Ledric D. Sherman

A Brotherhood Perspective: How African American Male Relationships May Improve Trust and Utilization of Health Care

The objective of this research was to explore interview data to understand and characterize the nature of brotherhood in a sample of African American men at two historically Black colleges and universities. The authors used thematic analysis on semistructured interview data, collected by an ethnically diverse research team. Recruitment and interviews were conducted at two historically Black colleges and universities in Texas. Twenty African American men, 18 to 35 years old, were randomly selected from 62 recruited participants. Five categories framed brotherhood and health care utilization: (a) trust lessens individual barriers to action, (b) identity unites men through a process of authentication, (c) generations lead by example, (d) approaching life as a shared learning experience, and (e) social pressure and ridicule uphold collective action. Findings suggest that participants trust a group view, identify with the collective, and respond to social pressure to conform; therefore, brotherhood acts as a support mechanism, and its validation influences individual-level engagement and nonengagement.

Understanding the essence and lived experience of self-care management among African-American men living with type 2 diabetes

Purpose: To explore, understand and describe the lived experience of African-American men (AA men) living with type 2 diabetes, with emphasis on capturing perceptions of challenges, facilitators and perceived barriers associated with self-care management. Materials and Methods: Participants (n = 19) were AA men ages 35-69 years, who were diagnosed with type 2 diabetes. Participants were recruited via community outreach efforts, including barbershops and churches located in predominantly African-American communities in southeast US. Upon consent, individual interviews were conducted, audio-recorded and subsequently transcribed. Transcripts were analyzed using a phenomenological approach, and focused on identifying common themes among the descriptions of AA men′s experiences specific to type 2 diabetes. Results: AA men perceived their experience of managing type 2 diabetes as tedious, complicated, demanding, and frustrating. Common themes included the perception of family histories and personal behaviors as causes or contributors to the development of diabetes, albeit there was lack of clarity regarding biological versus behavioral familial contributions. Other theses included fears related to long-term complications of type 2 diabetes, and the critical role of social support as a factor assisting with self-care management. Limb amputation, insulin injections and vision changes were fears related to having type 2 diabetes. Commensurately, important referent others (e.g., family and close friends) provided critical encouragement and support toward managing their diabetes. Conclusions: Future diabetes research and education should give attention to how masculinity may have a powerful influence on diabetes management behavior among African-American men′s as well as utilizing preventive health services.

An Analysis of the Recruitment and Participation of African American Men in Type 2 Diabetes Self-Management Research: A Review of the Published Literature

Research studies have shown that African American men have experienced higher rates of serious complications of type 2 diabetes, due in part to poor disease management. Although type 2 diabetes research among minority populations is consistently advancing, there still remains a scarcity of African American male representation within these studies. It is unclear if this scarcity stems from lack of interest among men, location of recruitment, or ways in which these men are motivated to participate in research studies. As a result, an analysis of recruitment methods and locations of literature that includes African American men with type 2 diabetes is needed. The purpose of this review of the literature is threefold: (a) determine the number of published empirical studies specific to type 2 diabetes self-management that included African Americans in the sample, (b) to evaluate the percentage of men that were represented in the study sample as compared to how many women, and (c) identify the method of recruitment of each study.

A Qualitative Inquiry of Lower Extremity Disease Knowledge Among African Americans Living With Type 2 Diabetes

The purpose of this study was to investigate how personal illness representations of type 2 diabetes affected the level of foot care knowledge and self-care strategies among African Americans adults. Thirteen African Americans (ages 32-72 years) participated in individual semistructured qualitative interviews regarding self-care practices and lower extremity disease knowledge related to type 2 diabetes. Using phenomenological methodology, all interviews were transcribed and analyzed by the research team for themes. Three major themes emerged from the interviews: basic foot care knowledge, lower extremity disease knowledge, and patient–provider communication. The study yielded that the majority of the participants lacked understanding of basic diabetic foot care as well as how lower extremity complications can evolve from uncontrolled type 2 diabetes. Diabetes self-management education is an essential component that could aid in the improvement of poor health outcomes of African Americans. Diabetes self-management education programs should consider implementing more detailed foot care educational tools, especially those individuals who are affected with complications due to the disease and that can lead to lower extremity amputations. This study provided insight on the importance of this knowledge as it relates to making common sense assumptions about the disease and self-management strategies.

Experiences Among African American Community Members With Pharmacy-Based Immunization Services in Detroit, Michigan

Background: Although vaccination rates improved modestly in the United States during the 2014-2015 season, racial and ethnic disparities in the use of vaccines persist. Pharmacy-based immunization programs expand access to immunization services; however, African Americans in one metropolitan community did not have the same level of access to this service as non-Hispanic whites. Objective: To examine the experiences of African Americans with pharmacy-based services and identify how pharmacies and pharmacy organizations can better service patients in urban communities with similar dynamics. Methods: This qualitative study utilized focus group discussions among African American residents in Detroit, Michigan, where there are reported disparities in access to pharmacists that immunize to learn more about their experiences with pharmacy-based immunization services. Results: Three major themes emerged: the pharmacy location is often more convenient and accessible than doctors’ offices, there is clear communication with the pharmacist, and perceived lower immunization fees at pharmacies. Participants found pharmacies easier to access in their community for immunization services. Consistent interaction with familiar pharmacists and pharmacy staff members facilitated strong relationships and dialogue between pharmacists and patients. Patients perceived costs for vaccines to be less at the pharmacy than at their physicians’ offices. Conclusions: Participants reported positive experiences with pharmacy-based immunization services and expansion of these services may influence more African Americans to receive recommended vaccines in this community.

