Powell Wizdom, Adams Leslie B, Cole-Lewis Yasmin, Agyemang Amma, Upton Rachel D
a University of North Carolina at Chapel Hill.
b University of Michigan-Ann Arbor.
Behav Med. 2016 Jul-Sep;42(3):150-63. doi: 10.1080/08964289.2016.1165174.
Men's tendency to delay health help-seeking is largely attributed to masculinity, but findings scarcely focus on African American men who face additional race-related, help-seeking barriers. Building principally on reactance theory, we test a hypothesized model situating racial discrimination, masculinity norms salience (MNS), everyday racism (ERD), racial identity, sense of control (SOC), and depressive symptomatology as key barriers to African American men's health help-seeking. A total of 458 African American men were recruited primarily from US barbershops in the Western and Southern regions. The primary outcome was Barriers to Help-Seeking Scale (BHSS) scores. The hypothesized model was investigated with confirmatory factor and path analysis with tests for measurement invariance. Our model fit was excellent [Formula: see text] CFI = 0.99; TLI = 1.00; RMSEA = 0.00, and 90% CI [0.00, 0.07] and operated equivalently across different age, income, and education strata. Frequent ERD and higher MNS contributed to higher BHHS scores. The relationship between ERD exposure and BHHS scores was partially mediated by diminished SOC and greater depressive symptomatology. Interventions aimed at addressing African American men's health help-seeking should not only address masculinity norms but also threats to sense of control, and negative psychological sequelae induced by everyday racism.
男性延迟寻求医疗帮助的倾向很大程度上归因于男子气概，但研究结果很少关注面临与种族相关的额外寻求帮助障碍的非裔美国男性。主要基于反抗理论，我们测试了一个假设模型，该模型将种族歧视、男子气概规范显著性（MNS）、日常种族主义（ERD）、种族认同、控制感（SOC）和抑郁症状作为非裔美国男性寻求医疗帮助的关键障碍。总共458名非裔美国男性主要从美国西部和南部地区的理发店招募。主要结果是寻求帮助障碍量表（BHSS）得分。使用验证性因子分析和路径分析以及测量不变性检验对假设模型进行了研究。我们的模型拟合非常出色[公式：见正文]CFI = 0.99；TLI = 1.00；RMSEA = 0.00，90%置信区间[0.00, 0.07]，并且在不同年龄、收入和教育阶层中具有等效的操作性。频繁的ERD和较高的MNS导致较高的BHHS得分。ERD暴露与BHHS得分之间的关系部分由SOC降低和抑郁症状加重介导。旨在解决非裔美国男性寻求医疗帮助问题的干预措施不仅应解决男子气概规范问题，还应解决对控制感的威胁以及日常种族主义引发的负面心理后遗症。
