Date Presented 04/05/19
The purpose of this qualitative study is to explore the health beliefs of community-dwelling African American male elders and the activities or behaviors associated with these beliefs. This research topic will advance the practice of OT through providing a client-centered perspective of the major influences on health behaviors and the role of engagement for a high-risk minority population.
Primary Author and Speaker: Leslie Roundtree
Additional Authors and Speakers: Farnaz Chaudhry, Rudi Holland, Katrina Morgan, Jacek Tomczak
PURPOSE: The purpose of this qualitative study is to explore the health beliefs of community dwelling African American male elders and the activities or behaviors associated with these beliefs. The research queries are:
1) What type of activities and behaviors do African American male elders believe assist to keep them healthy?
2) What cultural and ethnic influences shape the health beliefs of the individuals and the group?
3) What role does occupational engagement play in the health beliefs of African American male elders?
This research targets African American males due to their high rate of chronic illness, disability, mortality and low rate of participation in health promotion activities (Ward and Schiller, 2011; Kochanek, Arias, & Anderson, 2013). This study is assisting to construct a conceptual understanding of African American elders’ perspectives on health maintenance behaviors.
DESIGN: A hermeneutic narrative analysis design was used to explore and analyze the interpretations of individuals using non-direct interviewing techniques. Using this approach enables researchers to explore how the culture of the African American male experience, has influenced health beliefs, and health maintenance behaviors. The criteria for selection for participants included African American males, 65 years and older, who live in the community, and have the ability to express oneself in rich detail. Subjects were recruited from barbershops, churches and local McDonald’s and received a gift card for participating in interviews.
METHOD: The researchers conducted two in-depth semi-structured interviews with each of the eight participants. The question, “What are the things you believe a person your age should do to stay healthy?” elicited a list of beliefs/behaviors (Arcury, Bell, Vitolins, & Quandt, 2005). After the elders completed that list, the researcher probed each area by asking the subject to explain what the belief/behavior meant, and explored how the respondent engages in these behaviors and the influencing factors. An analytic induction process was used to develop themes, patterns, and meanings from the narratives. Member checking and triangulation with current literature was used to create trustworthiness.
RESULTS: The researchers defined four prevalent health beliefs and behaviors. The behaviors are denoted as (1) Eating right/Avoiding food, (2) Exercise/Staying active, (3) Seeing the doctor and (4) Slowing down. From the discussion of influences and the elder’s upbringing, two major themes emerged: “Health changing events” and “Do something or avoid something. These two themes influenced the elder’s behavioral choices and actions in health maintenance. The subjects had limited active engagement in occupations that were uniquely meaningful and influential to their health.
CONCLUSION: The major limitation of the study is the small sample size thus limiting generalization. The participants in this study demonstrated a basic knowledge of the recommended actions a person should do to be healthy, but they are not implementing these strategies. The missing element was engagement in healthy habits, and occupations that support healthy living. Occupational therapists can play a major role in assisting this population in identifying meaningful occupations, and habits to support health.
IMPACT STATEMENT: Occupational therapy has a key role in enhancing and reinforcing the use of everyday activities to promote and maintain their health among high risk populations. Through occupation-based practice, occupational therapy is in the unique position to design health promotion programs that address meaningful engagement that can help to improve African American males’ health status and reduce health disparities.
References
Arcury, T., Bell, R., Vitolins, M., & Quandt, S. (2005). Rural older adults' beliefs and behavior related to complementary and alternative medicine use. Complementary Health Practice Review, 10(1), 33-44.
Kochanek K.,D., Arias E., & Anderson, R.,N. (2013) How did cause of death contribute to racial differences in life expectancy in the United States in 2010? NCHS data brief, no 125. Hyattsville, MD: National Center for Health Statistics.
Ravenell, J. E., Johnson, W. E., & Whitaker, E. E. (2006). African-American men’s perceptions of health: a focus group study. Journal of the National Medical Association, 98(4) 544-550.
Ward B.,W., and Schiller J.,S. (2011)Prevalence of complex activity limitations among racial/ ethnic groups and Hispanic subgroups of adults: United States, 2003–2009. NCHS data brief, no 73. Hyattsville, MD: National Center for Health Statistics.
