VCU news

By Sathya Achia Abraham

When it comes to making decisions about their health care, African-American men want to be involved or work with their physicians rather than taking a passive role, according to a pilot study by a team of Virginia Commonwealth University researchers.

In the African-American Men Prostate Cancer Study, the team, led by Alton Hart Jr., M.D., M.P.H., associate scientific director of the VCU Center on Health Disparities, recruited 40 African-American men between the ages of 40 and 70 from several barbershops in the metro-Richmond area to learn about their preferred level of involvement in making decisions about their health with their physician or health care provider.

In the study, participants were interviewed about the role their doctor plays in their health decisions using the Degner Control Preference Scale. The team found that 50 percent of African-American men from this sample preferred a collaborative role, and 37.5 percent preferred an active role, while only 12.5 percent of the sample chose a passive decision-making role. Further, the team found that men who owned homes, had managerial/professional jobs and incomes greater than $70,000, or reported good to excellent health, were more often taking an active role in making health decisions.

“The relationship between home ownership, income and decision style may best be understood by considering historical and cultural influences upon African-American males,” Hart said. “Our aim is to help all African-American men make more informed decisions about their health regardless of their socioeconomic status.

“Also, it is very important for health care professionals to actively involve African-American men in health care decision making,” said Hart, who is assistant professor of medicine in the Division of Quality Health Care in the VCU School of Medicine.

In the traditional patient-physician relationship model, the physician has taken the authoritative role, deciding on course of treatment and care. But in recent years, patients have begun to take a more informed approach to their health, gathering information and making decisions with their physicians.
 
According to Hart, successful, community-based, health programs have used sites where people congregate to provide health services to underserved populations. Beauty salons, barbershops and churches have been used as sites for blood pressure screening programs and dietary interventions designed to reach low-income African-American populations.

Hart said that these strategies have been encouraged to help eliminate health disparities and that community partnerships are of key importance in researching underserved and vulnerable populations. As a result, he said, it is important to identify venues that would be most appropriate for such partnerships. 

It is also important to consider venues where natural social networks and communication channels exist, such as the neighborhood barbershop in the African-American community, he said.

“The openness of the barbershop environment in the African-American community is favorable to reaching men who could be potentially excluded from clinical recruitment processes due to lack of routine health care for various reasons,” said Hart.

The study was published online in July in the Journal of the National Medical Association.

Hart collaborated with VCU researchers Wally Smith, M.D., and Donna K. McClish, Ph.D., Micah McCreary, Ph.D., and Raymond H. Tademy, a gradate student in social psychology.

This work was supported by a grant from the American Cancer Society.