Too Important to Ignore: Leveraging Digital Technology to Improve Chronic Illness Management Among Black Men.

Health disparities associated with chronic illness experiences of black men demonstrate widespread, systematic failures to meet an urgent need. Well-established social and behavioral determinants that have led to health disparities among black men include racism, discrimination, and stress. While advocacy work that includes community-engagement and tailoring health promotion strategies have shown local impact, evidence shows the gaps are increasing. We suspect that failure to reduce current disparities may be due to conventional public health interventions and programs; therefore, we submit that innovative interventions, ones that embrace digital technologies and their ability to harness naturally occurring social networks within groups, like black men, have particular importance and deserve attention. This commentary characterizes the current literature on chronic illness among black men as well as health interventions that use digital technology, to build a case for expanding research in this area to reduce the overwhelming burden of chronic illness among black men.

National college health assessment sampling: Organizational barriers preventing black participation and organizational solutions for appropriate representation

Abstract Objective: This investigation longitudinally examined the participation of Black college students in the American College Health Association?s National College Health Assessment (ACHA-NCHA). Participants: All respondents to ACHA-NCHA from the years 2008, 2011, & 2014 were included in the analysis. Methods: This study compared the descriptive demographic student characteristics from the 2008, 2011, & 2014 ACHA-NCHA data to the National Center for Education Statistics (NCES) college enrollment for the corresponding years. Results: Despite constituting 14.5% of the total enrollment in 4-year universities and colleges from 2005 to 2013, Black students represented about 7% of the ACHA-NCHA respondents. Conclusion: Having a sample lacking valid representation of minorities can further lead to biased and flawed assumptions. Therefore, organizations such as ACHA should make concerted efforts to gather data that is reflective of national enrollment rates.

Perspectives of Fear as a Barrier to Self-Management in Non-Hispanic Black Men With Type 2 Diabetes:

Background. Self-managing type 2 diabetes (T2D) is critical but often challenging for non-Hispanic Black (NHB) men. Fears may contribute to poor self-management; however, the evidence is sparse. The purpose of this study is to examine the relationship between fear and diabetes self-management in NHB men from the southern United States. Methods. Nineteen NHB men with T2D were recruited from barbershops and churches. Interviews were conducted using a semistructured interview guide. Transcripts were analyzed using a phenomenological approach and focused on identifying common themes describing the perceptions of fear as a barrier to self-managing T2D in the study participants. Results. More than 68% of the sample was >55 years of age, where 42% reported an annual income of ≥

The More I Do, the Better I'll Be: The Treatment Preferences of Type 2 Diabetes Among African American Men.

100,000, 74% were married, and 26% had a college degree. Fifty-three percent expressed fear with diabetes management, while 47% reported no fears with diabetes management. Direct fears associated with self-management included the use of needles and syringes for self-monitoring and medication adherence, respectively. Indirect fears were associated with the development of adverse complications resulting in poor mental and physical quality of life. No fears were reported secondary to diabetes knowledge, perceived control, and social support. Conclusions. In this sample of NHB men, fear was perceived by many as a direct barrier to self-management and an indirect barrier to optimal quality of life. These findings suggest the need to address the fears of NHB men when guiding treatment and developing research interventions to improve self-management skills.

“If I Can Afford Steak, Why Worry About Buying Beans”: African American Men’s Perceptions of Their Food Environment:

To gain better insight to the preferred methods of managing and treating type 2 diabetes among African American men (AA men). Participants (n = 19) were AA men aged 35 to 69 years, who were diagnosed with type 2 diabetes. Participants were recruited via community outreach efforts, including barbershops and churches located in predominantly African American communities in Southeast United States. On consent, individual interviews were conducted, audio recorded, and subsequently transcribed. Transcripts were analyzed using a phenomenological approach, and focused on identifying common themes among the descriptions of AA men’s experiences specific to type 2 diabetes. Participants’ statements indicated three main commonalities regarding treatment preferences which were medication, dietary changes, and increase in exercise. Some participants from the study stated that they preferred taking oral medication primarily out of convenience, lack of pain, and how well the medicine makes them feel. Others stated educating themselves and having a consistent relationship with the diabetes physician has assisted them the most. Other participants shared preferences of being dedicated to proper diet and exercise without any medication (pill or injection), as well as maintaining the mental motivation needed to sustain management. Some participants preferred to not take an oral pill, while some did not mind taking pills at all. For some of the participants, it appears that it is easier for them to manage their diabetes by prescription medication than by lifestyle changes such as diet and exercise. Future studies are needed to investigate how social support system also assists these men in managing their diabetes.