Background: The MOCHA Moving Forward study aims to discover how to reduce chronic disease health disparities among older (ages 35-70) low-income, African-American men.

Methodology: We conducted life history (n=15) and semi-structured interviews (n=42) with African-American men between 35-70 years old living in a mid-size, low-income city in Massachusetts. That data informed the development of a story-based stress reduction intervention--Stories Matter. Interviews were analyzed by a team of researchers, individually and then collectively, which ensured that multiple perspectives were applied to all qualitative data.

Results: Analysis of interviews revealed patterns of relationship breakdown within the community related to structural vulnerability, including housing insecurity and lack of employment opportunities; histories of migration and isolation; and social norms around masculinity, violence, and survival. Participants noted issues with trust, betrayal, minding one’s own business to stay alive, and codes of conduct that result in isolation and lack of intimacy. However, patterns of resilience also emerged in the data, including: learning about vulnerability and finding connection through relationships with children and chosen family, and maintaining friendships in difficult circumstances. A common theme throughout was that social connection increased participants’ sense of health and well-being, and, conversely, that a sense of isolation was associated with a diminished sense of health.

Conclusion: The Stories Matter intervention is based on a stress reduction model that links increased social connection with decreased stress and improved health. The program includes activities designed to increase participant social connection by sharing, listening to, and supporting each other in discussing personal experiences.

Background: African American men and the ways that they see themselves are diverse, but few studies have explored ways to capture this heterogeneity or consider what it means for middle-aged and older African American men’s health.

Methodology: Using data from a criterion sample of 300 African American men 35-73 years old (M = 46.53), we used stepwise regression and correlation matrices to explore the demographic characteristics and aspects of African American Manhood that have the strongest relationship with self-rated health.

Results: We used stepwise regression and found that younger age, earning a college degree or higher, lower ideals associated with being a gentleman, lower perceived challenges with managing family responsibilities and health, and higher religiosity and spirituality each were significant predictors of good or excellent self-rated health. The most powerful of these predictors was religiosity and spirituality, and no aspect of racial identity was significantly predictive of good or excellent self-rated health. Traditional masculinity was strongly positively correlated with ideals associated with being a gentleman, and there was a strong positive correlation between having higher ideals associated with being a gentleman and a higher racial identity that is characterized by a strong sense of connectedness to African Americans and African American culture and where being African American is highly salient to their identity.

Conclusions: Earning a college degree or higher and religiosity and spirituality were most predictive of good or excellent self-rated health. We discuss the implications of these findings for how we seek to improve African American men’s health.

Context: The barbershop model has been proposed to conduct health screenings, health interventions, and research for African American (AA) men, who disproportionately suffer from health disparities. Previous research has assessed sociodemographic characteristics and attitudes towards receiving physical and mental health education and screenings in barbershops and other settings, as well as evaluated the perceived ability to influence the decision-making of AA men by age group. However, little research has been conducted on the feasibility of implementing mental health interventions and screenings within a barbershop. Method: African American Male participants (aged 18+) were recruited between, November ’16 and June ’17, to participate in an exploratory mixed methods study to assess the feasibility to include mental health interventions in a barbershop framework. Individuals were recruited using a purposive sampling method to identify barbers, barbershop clients, and health specialists. Participants completed a demographic questionnaire, a one-page self-administered survey, and a 1-hour semi-structured interview at a public health clinic in Chicago, IL. Participants were compensated with a $20 gift card.

Results: Participants’ demographic information were collected. Qualitative information gathered included themes pertaining to mental health topics that would be feasible in a barbershop setting such as: resilience, belonging, substance abuse, and family concerns. Further themes that were identified included the following: obstacles, opportunities, and feasibility of addressing mental health in a barbershop setting. Conclusion: This study found that the barbershop model may not be the best to address severe pathology but could be best used for psychoeducation and referrals to mental health clinics.

Background: Black men have excessive cardiovascular disease (CVD) burden. However, there is a lack of research among Black emerging adult men (BEAM) to examine factors that put them at risk for CVD. The purpose of this convergent mixed methods study was to enhance our understanding of multi-level factors associated with CVD risk factors among BEAM.

Methodology: A convenience sample of Black men completed a 10-minute electronic survey (e.g., demographics) and participated in focus groups (N = 21 men; 3 groups). Men aged 18-30 were recruited as this is when CVD risk behaviors peak and habits are established. Verbatim transcripts were analyzed in NVivo using a combined deductive and inductive approach. Survey data were analyzed in SPSS using descriptive statistics.

Results: Five themes emerged: 1) emergence and navigation of Black manhood stressors; 2) high expectations despite limited available resources; 3) heart disease socialization: explicit and vicarious experiences; 4) managing healthcare needs against fear, avoidance and toughing it out; and 5) camaraderie and social support can motivate or deter health practices. These findings along with sub-themes and quantitative results illuminate modifiable targets for future intervention work.

Conclusions: This study was a first step in exploring social and structural factors that influence CVD risk factors among BEAM. The results highlight the need for future research, as well as the need for CVD risk reduction interventions geared to promote CVD protective health behaviors among BEAM. The data can inform gender specific, culturally situated interventions for a population whose survival is threatened by CVD.

Educating patients remains a challenge for even the most skilled educator or practitioner. In healthcare literature, African American (AA) patients typically express a stated preference for racial and gender concordance with providers, and investigators have quantified the impact of near-peer educators, typically examining face-to-face interactions. Marketing, education and political science researchers have investigated the effect of attractive messengers on perception and message retention. This research hypothesized that an attractive near-peer female messenger would increase the retention of healthcare information.

A randomized control trial was conducted with AA men (n=103) in an artefactual field experiment with participants completing a diabetes knowledge pretest prior to random assignment to a control condition, where participants read a diabetes discharge sheet or one of six treatment conditions consisting of a short video (less than 5 minutes). Treatment conditions featured either an African American male or female in their mid-thirties who presented as a physician, nurse or near-peer. Participants used their own smartphones or a 7” tablet to complete the study. Differences between pre and post-test scores were calculated for each condition with the strongest effect coming from the female physician condition (R2=0.01, F(1,95)=2.86, p=0.09, β = 1.9).

This research questions the efficacy of near-peer educators and value of gender concordance, as well as the current emphasis and value placed on printed materials to provide medical information as the ubiquity of handheld media devices has changed in recent years. Future research will evaluate the messenger's ability to impact behavior change.