Volume 33, Issue 4 p. 528-540
RESEARCH ARTICLE

Pathways to Help-Seeking Among Black Male Trauma Survivors: A Fuzzy Set Qualitative Comparative Analysis

John A. Rich

Corresponding Author

John A. Rich

Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA

Department of Emergency Medicine, College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA

Center for Nonviolence and Social Justice, Drexel University, Philadelphia, Pennsylvania, USA

Correspondence concerning this article should be addressed to John A. Rich, 1505 Race Street, MS 1047, 6th floor, Philadelphia, PA 19102. Email: jar82@drexel.edu

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Theodore J. Corbin

Theodore J. Corbin

Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA

Department of Emergency Medicine, College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA

Center for Nonviolence and Social Justice, Drexel University, Philadelphia, Pennsylvania, USA

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Sara F. Jacoby

Sara F. Jacoby

Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA

Penn Injury Science Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA

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Jessica L. Webster

Jessica L. Webster

Department of Biobehavioral Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA

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Therese S. Richmond

Therese S. Richmond

Penn Injury Science Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA

Department of Biobehavioral Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA

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First published: 09 June 2020
Citations: 4

The research reported in the present publication was supported by the National Institute of Nursing Research of the National Institutes of Health (R01NR013503; PI: Richmond). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. No authors report conflicts of interest.

The authors wish to acknowledge the contributions of Andrew Robinson to data management, as well as Dr. Peer Fiss for his training and assistance with Fuzzy Set Qualitative Comparative Analysis.

Abstract

en

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, and a lack of financial resources. The objective of the present study was to understand how traumatic symptoms and social factors combine in complex ways toward the outcome of psychological help-seeking. We analyzed qualitative and quantitative data from 32 injured Black men admitted to a Level 1 trauma center. Qualitative interviews explored their attitudes toward seeking professional psychological help. We analyzed quantitative data, collected using validated instruments, on posttraumatic stress and depression symptoms, financial worry, and discrimination/stigma. Fuzzy set qualitative comparative analysis (fsQCA) was conducted by calibrating each condition to fuzzy set membership scores based on our knowledge of the causal conditions and the cases. We then constructed truth tables for QCA analysis using fsQCA software. Three causal pathways for psychological help-seeking were identified: Two pathways showed that severe trauma 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 trauma symptoms were sufficient for help-seeking. We identified two causal pathways for negated help-seeking, in which low posttraumatic symptom severity and low levels of discrimination or financial worry were sufficient for not seeking psychological help. The QCA analysis revealed multiple pathways for psychological help-seeking among Black men who suffer trauma. These findings highlight the need for further research to understand complex pathways toward psychological help-seeking in this population.

Resumen

es

JOTS-19-0144.R2

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET)

Trayectorias hacia la búsqueda de ayuda en hombres de raza negra sobrevivientes de trauma: Un análisis difuso de análisis cualitativo comparativo

DESARROLLO DEL REPOSITORIO TEPT

Dada la extensa investigación sobre el tratamiento del trastorno de estrés postraumático (TEPT), un único repositorio actualizable de datos de estudios de tratamiento del TEPT sería útil para los actores clínicos, de investigación, y de política. Para satisfacer esta necesidad, establecimos un conjunto preliminar de datos de un ensayo de TEPT abstraído, que sirven de base para el Repositorio de Datos Estandarizados de Ensayos del TEPT (Repositorio del TEPT), mantenido por el Centro Nacional para el TEPT (NCPTSD en su sigla en inglés). Se siguieron los métodos de revisión sistemática para identificar ensayos controlados aleatorios (ECAs) publicados de intervenciones del TEPT. Consultamos con un panel de expertos para determinar los criterios de inclusión a priori, asegurar que capturamos todos los estudios relevantes, e identificar variables para la abstracción. Se realizaron búsquedas en múltiples bases de datos de materiales publicados desde 1980 hasta 2018 y se revisaron las listas de referencias de revisiones sistemáticas relevantes y guías de práctica clínica. En total, se incluyeron 318 ECAs de intervenciones del TEPT que inscribieron a casi 25,000 participantes. Extrajimos 337 variables de todos los estudios, incluidas las características del estudio, participantes, y de la intervención, así como los resultados. En el presente documento, describimos nuestros métodos y definimos elementos de datos incluidos en las tablas de datos. Explicamos los desafíos de codificación, identificamos inconsistencias en el reporte en todos los tipos de estudio, y discutimos las formas en que los actores interesados pueden usar los datos del Repositorio del TEPT para mejorar la investigación, la educación, y las políticas. Los datos ectraídos están actualmente disponibles públicamente en el sitio web del NCPTSD y pueden utilizarse para futuras revisiones sistemáticas e identificar brechas de investigación y como un recurso de información para clínicos, pacientes, y familiares.

