A new approach to aiding black male trauma survivors

July 23, 2020

PHILADELPHIA (July 23, 2020) - Many Black men suffer symptoms of traumatic stress in the aftermath of traumatic injury, and they also often carry social concerns, including experiences of discrimination and stigma. Yet despite their significant needs, underserved populations often have limited access to behavioral health care as well as a lack of financial resources to pay for such care. Because of these barriers, many trauma survivors do not seek professional behavioral health care and instead rely on informal or alternative sources of care.

A new study by researchers at the University of Pennsylvania School of Nursing (Penn Nursing) and Drexel University has explored how Black male survivors of trauma articulate the factors that facilitate or hinder their help-seeking for psychological symptoms after injury. The objective was to use a novel analytic approach called Qualitative Comparative Analysis (QCA) to understand how traumatic symptoms and social factors combine in complex ways toward the outcome of psychological help-seeking.

The study revealed that severe posttraumatic symptoms create pathways to help-seeking among some Black men who survive trauma exposure, while for others, financial worry and discrimination combine in a pathway toward help-seeking even in the absence of severe psychological symptoms after trauma. Factors combine in ways that reflect a complex intersection between barriers and facilitators.

"The existence of these distinct pathways challenges the tendency to view factors individually and either as barriers or facilitators," explains lead author John A. Rich, MD, MPH, Professor of Health Management and Policy at the Dornsife School of Public Health at Drexel University. "We were able to show that various causal conditions, some classically thought to be facilitators and others thought to be barriers, may combine in different ways toward the outcome of help-seeking among the Black men in this study. This supports our view that causation is complex and often intersectional."

Using fuzzy set QCA, researchers identified three different causal pathways for psychological help?seeking among the injured Black men studied. Two pathways showed that severe psychological symptoms in the absence of financial worry were sufficient for seeking help, whereas the third showed that financial worry and discrimination in the absence of psychological symptoms were sufficient for help?seeking.

The research also identified two causal pathways which negated help-seeking, in which low posttraumatic symptom severity and low levels of discrimination or financial worry were sufficient for not seeking psychological help.

"Our study has implications for future research," said Penn Nursing's Therese S. Richmond, PhD, RN, FAAN, the Andrea B. Laporte Professor of Nursing and Associate Dean for Research & Innovation, "Understanding different pathways to help-seeking behavior may identify new approaches to aiding Black men who are victims of trauma. Somewhat akin to a precision medicine approach, future examination of these pathways may help to develop theories about the utilization of behavioral health services for Black men that are based on their experiences rather than the assumption that all Black men who are trauma survivors have a single perspective on seeking help."

The study also helps highlight that Black men bring more than their race and gender to their experience of trauma exposure, combating the tendency to see Black men only as part of a group, which is problematic from a research perspective.

"We were able to show that various causal conditions, some classically thought to be facilitators and others thought to be barriers, may combine in different ways toward the outcome of help-seeking among the Black men in this study," says co-author Theodore J. Corbin, MD, MPH, Professor of Emergency Medicine at Drexel University College of Medicine and co-director of the Drexel Center for Nonviolence and Social Justice. "Applying similar configurational methods in health research could uncover important causal pathways for health inequalities rather than focusing on race or other demographic categories that are often investigated in isolation of their socioecological context."
The study's findings have been published in The Journal of Traumatic Stress in an article titled "Pathways to Help-Seeking Among Black Male Trauma Survivors: A Fuzzy Set Qualitative Comparative Analysis." Additional co-authors of the article include Sara F. Jacoby, PhD, and Jessica L. Webster, MS, LPC, both of Penn Nursing. The study was funded by the National Institute of Nursing Research of the National Institutes of Health (R01NR013503; PI - Richmond).

About the University of Pennsylvania School of Nursing

The University of Pennsylvania School of Nursing is one of the world's leading schools of nursing. For the fifth year in a row, it is ranked the #1 nursing school in the world by QS University and is consistently ranked highly in the U.S. News & World Report annual list of best graduate schools. Penn Nursing is currently ranked # 1 in funding from the National Institutes of Health, among other schools of nursing, for the third consecutive year. Penn Nursing prepares nurse scientists and nurse leaders to meet the health needs of a global society through innovation in research, education, and practice. Follow Penn Nursing on: Facebook, Twitter, LinkedIn, & Instagram.

University of Pennsylvania School of Nursing

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.