision medicine would make African Americans further vulnerable to provider racism and discrimination in and outside of health care.Conclusions: While these groups believed precision medicine might yield benefits for health outcomes, they are also skeptical about whether African Americans and Hispanics would actually benefit from precision medicine given current structural limitations and disparities in health care access and quality. Ethn Dis. 2020;30(Suppl 1):149-158; doi:10.18865/ed.30.S1.149
Abstract Introduction Guided by an intersectional approach, we assessed the association between social categories (individual and combined) on time to linkage to HIV care in Tennessee.
Methods Tennessee residents diagnosed with HIV from 2012-2016 were included in the analysis (n=3750). Linkage was defined by the first CD4 or HIV RNA test date after HIV diagnosis. We used Cox proportional hazards models to assess the association of time to linkage with individual-level variables. We modeled interactions between race, age, gender, and HIV acquisition risk factor (RF), to understand how these variables jointly influence linkage to care.
Results Age, race, and gender/RF weAima A. Ahonkhaire strong individual (p < 0.001 for each) and joint predictors of time to linkage to HIV care (p < 0.001 for interaction). Older individuals were more likely to link to care (aHR comparing 40 vs. 30 years, 1.20, 95%CI 1.11-1.29). Blacks were less likely to link to care than Whites (aHR= 0.73, 95% CI: 0.67-0.79). Men who have sex with men (MSM) (aHR = 1.18, 95%CI: 1.03-1.34) and heterosexually active females (females) (aHR = 1.32, 95%CI: 1.14-1.53) were more likely to link to care than heterosexually active males. The three-way interaction between age, race, and gender/RF showed that Black males overall and young, heterosexually active Black males in particular were least likely to establish care.
Conclusions Racial disparities persist in establishing HIV care in Tennessee, but data highlighting the combined influence of age, race, gender, and sexual orientation suggest that heterosexually active Black males should be an important focus of targeted interventions for linkage to HIV care.
The fourth edition of Community Organizing and Community Building for Health and Social Equity provides both classic and recent contributions to the field, with a special accent on how these approaches can contribute to health and social equity. The 23 chapters offer conceptual frameworks, skill- building and case studies in areas like coalition building, organizing by and with women of color, community assessment, and the power of the arts, the Internet, social media, and policy and media advocacy in such work. The use of participatory evaluation and strategies and tips on fundraising for community organizing also are presented, as are the ethical challenges that can arise in this work, and helpful tools for anticipating and addressing them. Also included are study questions for use in the classroom. Many of the book's contributors are leaders in their academic fields, from public health and social work, to community psychology and urban and regional planning, and to social and political science. One author was the 44th president of the United States, himself a former community organizer in Chicago, who reflects on his earlier vocation and its importance. Other contributors are inspiring community leaders whose work on-the-ground and in partnership with us "outsiders" highlights both the power of collaboration, and the cultural humility and other skills required to do it well. Throughout this book, and particularly in the case studies and examples shared, the role of context is critical, and never far from view. Included here most recently are the horrific and continuing toll of the COVID-19 pandemic, and a long overdue, yet still greatly circumscribed, "national reckoning with systemic racism," in the aftermath of the brutal police killing of yet another unarmed Black person, and then another and another, seemingly without end. In many chapters, the authors highlight different facets of the Black Lives Matter movement that took on new life across the country and the world in response to these atrocities. In other chapters, the existential threat of climate change and grave threats to democracy also are underscored. View the Table of Contents and introductory text for the supplementary instructor resources. (https://d3tto5i5w9ogdd.cloudfront.net/wp-content/uploads/2022/02/04143046/9781978832176_optimized_sampler.pdf) Supplementary instructor resources are available on request: https://www.rutgersuniversitypress.org/communityorganizing
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