Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Johns Hopkins Dr, Camperdown, Sydney, NSW 2050, Australia.
Health Promot Int. 2024 Apr 1;39(2). doi: 10.1093/heapro/daae024.
Delayed engagement with health services is a key contributor to poorer health outcomes experienced by men. Patterns of health service usage which reduce the opportunity for disease prevention and health promotion appear to be especially prominent amongst young men. To identify the multiple and intersecting determinants of young men's help-seeking practices and health services usage, this review uses the social ecological model (SEM) to guide a critical synthesis of the literature on barriers and facilitators experienced by young men in accessing health services. A systematic review was conducted across five databases (MEDLINE, Embase, PsychINFO, CINAHL and Scopus). Included studies presented primary data regarding young men's (12-24 years) barriers and/or facilitators to seeking and accessing health care. Thirty-one studies (24 qualitative and 7 quantitative) underwent data extraction, quality appraisal and thematic analysis under the guiding framework of the SEM. Seven key themes were constructed, encapsulating the perceived barriers and facilitators to help-seeking and accessing health care experienced by young men, including masculine attitudes, health literacy, social pressure, service accessibility, economic factors, service characteristics and cultural attitudes. These findings highlight the complex interplay between the individual, interpersonal, organizational and societal factors impacting young men's healthcare engagement. They also illuminate avenues for multifaceted, context-specific interventions to enhance healthcare accessibility for this group, including addressing health literacy gaps, providing culturally sensitive care and reducing cost barriers.
延迟使用医疗服务是导致男性健康状况较差的一个主要因素。在年轻男性中，似乎有一种减少疾病预防和促进健康机会的卫生服务使用模式。为了确定年轻男性寻求帮助的实践和卫生服务使用的多种和相互交织的决定因素，本综述使用社会生态学模型 (SEM) 来指导对年轻男性获得卫生服务的障碍和促进因素的文献进行批判性综合分析。我们在五个数据库（MEDLINE、Embase、PsychINFO、CINAHL 和 Scopus）中进行了系统综述。纳入的研究提供了有关年轻男性（12-24 岁）在寻求和获得医疗保健方面的障碍和/或促进因素的主要数据。根据 SEM 的指导框架，对 31 项研究（24 项定性研究和 7 项定量研究）进行了数据提取、质量评估和主题分析。构建了七个关键主题，包括年轻男性寻求和获得医疗保健时的感知障碍和促进因素，包括男性态度、健康素养、社会压力、服务可及性、经济因素、服务特征和文化态度。这些发现强调了影响年轻男性医疗保健参与的个体、人际、组织和社会因素之间的复杂相互作用。它们还为增强该群体医疗保健可及性的多方面、具体情况的干预措施指明了方向，包括解决健康素养差距、提供文化敏感的护理和减少成本障碍。
