Assessing Situational Awareness for Healthful Behaviors and the “Self-Care Gap” Among Non-Hispanic Black and Hispanic Men With Chronic Conditions

Objective: This study sought to identify factors associated with (1) situational awareness (i.e., daily recognition of situations to make choices to act in the best interest of one’s health) and (2) the self-care gap (i.e., not acting in one’s best interest despite having recognized at least one opportunity to perform healthful behaviors). Methods: Data from 1,761 non-Hispanic Black (58.4%) and Hispanic (41.6%) men aged 40 years or older with chronic conditions were collected using an internet-delivered questionnaire. Two linear regression models were fitted to assess factors associated with situational awareness and the self-care gap, respectively. Regression models were adjusted for sociodemographics, disease symptomatology, preventive screening activity, health behaviors, and health-related perceptions. Results: Situational awareness levels were lower for older individuals (B = −.03, p < .001). Men who had higher fatigue (B = .11, p = .002), more stress (B = .07, p = .032), utilized more prevention screenings (B = .13, p = .001), adhered to physical activity guidelines (B = .36, p = .044), and received more social support (B = .89, p < .001) reported higher situational awareness. The self-care gap was more pronounced among non-Hispanic Black men (B = −.32, p = .026). Men who reported higher fatigue (B = .06, p = .041), clinical depression (B = .39, p = .039), more barriers to self-care (B = .11, p < .001), and higher frustrations with health care (B = .12, p < .001) were associated with greater self-care gaps. Conclusions: Men’s recognition of healthful opportunities was largely driven by their disease symptomatology, greater engagement in preventive screenings, and receiving social support. However, the self-care gap was seemingly driven by mental health and challenges with disease self-management and health care interactions. Efforts are needed to narrow disparities in the self-care gap between non-Hispanic Black and Hispanic men.