title: Masculinity and Race-Related Factors as Barriers to Health Help-Seeking Among African American Men.
abstract: 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.
authors.affiliation: a University of North Carolina at Chapel Hill.
authors.forename: Wizdom
authors.initials: W
authors.lastname: Powell
authors.affiliation: a University of North Carolina at Chapel Hill.
authors.forename: Leslie B
authors.initials: LB
authors.lastname: Adams
authors.affiliation: b University of Michigan-Ann Arbor.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Cole-Lewis
authors.affiliation: c Virginia Commonwealth University.
authors.forename: Amma
authors.initials: A
authors.lastname: Agyemang
authors.affiliation: d American Institutes for Research.
authors.forename: Rachel D
authors.initials: RD
authors.lastname: Upton
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D001294:Attitude to Health; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D057228:Masculinity; D008960:Models, Psychological; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D063505:Racism / Q000523:psychology*
keywords: African Americans; health disparities; help-seeking; masculinity; men's health