Predictors of Cancer Screening Among Culturally Diverse Men

Assessing organizational readiness for the Clean Cuts and Sharp Minds Collective: a barbershop health promotion network

BACKGROUND

Black men have among the lowest life expectancy in the United States. Alarmingly, these men are underrepresented in health promotion efforts. There are well-documented barriers to recruiting and retaining Black men in health promotion efforts, such as exclusionary research practices - many researchers may be hesitant to reach Black men in culturally unique spaces, such as barbershops. Despite these practices, qualitative research among Black men unanimously find that Black men are interested in health promotion efforts. The Clean Cuts and Sharp Minds Collective (CCSMC) was designed to bridge this gap. The objectives of the CCSMC are to train barbers to be lay advocates for their clients, train barbers to be research partners, and serve as a nexus between barbers interested in health promotion at their shops and researchers interested in implementing such efforts. The present study sought to assess the organizational readiness of barbershops in South Carolina (SC) to participate in the CCSMC.

METHODS

Barbers in SC were invited to complete a modified version of the Readiness Thinking Tool to assess organizational readiness to participate in the CCSMC.

RESULTS

Thirty-six (36; mean age = 41.12; 94.4% identified as Black; 91.7% identified as male) barbers completed the organizational readiness assessment. Results indicated that there was a high level of motivation, innovation-specific capacity, and general capacity within barbershops to participate in the CCSMC. Additionally, many barbers indicated that there would be widespread support to join the CCSMC.

CONCLUSIONS

The results from the present study highlight exciting opportunities and future directions for barbershop-academic partnerships. Such partnerships have the potential to promote health equity among, and in partnership with, Black men.

Understanding and Promoting Preventive Health Service Use Among Black Men: Community-Driven and Informed Insights

Black men experience high rates of adverse health that can be prevented or mitigated by the regular use of preventive health services. Efforts are urgently needed to promote this type of health service use among Black men. The U.S. Preventive Services Task Force and the Institute of Medicine indicate that such efforts must align with Black men's values, perspectives, and preferences. However, little guidance exists on how to align these efforts for Black men. The present qualitative study was developed to understand factors associated with preventive health service use among Black men and community-informed strategies to promote preventive health service use among these men. An approach rooted in community-based participatory research and ecological theory was used. A core leadership team consisting of five Black men from the area guided the project's development, implementation, and evaluation. The core leadership team conducted 22 interviews with Black men from their communities. Four themes emerged from these interviews: (1) holistic well-being challenges faced by Black men: interaction of mental, physical, and societal forces; (2) the interplay of financial, informational, and gendered barriers/facilitators to using preventative health services among Black men; (3) the importance of shared identity in peer health education about preventive health service use; and (4) the need for community-centered initiatives to improve preventive health service use among Black men that prioritize accessibility and information. Findings of the present study can be used to tailor preventive health service use efforts for Black men. Such efforts have the potential to promote health and mitigate health disparities.

Psychometric Properties and Analysis of the Masculinity Barriers to Medical Care Scale Among Black, Indigenous, and White Men

Non-Hispanic (NH) Black, American Indian/Alaska Native (Indigenous), and NH-White men have the highest colorectal cancer (CRC) mortality rates among all other racial/ethnic groups. Contributing factors are multifaceted, yet no studies have examined the psychometric properties of a comprehensive survey examining potential masculinity barriers to CRC screening behaviors among these populations. This study assessed the psychometric properties of our Masculinity Barriers to Medical Care (MBMC) Scale among NH-Black, Indigenous, and NH-White men who completed our web-based MBMC, Psychosocial Factors, and CRC Screening Uptake & Intention Survey. We conducted exploratory factor analysis on a sample of 254 men and multivariate analysis of variance (MANOVA) on a separate sample of 637 men nationally representative by age and state of residence. After psychometric assessment, the MBMC scale was reduced from 24 to 18 items and from six to four subscales. NH-Black men’s mean scores were lowest on three of four subscales (Being Strong, Negative and Positive Attitudes) and highest on the Acknowledging Emotions subscale. Compared with both Indigenous and NH-White men, NH-Black men had significantly lower Negative Attitudes subscale scores and significantly higher scores on the Acknowledging Emotions subscale. Compared with both Indigenous and NH-Black men, NH-White men had significantly higher Being Strong and Positive Attitudes subscales scores. This study expands on previous research indicating that, among racialized populations of men, endorsement of traditional masculine ideologies influences engagement in preventive health behaviors. Our scale can be tailored to assess attitudes to screening for other cancers and diseases that disproportionately burden medically underserved populations.

Knowledge, beliefs, and practices related to cancer screening and prevention in Lebanon: community and social media users' perspectives

OBJECTIVE

Common to many countries in the Middle East, Lebanon has an increasing cancer burden; however, national screening programs are limited to breast cancer. The literature on cancer screening practices and beliefs is scarce. This cross-sectional study investigates the knowledge, beliefs, and practices related to the prevention and screening for breast, cervical, colon, lung, and skin cancers among Lebanese residents, recruited through social media advertisements and community outreach activities.

METHODS

Participants filled an anonymous questionnaire either via a web-based interface or using tablets distributed at primary health clinics. The characteristics of the two cohorts were compared with chi-square and t-tests. We performed descriptive analysis, followed by multivariate logistic regression for predictors of cancer screening.

RESULTS

A total of 407 participants completed the survey online, and 262 filled the study in tablets available at primary care clinics. The two samples were significantly different in terms of age, education, and perceived socioeconomic status. Online participants demonstrated higher knowledge and higher participation in screening practices than their counterparts recruited through community outreach. Mammography (44.7% online and 39.9% in-person), and cervical cancer screening (44.5% online and 36.7% community) had the highest participation rates. In both samples, participants who were older and more educated were more likely to report engagement with cancer screening practices.

CONCLUSIONS

Our study revealed significant knowledge gaps in cancer prevention and screening. Different sampling techniques accessed diverse populations, highlighting the need for educational messages and targeted screening programs to be inclusive of socio-economically disadvantaged communities with low education and health literacy.

Cancer diagnoses among lesbian, gay, and bisexual adults: results from the 2013-2016 National Health Interview Survey

PURPOSE

The objective of this study was to compare cancer diagnoses by age, gender, and sexual orientation.

METHODS

This study used data on 129,431 heterosexual adults and 3,357 lesbian, gay, and bisexual (LGB) adults in the 2013-2016 National Health Interview Survey. Logistic regression models compared the prevalence of cancer diagnoses by sexual orientation while controlling for demographics, socioeconomic status, and health profiles. Then, using coefficients from fully adjusted models, we estimated average marginal effects to compare the probability of a cancer diagnosis by sexual orientation across five age categories.

RESULTS

After controlling for demographic and socioeconomic characteristics, gay men (odds ratio [OR] 1.54; 95% confidence interval [CI] 1.10-2.18) were more likely to have been diagnosed with cancer compared to heterosexual men, and bisexual women (OR 1.70; 95% CI 1.16-2.48) were more likely to have been diagnosed with cancer compared to heterosexual women. Gay men aged 65 years and older were 6.0% points (p < 0.05) more likely to be diagnosed with cancer compared to heterosexual men of the same age. Bisexual women aged 65 years and older were 7.6% points (p < 0.05) more likely to be diagnosed with cancer compared to women of the same age.

CONCLUSIONS

Some sexual minorities may be at greater risk for cancer (or having a personal history of cancer) compared to heterosexuals. More research on cancer detection, treatment, and survivorship in sexual minorities is critically needed. Health care providers and public health practitioners should be aware of the unique health care needs in LGB adults, including their elevated cancer risks.