Efforts to increase consumer responsibility for health and rehabilitation utilization must be directed at the individual consumer. Increasing one's beliefs that one can successfully access and participate in appro priate health and rehabilitative services should be a desired individual goal. These beliefs may be more difficult to promote among those African Americans who have not had extensive experience with taking control. However, these beliefs can be learned. (Strategies for increasing self-efficacy beliefs and the perception of control are discussed in chapter 8.)
The encouragement of appropriate beliefs and skills can be facilitated by other consumers. While rehabilitation and health professionals can facilitate this process, in order for true internalization of appropriate behaviors to occur, consumers must see (and subsequently model) the actions of similar others.
One helpful strategy is the creation of self-help consumer groups. Professionals can be helpful in this process by proving administrative support such as a place to meet and other necessary resources (i.e., transportation assistance if needed, child care, etc.), but the group should be consumer directed.
Self-help consumer groups could host sessions in which persons teach and train each other to access health care systems by sharing experiences and resources. Here, consumers could share their own experiences regarding what works and what doesn't. Sessions on how to be assertive and stand up for one's rights should be helpful. Having access to information on consumer legal rights could be shared within the context of these groups. (A more detailed discussion of how to implement a support group is provided in chapter 7.)
Health and rehabilitation professionals can be helpful in this process by communicating to consumers that they are ultimately responsible both for their health and related outcomes and for whether they receive appropriate treatment. Consumers should be encouraged to ask questions and to challenge the prescribed recommendation when they have doubts.
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