Increasing men's access to health services: A case management intervention at workforce development programs in Upper Manhattan

Widespread racial/ethnic and gender-based disparities in health behaviors and outcomes place men of color at a notable disadvantage relative to other groups. Men of color are less likely to have health insurance and to use health services (especially for preventive care), and experience higher rates of chronic diseases compared to white men or women of color. Societal pressure to endorse traditional ideas and behavioral prescriptions about masculinity (e.g. “real mean ‘tough it out'; women go to doctors”) compounds these structural barriers and further deters men from seeking health information and health services. This paper describes the design, implementation, and evaluation of a case management health promotion intervention with males ages 18-55. The intervention was designed to increase men's use of health and dental services by “outposting” a social worker from a men's health clinic to two workforce development agencies in Upper Manhattan. The social worker conducted individualized health assessments, gave referrals, and communicated positive messages about masculinity and health behaviors (e.g. “men can take care of business by going to the doctor”). A “community health navigator” tracked referrals and provided follow-up support. This quasi-experimental study employed an intervention-control group design. Self-administered pretest questionnaires were completed before participants were exposed to the program, and telephone posttest interviews occurred six months later. This research examines the effectiveness and feasibility of partnering with workforce development programs to provide case management services to connect men to health services. Study findings will help guide the development of future health interventions aimed at this population.