Toward healthcare disparities elimination: An intervention to increase preventive service utilization among insured African American men

Background: Numerous studies have found that racial and ethnic minorities are less likely to receive preventive services compared to Whites. This is especially true for non-White men even after controlling for insurance status and other economic access factors. In order to address disparities in preventive care among an insured group of African American men, a health plan and a health system in the Midwest partnered to implement a preventive screening program for this group. Focus groups were held and the findings were used to design the intervention. Methods: A total of 8,423 individuals were identified as African American men between the ages of 18 and 64 living within 30 miles of the intervention site who were patients previously seen in the health system and members of the health plan. Invitations to attend the free, culturally-tailored event were mailed to all identified men. Available assessments included blood pressure, BMI, cholesterol, glomerular filtration rate (GFR), and fasting blood glucose. Prior to leaving the event, each participant was scheduled for a follow-up visit with their primary care physician (PCP) for chronic disease management and to discuss any additional screenings needed for prostate or colon cancer. Finally a presentation about African American men's health and consultation with a dietician and a case manager were available. Everyone received a $25 gift card for attending the event with the opportunity to receive a second $25 gift card after completing their follow-up appointment. Results: Registration was limited to 300 men and 201 attended. Participants rated their overall satisfaction 4.8 out of 5, on average. Ninety-four percent (94%) reported that they preferred this type of “one stop shop” to receive their annual screenings, and 100% reported that they would participate again and that they would share this information with other men. Of the men due for screening, 15.7% had abnormal glucose, 25.7% had an abnormal GFR, and 27.8% had an abnormal cholesterol reading. Additionally, 33.2% were overweight and 55.4% obese. Twenty-eight percent (28.3%) had a blood pressure classified as stage 1 hypertension or greater according to the Joint National Committee guidelines. Conclusions: Participants were very satisfied with this intervention and reported interest in future attendance. A number of men had abnormal assessments that will be addressed by their PCP during the follow-up visit. Similar efforts that successfully engage African American men could inform local policy and serve as a systematic approach to eliminate healthcare disparities.