Department of Biology, North Carolina A&T State University, College of Arts & Sciences, A411 General Classroom Bldg, 1601 E Market St, Greensboro, NC 27411, USA.
J Natl Med Assoc. 2011 Jun;103(6):480-7. doi: 10.1016/s0027-9684(15)30361-8.
The health and well-being of all individuals, independent of race, ethnicity, or gender, is a significant public health concern. Despite many improvements in the status of minority health, African American males continue to have the highest age-adjusted mortality rate of any race-sex group in the United States. Such disparities are accounted for by deaths from a number of diseases such as diabetes, human immunodeficiency virus (HIV), cancer, and cardiovascular disease, as well as by many historical and present social and cultural constructs that present as obstacles to better health outcomes. Distrust of the medical community, inadequate education, low socioeconomic status, social deprivation, and underutilized primary health care services all contribute to disproportionate health and health care outcomes among African Americans compared to their Caucasian counterparts. Results of clinical research on diseases that disproportionately affect African American males are often limited in their reliability due to common sampling errors existing in the majority of biomedical research studies and clinical trials. There are many reasons for underrepresentation of African American males in clinical trials, including their common recollection and interpretation of relevant historical of biomedical events where minorities were abused or exposed to racial discrimination or racist provocation. In addition, African American males continue to be less educated and more disenfranchised from the majority in society than Caucasian males and females and their African American female counterparts. As such, understanding their perceptions, even in early developmental years, about health and obstacles to involvement in research is important. In an effort to understand perspectives about their level of participation, motivation for participation, impact of education, and engagement in research, this study was designed to explore factors that impact their willingness to participate. Our research suggests that: (1) African American males across all ages are willing to participate in several types of research studies, even those that require human samples; (2) their level of participation is significantly influenced by education level; and (3) their decision to participate in research studies is motivated by civic duty, monetary compensation, and whether they or a relative has had the disease of interest. However, African American males, across all age groups, continue to report a lack of trust as a primary reason for their unwillingness to participate in biomedical research. There is an ongoing need to continue to seek advice, improve communication, and design research studies that garner trust and improve participation among African American males as a targeted underrepresented population. Such communication and dialogues should occur at all age levels of research development to assess. current attitudes and behaviors of African American males around participation.
所有人的健康和福祉,无论其种族、民族或性别如何,都是一个重大的公共卫生关注点。尽管少数族裔健康的状况已经有了许多改善,但非裔美国男性的年龄调整死亡率仍然是美国所有种族-性别群体中最高的。这种差异归因于多种疾病的死亡,如糖尿病、人类免疫缺陷病毒(HIV)、癌症和心血管疾病,以及许多历史和当前的社会和文化结构,这些结构对更好的健康结果构成了障碍。对医疗保健机构的不信任、教育程度低、社会经济地位低、社会剥夺以及初级医疗保健服务的利用不足,这些都导致非裔美国人的健康和医疗保健结果与白种人相比存在不成比例的情况。由于大多数生物医学研究和临床试验中存在常见的抽样错误,因此对严重影响非裔美国男性的疾病的临床研究结果的可靠性往往受到限制。非裔美国男性在临床试验中代表性不足的原因有很多,包括他们对少数群体受到虐待或遭受种族歧视或种族挑衅的相关生物医学事件的常见回忆和解释。此外,非裔美国男性在受教育程度和社会中的代表性方面仍然低于白种人男性和女性以及他们的非裔美国女性同龄人。因此,了解他们在健康方面的看法,甚至在早期发展阶段,以及他们参与研究的障碍是很重要的。为了了解他们对参与程度、参与动机、教育影响以及参与研究的看法,本研究旨在探讨影响他们参与意愿的因素。我们的研究表明:(1)各个年龄段的非裔美国男性都愿意参与多种类型的研究,甚至是那些需要人类样本的研究;(2)他们的参与程度受到教育水平的显著影响;(3)他们参与研究的决定是出于公民义务、金钱补偿以及他们自己或亲属是否患有感兴趣的疾病。然而,所有年龄段的非裔美国男性都继续报告缺乏信任是他们不愿意参与生物医学研究的主要原因。我们需要继续寻求建议、改善沟通,并设计能够赢得非裔美国男性信任并提高他们参与度的研究,因为他们是非裔美国男性中代表性不足的群体。这种沟通和对话应该在研究发展的所有年龄阶段进行,以评估非裔美国男性在参与方面的当前态度和行为。