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Andersen, R. M., and P. L. Davidson. "Ethnicity, Aging, and Oral Health Outcomes: A Conceptual Framework." Advances in Dental Research 11, no. 2 (May 1997): 203–9. http://dx.doi.org/10.1177/08959374970110020201.
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An expanded version of Andersen's Behavioral Model of Health Services Utilization is used as the theoretical and analytical framework for the International Collaborative Study of Oral Health Outcomes (ICS-II). The conceptual framework for understanding determinants of oral health is based on a "systems" perspective. The framework posits that characteristics of the external environment, the dental care delivery system, and the personal characteristics of the population influence oral health behaviors. The expanded behavioral model conceptualizes health behaviors (oral hygiene practices and dental services utilization) as intermediate dependent variables, which in turn influence oral health outcomes (evaluated, perceived, patient satisfaction). The framework is presented with an increased focus on the effects of race-ethnicity and age cohort, the major exogenous variables used in this study for systematic assessment of the differences in the multitude of factors influencing oral health. The framework can be applied by policy analysts and health services managers to help describe, predict, and explain population-based health behaviors and health outcomes.
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Reiman, Amanda. "Medical Cannabis Patients: Patient Profiles and Health Care Utilization Patterns." Complementary health practice review 12, no. 1 (January 2007): 31–50. http://dx.doi.org/10.1177/1533210107301834.
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The possible medicinal uses of cannabis are growing, yet research on how patients use medical cannabis facility services remains scarce. This article reports on the Cannabis Care Study, in which 130 medical cannabis patients at seven facilities in the San Francisco Bay Area were surveyed to gather information about demographics, personal health practices, health outcomes, service use, and satisfaction with medical cannabis facilities. The study was modeled after Andersen's Behavioral Model of Health Services Use. Results show that patients tend to be males older than 35, identify with multiple ethnicities, and report variable symptom duration and current health status. Nearly half the sample reported substituting cannabis for alcohol and illegal drugs; 74% reported substituting it for prescription drugs. Satisfaction did not differ across study sites and was significantly higher than nationally reported satisfaction with health care. Implications for the medical cannabis community and the greater system of health and social care are discussed.
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Volkert, Jana, Sylke Andreas, Martin Härter, Maria Christina Dehoust, Susanne Sehner, Anna Suling, Berta Ausín, et al. "Predisposing, enabling, and need factors of service utilization in the elderly with mental health problems." International Psychogeriatrics 30, no. 7 (December 4, 2017): 1027–37. http://dx.doi.org/10.1017/s1041610217002526.
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ABSTRACTBackground:Empirical data on the use of services due to mental health problems in older adults in Europe is lacking. The objective of this study is to identify factors associated with service utilization in the elderly.Methods:As part of the MentDis_ICF65+ study, N = 3,142 people aged 65–84 living in the community in six European and associated countries were interviewed. Based on Andersen's behavioral model predisposing, enabling, and need factors were analyzed with logistic regression analyses.Results:Overall, 7% of elderly and 11% of those with a mental disorder had used a service due to mental health problems in the last 12 months. Factors significantly associated with underuse were male sex, lower education, living in the London catchment area, higher functional impairment and more comorbid mental disorders. The most frequently reported barrier to service use was personal beliefs, e.g. “I can deal with my problem on my own” (90%).Conclusion:Underutilization of mental health services among older people in the European community is common and interventions are needed to achieve an adequate use of services.
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Kim, Han-Kyoul, and Munjae Lee. "Factors associated with health services utilization between the years 2010 and 2012 in Korea: using Andersen's Behavioral model." Osong Public Health and Research Perspectives 7, no. 1 (February 2016): 18–25. http://dx.doi.org/10.1016/j.phrp.2015.11.007.
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Fortin, Marilyn, Jean-Marie Bamvita, and Marie-Josée Fleury. "Patient satisfaction with mental health services based on Andersen’s Behavioral Model." Canadian Journal of Psychiatry 63, no. 2 (October 23, 2017): 103–14. http://dx.doi.org/10.1177/0706743717737030.
