Psychosocial determinants of routine health visit scheduling among community-residing African American men

African American men's disproportionate morbidity and mortality from preventable conditions is alarming. While numerous upstream strategies have been proposed to reduce African American male health disparities, efforts focused more downstream might also have a positive impact on the health status of this group. For instance, scheduling an annual routine health visit may increase the likelihood of early disease detection among African American men. Men's general tendency to underutilize health services has been well-documented and efforts to identify psychosocial correlates of men's healthcare utilization have recently intensified. For example, researchers have suggested that male role assumptions exert an influence over men's use of health services by establishing a specific set of valued norms and responses to health concerns (Courtenay, 2000; Tudiver & Talbot, 1998; Williams, 2003). The notion that men do not tell, cry, or complain is a socially reinforced precept governing the help-seeking behavior of men. However, the role of these factors in motivating African American men to use routine health services has rarely been explored. The current study employed the Aday-Andersen Model of Health Services Use and The Theory of Reasoned Action to investigate the relative contribution of predisposing, enabling, need for care, and normative/attitudinal factors to African American men's routine visit scheduling. Two hundred and sixteen community-residing African American men aged 18-78 were recruited from barbershops and educational institutions/events in the Northeast, Midwest, and Southeast regions of the United States in 2003 and 2004. The response rates were 90% (barbershops) and 65% (educational institutions/events). Participants completed measures assessing demographic factors, physical/mental health status, masculinity, exposure to male norms, health value, and medical mistrust. The main outcome measure was a self-reported scheduled routine health visit in the past year. Multiple logistic regression analyses were conducted to assess the contribution of the study factors. Consistent with previous studies, results indicate that the odds of routine health visit scheduling were reduced for men with more medical mistrust and increased for men who were married, had healthcare access, exposure to positive male role norms, and higher SES. Contrary to previous findings, this study found that poorer mental health status reduced the odds of healthcare services use among African American men. Implications for multi-level preventive health interventions with African American men are discussed.