Willingness to participate in adapted pain and disease self-management programs: evaluating preferences of Black men

Background and objective: The health of Black men continues to be a discussion of public health concern. To address this concern, this exploratory study aimed to assess Black men's willingness and preferences for participating in tailored pain and/or disease self-management programs.

Materials and methods: Three program designs were presented, with varying delivery modalities. Participants responded to a series of questions regarding the content and form of program implementation. A total of 75 Black men, with an average age of 57 (SD = 14.8) years, were included for study participation.

Results: Responses to a set of closed- and open-ended questions showed that less than one-third (29.3%) had never heard of chronic disease self-management programs, with another 77.3% never participating in a self-management program. Overall, the majority of the men preferred receiving health information from books (73.3%) or brochures (74.7%). Few (15.0%) preferred receiving health advice from family. More than one-third however, preferred receiving information from friends (38.7%) or a religious leader (33.3%).

Conclusion: Results from this study contribute to our understanding of how more effective programming and systems tailored to the health needs of this gendered population is needed in order to promote safe and cost-effective approaches to prevention and treatment efforts.

Black men; Pain; Self-management programs; Chronic disease; Healthcare disparities

[1] Kroeper KM, Sanchez DT, Himmelstein MS. Heterosexual Men’s Confrontation of Sexual Prejudice: the Role of Precarious Manhood. Sex Roles. 2014; 70: 1–13.

[2] Samulowitz A, Gremyr I, Eriksson E, Hensing G. “Brave Men” and “Emotional Women”: a Theory-Guided Literature Review on Gender Bias in Health Care and Gendered Norms towards Patients with Chronic Pain. Pain Research and Management. 2018; 2018: 1–14.

[3] Williams DR. The Health of Men: Structured Inequalities and Opportunities. American Journal of Public Health. 2003; 93: 724–731.

[4] Mahalik JR, Pierre MR, Wan SSC. Examining Racial Identity and Masculinity as Correlates of Self-Esteem and Psychological Distress in Black Men. Journal of Multicultural Counseling and Development. 2006; 34: 94–104.

[5] Green CR, Anderson KO, Baker TA, Campbell LC, Decker S, Fillingim RB, et al. The Unequal Burden of Pain: Confronting Racial and Ethnic Disparities in Pain. Pain Medicine. 2003; 4: 277–294.

[6] McClish DK, Smith WR, Levenson JL, Aisiku IP, Roberts JD, Roseff SD, et al. Comorbidity, Pain, Utilization, and Psychosocial Outcomes in Older versus Younger Sickle Cell Adults: the PiSCES Project. BioMed Research International. 2017; 2017: 1–10.

[7] Sommer C. Comorbidity of pain and psychoaffective diseases—an update. European Psychiatry. 2010; 25: 162.

[8] Sullivan-Singh SJ, Sawyer K, Ehde DM, Bell KR, Temkin N, Dikmen S, et al. Comorbidity of pain and depression among persons with trau-matic brain injury. Archives of Physical Medicine and Rehabilitation. 2014; 95: 1100–1105.

[9] Li J. Pain and depression comorbidity: a preclinical perspective. Behavioural Brain Research. 2015; 276: 92–98.

[10] Reid MC, Eccleston C, Pillemer K. Management of chronic pain in older adults. British Medical Journal. 2015; 350: h532–h532.

[11] Baker T, Minahan J, Atakere D. Pain and men. Annual Review of Gerontology & Geriatrics. 2018; 39: 95–106.

[12] Clark LH, Hudson JL, Rapee RM, Grasby KL. Investigating the impact of masculinity on the relationship between anxiety specific mental health literacy and mental health help-seeking in adolescent males. Journal of Anxiety Disorders. 2020; 76: 102292.

[13] Daheim J, Kim SY, Neduvelil A, Nguyen NP. Men, Chronic Pain, and Prescription Pain Medication Use: the Role of Gender Role Beliefs in a Longitudinal Moderated Mediation Model. Pain Medicine. 2019; pnz200: 1–12.

[14] Cuevas A, O’Brien K, Saha S. African American experiences in healthcare: “I always feel like I’m getting skipped over”. Health Psychology. 2016; 36: 987–995.

[15] Eaton LA, Driffin DD, Kegler C, Smith H, Conway-Washington C, White D, et al. The role of stigma and medical mistrust in the routine health care engagement of black men who have sex with men. American Journal of Public Health. 2015; 105: e75–e82.

[16] Ricks TN, Frederick A, Harrison T. Health and Disability among Young Black Men. Nursing Research. 2020; 69: 13–21.

[17] U.S. Census Bureau. Income, poverty, and health insurance coverage in the United States: 2020. 2020. Available at: https://www.census.gov/content/dam/Census/library/visualizations/2020/demo/p60-270/figure2.pdf

(Accessed: 17 April 2021).