抽象

zh

Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS)

簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯

Pathways to Help-Seeking Among Black Male Trauma Survivors: A Fuzzy Set Qualitative Comparative Analysis.

Traditional Chinese

標題: 黑人男性創傷生還者尋求治療的路徑:模糊集合質性比較分析

撮要: 目前有廣泛的創傷後壓力症(PTSD)治療研究, 從這些治療研究的所得建立可持續更新的數據資料庫, 對臨床治療、研究與制訂政策的持份者來說, 都應該有用。為此, 我們建立了一個初步的PTSD試驗撮要資料集, 作為國家PTSD中心(NCPTSD)所管理的PTSD試驗標準化數據資料庫(PTSD-Repository)的基礎。我們採用系統性評估的方法, 找出針對PTSD干預已發表的隨機對照試驗(RCTs);亦徵詢專家小組的意見, 以決定先驗包含準則, 確保我們包含所有相關的研究, 並找出應作撮要的變量。我們在多個數據庫搜尋由1980年至2018年發表的研究, 亦審視了相關的系統性評估和臨床治療指引的參考資料。我們共包含了318個有關PTSD干預的RCTs, 內含接近25,000名樣本, 對337個變量作撮要, 當中包括研究、樣本、干預特徵和結果。我們在本論文描述採用的方法, 定義數據表內含的數據元素;解釋編碼時遇到的困難, 辨識不同研究類型其報告不一致的地方, 亦討論持份者可怎樣採用PTSD-Repository數據, 來協助研究、教育和制訂政策。撮要資料現已載於NCPTSD的網站讓公眾閱讀。它在未來可用以作系統性評估或找出研究漏洞, 亦可為臨床治療師、患者及其家人提供資料。

Simplified Chinese

标题: 黑人男性创伤生还者寻求治疗的路径:模糊集合质性比较分析

撮要: 目前有广泛的创伤后压力症(PTSD)治疗研究, 从这些治疗研究的所得建立可持续更新的数据数据库, 对临床治疗、研究与制订政策的持份者来说, 都应该有用。为此, 我们建立了一个初步的PTSD试验撮要数据集, 作为国家PTSD中心(NCPTSD)所管理的PTSD试验标准化数据数据库(PTSD-Repository)的基础。我们采用系统性评估的方法, 找出针对PTSD干预已发表的随机对照试验(RCTs);亦征询专家小组的意见, 以决定先验包含准则, 确保我们包含所有相关的研究, 并找出应作撮要的变量。我们在多个数据库搜寻由1980年至2018年发表的研究, 亦审视了相关的系统性评估和临床治疗指引的参考数据。我们共包含了318个有关PTSD干预的RCTs, 内含接近25,000名样本, 对337个变量作撮要, 当中包括研究、样本、干预特征和结果。我们在本论文描述采用的方法, 定义数据表内含的数据元素;解释编码时遇到的困难, 辨识不同研究类型其报告不一致的地方, 亦讨论持份者可怎样采用PTSD-Repository数据, 来协助研究、教育和制订政策。撮要资料现已载于NCPTSD的网站让公众阅读。它在未来可用以作系统性评估或找出研究漏洞, 亦可为临床治疗师、患者及其家人提供数据。

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