The development of a model of acculturation and health practices among sub-Saharan African Men (MAPS) in the United States: a grounded theory study of prostate cancer early detection.

BACKGROUND: The past two decades has seen a steady rise in the number of immigrants from sub-Saharan Africa to the United States (US). While this population represent one of the fastest growing segments of the US immigrant population, research examining the impact of migration on the health practices and behaviors among this population has lagged. Acculturation is the modification of an individual’s beliefs, values, and behavior upon contact with a different culture. This study aimed to enhance understanding of the links between acculturation and health practices among sub-Saharan Africa immigrants in the US. METHODS: Constructivist Grounded Theory methodology was employed to develop a process model that explains the relationship between acculturation and health behaviors of sub-Saharan African immigrant men. This qualitative approach included in-depth interviews with 36 participants and a follow-up interview with 10 participants. Purposive sampling was used to recruit participants and audio recordings of interviews were transcribed, verified, and analyzed using an iterative constant comparative approach that comprised open, axial, and focused coding. Emerging constructs were identified and synthesized into a process model which was further refined with input from an advisory panel and participant checking. RESULTS: The Model of Acculturation and Health Practices among sub-Saharan African immigrant men (MAPS) in the US can be categorized into four main pillars: inputs, contexts, mechanisms, and outcomes. Inputs conceptualize pre-immigration experience including reasons for migration. Contextual factors describe prevailing conditions in the US including the political and economic aspects surrounding immigration. Mechanisms depict how acculturation impacts health behaviors. Outcomes illustrate the proximal and distal outcomes. CONCLUSION: This Model of Acculturation and Health Practices among sub-Saharan African immigrant men identifies key constructs that should be considered when studying acculturation and health practices among sub-Saharan Africa immigrants in the US. Notably, MAPS can aid in providing healthcare providers with a comprehensive lens through which to understand the complexities of sub-Saharan African Immigrant men’s health behaviors. This study fills the void of dearth in theoretical models that elucidate behavioral adaptation and preventive behavior among sub-Saharan Africa immigrants in the US.