Through our eyes: exploring African-American men's perspective on factors affecting transition to manhood.

BACKGROUND: Premature mortality and disparities in morbidity observed in African-American men may be associated with factors in their social, economic, and built environments that may be especially influential during the transition to adulthood. OBJECTIVE: To have young, African-American men from Los Angeles County identify and prioritize factors associated with their transition to manhood using photovoice methodology and pile-sorting exercises. DESIGN: Qualitative study using community-based participatory research (CBPR) and photovoice PARTICIPANTS: Twelve African-American men, ages 16-26 years, from Los Angeles County, California. APPROACH: We used CBPR principles to form a community advisory board (CAB) whose members defined goals for the partnered project, developed the protocols, and participated in data collection and analysis. Participants were given digital cameras to take 50-300 photographs over three months. Pile-sorting techniques were used to facilitate participants' identification and discussion of the themes in their photos and selected photos of the group. Pile-sorts of group photographs were analyzed using multidimensional scaling and hierarchical cluster analysis to systematically compare participants' themes and identify patterns of associations between sorted photographs. Sub-themes and related quotes were also elicited from the pile-sorting transcripts. The CAB and several study participants met periodically to develop dissemination strategies and design interventions informed by study findings. KEY RESULTS: Four dominant themes emerged during analysis: 1) Struggles face during the transition to manhood, 2) Sources of social support, 3) Role of sports, and 4) Views on Los Angeles lifestyle. The project led to the formation of a young men's group and community events featuring participants. CONCLUSIONS: CBPR and photovoice are effective methods to engage young, African-American men to identify and discuss factors affecting their transition to manhood, contextualize research findings, and participate in intervention development.

Using prayer in psychotherapy: applying Sue's differential to enhance culturally competent care.

In this article, the authors discuss the application of Sue's cultural competence differential of hypothesis testing, dynamic sizing, and cultural specific expertise as a model for considering cultural factors in the treatment of an African American family. Three cultural dimensions are highlighted: spirituality, womanism, and community exposure to trauma. Given the centrality of spirituality for this African American family, prayer is used to facilitate the therapeutic process. Discussion from a womanist perspective highlights the spiritual, communal, and personal dimensions that the aunt faces as an African American woman. Consideration of the community context and potential exposure to trauma and loss allows for a fuller appreciation of the psychosocial context of the nephew. Sue's differential guides the case discussion.