Getting Black Men Involved in Their Health Care, Clinical Research

As previously discussed with Aaron Henry, PA-C, MSHS, assistant professor of physician assistant studies at The George Washington School of Medicine & Health Sciences, the modern issues of distrust between Black men and the US health care system is historically informed—and associated with significantly disparate health outcomes and life expectancies. Some of the simpler solutions to improving that trust, Henry noted, include greater individual attention from clinicians and a greater embrace of community-based health programs.¹

In second segment of the interview with HCPLive at the American Academy of Physician Associates (AAPA) 2024 Conference & Expo in Houston, TX, this week, Henry discussed the need to also focus on better facilitating Black men to primary care settings. He noted that research shows a tendency of Black men to bypass a frontline clinician as a primary source of care and instead initially present to the emergency department (ED).²

“And what that tells us is that these men are going to the ER because they'd rather wait till the wheels fall off than go and establish regular routine preventative care which would have detected prostate cancer, diabetes, high blood pressure, or heart failure much sooner,” Henry said. “So, I would say starting off at primary care is key.”

That doesn’t mean other specialties of medicine are in a better position with Black male patient trust; Henry noted it’s key to learn how such patients are being treated when referred to cardiologists and nephrologists, among others. “Because all it takes is one bad incident for these men to just fall off the map and never return,” he said.

Henry additionally discussed the prospect of achieving greater buy-in and participation from Black men in clinical research that may more significantly impact them than other populations. Through his PhD program for Translational Health Science, Henry has been researching community-based participatory trials.

“This is where from the ground level, you're involving people from the community—in this case, black men—in every phase of research,” Henry said. “Every stage, from the development of an intervention, testing it out, and even before it rolls out, getting back to the community and saying, 'Hey, does this look right? Is this legit? Does this make sense from your perspective?' to make sure that every approach, every intervention aligns with the goals of the community.”

Some proven models of this method include “barbershop interventions,” wherein local clinicians and care providers collaborate with community leaders at popular local venues to provide an opportunity to openly discuss a health practice such as immunization or cardiovascular disease, and to then offer free services like blood pressure screening in the moment.³ Henry stressed a frequently dismissed step in this practice, though, is considering whether this practice may be perceived as an intrusion on the community.

“Which is vital, because if they don't want researchers in the area, what's the quality of data you're going to get?” Henry said. “There are many examples throughout literature that demonstrate (the benefit), but at the end of the day, it's clear that you can't create something if you didn't get input from the population you're trying to help.”

Henry concluded with a sentiment that, despite centuries of historical distrust that’s built up between Black men and health care, the opportunity to build strong relationships remains there for those who make the effort.

“Showing that little bit of compassion—just coming in from a human level, treating someone like they're your relative and asking what's going on—I think that makes a huge difference,” he said.

References

1. ^{Kunzmann K. Aaron Henry, PA-C, MSHS: Regaining Black Male Patient Trust in the Doctor's Office. HCPLive. Published May 20, 2024. https://www.hcplive.com/view/aaron-henry-regaining-black-male-patient-trust-in-the-doctors-office}
2. ^{Arnett MJ, Thorpe RJ Jr, Gaskin DJ, Bowie JV, LaVeist TA. Race, Medical Mistrust, and Segregation in Primary Care as Usual Source of Care: Findings from the Exploring Health Disparities in Integrated Communities Study. J Urban Health. 2016;93(3):456-467. doi:10.1007/s11524-016-0054-9}
3. ^{Victor RG, Lynch K, Li N, et al. A Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops. N Engl J Med. 2018;378(14):1291-1301. doi:10.1056/NEJMoa1717250}