Ravenell Joseph E, Whitaker Eric E, Johnson Waldo E
Hypertension Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, USA.
J Natl Med Assoc. 2008 Oct;100(10):1153-60. doi: 10.1016/s0027-9684(15)31479-6.
We sought to elicit barriers to health and primary healthcare use among African-American men residing in a low-income, urban area.
We conducted a qualitative study of African-American men using focused group interviews. A purposive sampling technique was used to recruit 8 select subgroups: adolescents (age 16-18), trauma survivors, HIV-positive men, homeless men, men who have sex with men (MSM), substance abusers, church affiliated men and a mixed sample (N=71). Focus groups were moderated by trained, African-American male focus group leaders.
Qualitative analysis of focused group transcripts yielded 2 major categories-intrinsic barriers and extrinsic barriers. Within the intrinsic barriers category, 5 subcategories emerged: lack of health awareness, fear, healthcare as needed, medical mistrust and fatalism. Extrinsic barriers included cost/benefit, clinic experience, and cultural and linguistic differences. Participants also offered solutions to address key barriers.
African-American men identified key intrinsic and extrinsic barriers to health and primary healthcare, including lack of health awareness and providers' cultural and linguistic differences. These barriers constitute important areas of future research and intervention to address African-American men's health and willingness to seek healthcare.
我们试图找出居住在低收入城市地区的非裔美国男性在健康及使用初级医疗保健方面面临的障碍。
我们采用焦点小组访谈对非裔美国男性进行了一项定性研究。运用目的抽样技术招募了8个特定亚组：青少年（16 - 18岁）、创伤幸存者、艾滋病毒阳性男性、无家可归男性、男男性行为者（MSM）、药物滥用者、与教会有关联的男性以及一个混合样本（N = 71）。焦点小组由训练有素的非裔美国男性焦点小组组长主持。
对焦点小组访谈记录的定性分析产生了2个主要类别——内在障碍和外在障碍。在内在障碍类别中，出现了5个子类别：缺乏健康意识、恐惧、按需就医、对医疗的不信任和宿命论。外在障碍包括成本/效益、诊所体验以及文化和语言差异。参与者还提出了解决关键障碍的办法。
非裔美国男性确定了健康及初级医疗保健方面关键的内在和外在障碍，包括缺乏健康意识以及医疗服务提供者的文化和语言差异。这些障碍构成了未来研究和干预的重要领域，以解决非裔美国男性的健康问题及其寻求医疗保健的意愿。
