Anthony G. Brown

Perceived sources of stress and resilience in men in an African American community.

Background: Little is known about the perceived causes of stress and what strategies African American men use to promote resiliency. Participatory research approaches are recommended as an approach to engage minority communities. A key goal of participatory research is to shift the locus of control to community partners.Objective: To understand perceived sources of stress and tools used to promote resiliency in African American men in South Los Angeles.Methods: Our study utilized a community-partnered participatory research approach to collect and analyze open-ended responses from 295 African American men recruited at a local, cultural festival in Los Angeles using thematic analysis and the Levels of Racism framework.Results: Almost all men (93.2%) reported stress. Of those reporting stress, 60.8% reported finances and money and 43.2% reported racism as a specific cause. More than 60% (63.4%) reported that they perceived available sources of help to deal with stress. Of those noting a specific source of help for stress (n = 76), 42.1% identified religious faith. Almost all of participants (92.1%) mentioned specific sources of resiliency such as religion and family.Conclusions: Stress owing to psychosocial factors such as finances and racism are common among African American men. But, at the same time, most men found support for resiliency to ameliorate stress in religion and family. Future work to engage African American men around alleviating stress and supporting resiliency should both take into account the perceived causes of stress and incorporate culturally appropriate sources of resiliency support.

Community Partners in Care: 6-Month Outcomes of Two Quality Improvement Depression Care Interventions in Male Participants

OBJECTIVE Limited data exist on approaches to improve depression services for men in under-resourced communities. This article explores this issue using a sub-analysis of male participants in Community Partners in Care (CPIC). DESIGN Community partnered, cluster, randomized trial. SETTING Hollywood-Metropolitan and South Los Angeles, California. PARTICIPANTS 423 adult male clients with modified depression (PHQ-8 score≥10). INTERVENTIONS Depression collaborative care implementation using community engagement and planning (CEP) across programs compared with the more-traditional individual program, technical assistance (Resources for Services, RS). MAIN OUTCOME MEASURES Depressive symptoms (PHQ-8 score), mental health-related quality of life (MHRQL), mental wellness, services utilization and settings. RESULTS At screening, levels of probable depression were moderate to high (17.5%-47.1%) among men across services sectors. Intervention effects on primary outcomes (PHQ-8 score and MHRQL) did not differ. Men in CEP compared with RS had improved mental wellness (OR 1.85, 95% CI 1.00-3.42) and reduced hospitalizations (OR .40, 95% CI .16-.98), with fewer mental health specialty medication visits (IRR 0.33, 95% CI .15-.69), and a trend toward greater faith-based depression visits (IRR 2.89, 95% CI .99-8.45). CONCLUSIONS Exploratory sub-analyses suggest that high rates of mainly minority men in under-resourced communities have high prevalence of depression. A multi-sector coalition approach may hold promise for improving community-prioritized outcomes, such as mental wellness and reduced hospitalizations for men, meriting further development of this approach for future research and program design.

A Community Partnered-Participatory Research Approach to Reduce Cancer Disparities in South Los Angeles

Background: Community–academic partnerships may offer opportunities to improve population health in communities that suffer from cancer-related health disparities.Objectives: This project describes a community partnered effort to promote cancer research and reduce local cancer-related disparities.Methods: We used a community-partnered participatory research (CPPR) model and modified Delphi method approach to bring together community and academic stakeholders from South Los Angeles around reducing cancer disparities.Results: The 36-member Community–Academic Council consisted of cancer survivors, academics, and representatives of local community-based organizations and churches. Forty-nine unique cancer-related community priorities were collaboratively used to develop shared products. Early CPPR products included convening of a community conference, a collaboratively developed survey instrument, and new partnerships resulting in externally funded projects.Conclusions: Our approach demonstrates the feasibility of the use of a replicable model of community and academic engagement that has resulted in products developed through collaborative efforts.