503 - Adolescent Males’ Perspective on Health Care: What is keeping them away?

To better understand "fear, shame and embarrassment” and other concerns, we embarked on a series of semi-structured interviews to explore these themes further.

Design/Methods: We recruited male public high school students, ages 13-17 years old, enrolled at two School-Based Health Centers in the Bronx, NY to participate in 1-1 interviews lasting 10-15 minutes.  Three different questions were asked: What do you think are the biggest health problems for young men your age?; What kinds of things do you think young men go to the doctor for?, and, What do you think are the most important reasons young men your age do not go to the doctor?  Interviews were recorded, professionally transcribed, and if in Spanish, professionally translated.  Research staff evaluated transcripts individually in a line-by-line open coding process to generate a list of themes for each question. We then convened to reach consensus on common themes for each question, and collapse themes into categories; illustrative quotes were identified.

Results:

14 interviews were completed and analyzed.  Common responses to “biggest health problems” included sexual health, maintaining a healthy lifestyle, mental health and stress, substance abuse, acute illness, and lack of health insurance.  Common responses to “reasons for going to the doctor” included sexual health, preventative care or visits about general health, mental health, dental care, and sick visits. Common responses to “reasons for not going to the doctor” included fear of being diagnosed with a serious illness, fear of confidentiality being broken and feelings of shame.  Also cited were lack of access, lack of support, lack of relationship with doctor, personal health beliefs and priorities, including viewing seeking health care as not masculine.

Conclusion(s):

This analysis suggests that young men’s fear and shame around health care as well as concerns about masculinity are complex feelings that need to be understood more to normalize care and increase engagement.  Further inquiry is needed confirm the representativeness of these findings and work with young men to identify and design strategies to increase awareness and engagement in care.