[18] Charron-Chénier R, Mueller CW. Racial Disparities in Medical Spending: Healthcare Expenditures for Black and White Households (2013–2015). Race and Social Problems. 2018; 10: 113–133.

[19] Mayr FB, Yende S, D’Angelo G, Barnato AE, Kellum JA, Weissfeld L, et al. Do hospitals provide lower quality of care to black patients for pneumonia? Critical Care Medicine. 2010; 38: 759–765.

[20] Aymer SR. Clinical Practice with African American Men: what to Consider and what to do. Smith College Studies in Social Work. 2009; 80: 20–34.

[21] Alsan M, Wanamaker M. TUSKEGEE and the HEALTH of BLACK MEN. The Quarterly Journal of Economics. 2018; 133: 407–455.

[22] Schulman-Green D, Jaser S, Martin F, Alonzo A, Grey M, McCorkle R, et al. Processes of Self-Management in Chronic Illness. Journal of Nursing Scholarship. 2012; 44: 136–144.

[23] Brady TJ, Murphy L, O’Colmain BJ, Beauchesne D, Daniels B, Greenberg M, et al. A meta-analysis of health status, health behaviors, and health care utilization outcomes of the Chronic Disease Self-Management Program. Preventing Chronic Disease. 2013; 10: 120112.

[24] Lorig KR, Hurwicz M, Sobel D, Hobbs M, Ritter PL. A national dissemination of an evidence-based self-management program: a process evaluation study. Patient Education and Counseling. 2005; 59: 69–79.

[25] Goeppinger J, Armstrong B, Schwartz T, Ensley D, Brady TJ. Self-management education for persons with arthritis: Managing comor-bidity and eliminating health disparities. Arthritis and Rheumatism. 2007; 57: 1081–1088.

[26] James DCS, Harville C. Barriers and Motivators to Participating in mHealth Research among African American Men. American Journal of Men’s Health. 2017; 11: 1605–1613.

[27] Long E, Ponder M, Bernard S. Knowledge, attitudes, and beliefs related to hypertension and hyperlipidemia self-management among African-American men living in the southeastern United States. Patient Education and Counseling. 2017; 100: 1000–1006.

[28] Gadson SL. The third world health status of black American males. Journal of the National Medical Association. 2006; 98: 488–491.

[29] Calvert WJ, Isaac EP, Johnson S. Health-related quality of life and health-promoting behaviors in black men. Health & Social Work. 2012; 37: 19–27.

[30] Calvert W, Isaac-Savage E, Paulette E. Motivators and barriers to participating in health promotions behaviors in black men. Western Journal of Nursing Research. 2013; 35: 829–848.

[31] Gamble VN. Under the shadow of Tuskegee: African Americans and health care. American Journal of Public Health. 1997; 87: 1773–1778.

[32] Gitlin LN, Chernett NL, Harris LF, Palmer D, Hopkins P, Dennis MP. Harvest health: translation of the chronic disease self-management program for older African Americans in a senior setting. The Gerontologist. 2008; 48: 698–705.

[33] Lorig KR, Holman H. Self-management education: history, definition, outcomes, and mechanisms. Annals of Behavioral Medicine. 2003; 26: 1–7.

[34] Muscat DM, Song W, Cvejic E, Ting JHC, Medlin J, Nutbeam D. The Impact of the Chronic Disease Self-Management Program on Health Literacy: A Pre-Post Study Using a Multi-Dimensional Health Literacy Instrument. International Journal of Environmental Research and Public Health. 2020; 17: 58.

[35] Hawkins JM, Mitchell J. The Doctor never Listens: Older African American Men’s Perceptions of Patient–Provider Communication. Social Work Research. 2018; 42: 57–63.

[36] Matusitz J, Spear J. Effective doctor-patient communication: an updated examination. Social Work in Public Health. 2014; 29: 252–266.

[37] Street RL, Makoul G, Arora NK, Epstein RM. How does communica-tion heal? Pathways linking clinician-patient communication to health outcomes. Patient Education and Counseling. 2009; 74: 295–301.

[38] Frencher SK, Sharma AK, Teklehaimanot S, Wadzani D, Ike IE, Hart A, et al. PEP Talk: Prostate Education Program, “Cutting through the Uncertainty of Prostate Cancer for Black Men Using Decision Support Instruments in Barbershops”. Journal of Cancer Education. 2016; 31: 506–513.

[39] Wilson TE, Gousse Y, Joseph MA, Browne RC, Camilien B, McFarlane D, et al. HIV Prevention for Black Heterosexual Men: the Barbershop Talk with Brothers Cluster Randomized Trial. American Journal of Public Health. 2019; 109: 1131–1137.