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Objective: The purpose of this article was to assess the satisfaction of adult patients who received mental health services (MHS) in healthcare networks staffed by multidisciplinary professionals and offering a range of MHS, and to identify variables associated with patient satisfaction. Methods: This cross-sectional study included 325 patients with mental disorders (MDs) among 4 Quebec health service networks. Data were collected using 9 standardized instruments and participant medical records. A 3-factor conceptual framework (predisposing, enabling, and needs-related factors) based on Andersen’s Behavioral Model was used, integrating sociodemographic, clinical, needs-related, service utilization, social support, and quality-of-life (QOL) variables. An adjusted multiple linear regression model was performed. Results: The global mean score for patient satisfaction was 4.11 (minimum: 2.0; maximum: 5.0). Among the enabling factors, continuity of care, having a case manager, and help received from services were positively associated with patient satisfaction, whereas being hospitalized was negatively associated. Among the needs-related factors, the number of needs was negatively associated with satisfaction. Conclusions: Findings demonstrated higher levels of satisfaction among patients who received good continuity of care and well-managed, frequent services in relation to their needs. Dissatisfaction was higher for patients with serious unmet needs or those hospitalized, which underlines the importance of taking these particular variables into account in the interest of improving MHS delivery and patient recovery.
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Jin, Seok Won, Hee Yun Lee, and Jongwook Lee. "Analyzing factors enabling colorectal cancer screening adherence in Korean Americans using the Andersen's Behavioral Model of Health Services Utilization." Journal of Psychosocial Oncology 37, no. 6 (July 22, 2019): 729–45. http://dx.doi.org/10.1080/07347332.2019.1608347.
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Acosta-Ramírez, Naydú, Luis G. Durán-Arenas, Julia I. Eslava-Rincón, and Julio C. Campuzano-Rincón. "Determinants of vaccination after the Colombian health system reform." Revista de Saúde Pública 39, no. 3 (June 2005): 421–29. http://dx.doi.org/10.1590/s0034-89102005000300013.
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OBJECTIVE: To assess the effects of individual, household and healthcare system factors on poor children's use of vaccination after the reform of the Colombian health system. METHODS: A household survey was carried out in a random sample of insured poor population in Bogota, in 1999. The conceptual and analytical framework was based on the Andersen's Behavioral Model of Health Services Utilization. It considers two units of analysis for studying vaccination use and its determinants: the insured poor population, including the children and their families characteristics; and the health care system. Statistical analysis were carried out by chi-square test with 95% confidence intervals, multivariate regression models and Cronbach's alpha coefficient. RESULTS: The logistic regression analysis showed that vaccination use was related not only to population characteristics such as family size (OR=4.3), living area (OR=1.7), child's age (OR=0.7) and head-of-household's years of schooling (OR=0.5), but also strongly related to health care system features, such as having a regular health provider (OR=6.0) and information on providers' schedules and requirements for obtaining care services (OR=2.1). CONCLUSIONS: The low vaccination use and the relevant relationships to health care delivery systems characteristics show that there are barriers in the healthcare system, which should be assessed and eliminated. Non-availability of regular healthcare and deficient information to the population are factors that can limit service utilization.
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Bads, Enis, François Champagne, and Michéle Rivard. "Determinants of Ambulatory Physician Utilization among Adults with Chronic Diseases in Quebec." Journal of Health Services Research & Policy 3, no. 2 (April 1998): 82–91. http://dx.doi.org/10.1177/135581969800300205.
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Objectives: To test the explanatory power of a model of ambulatory service use and to determine the relative roles of the main determinants of physician utilization for two chronic medical conditions in adults in Quebec. Methods: A behavioral model based on Andersen's model was developed and tested by linking two databases: the Quebec health survey as regards patient characteristics, and the Quebec health insurance board data on physician characteristics and service use. Path analysis was used for data analysis. Results: The model explained a little less than 20% of the variation in service use. The number of hospitalizations, physician's specialty and perceived health were the most important predictors of the volume of visits. Conclusion: Further specification of utilization, relating it to a particular medical condition, does not necessarily lead to an increase in the explanatory power of the model. We recommend that future research should put more emphasis on provider-related determinants rather than focusing on the type and purpose of utilization.
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Mou, Chaozhou, Minlan Xu, and Juncheng Lyu. "Predictors of Undiagnosed Diabetes among Middle-Aged and Seniors in China: Application of Andersen’s Behavioral Model." International Journal of Environmental Research and Public Health 18, no. 16 (August 8, 2021): 8396. http://dx.doi.org/10.3390/ijerph18168396.
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Undiagnosed diabetes is a threat to public health. This study aims to identify potential variables related to undiagnosed diabetes using Andersen’s behavioral model. Baseline data including blood test data from the China Health and Retirement Longitudinal Study (CHARLS) were adopted. First, we constructed health service related variables based on Andersen model. Second, univariate analysis and multiple logistic regression were used to analyze the relations of variables to undiagnosed diabetes. The strength of relationships was presented by odds ratios (ORs) and 95% confidence intervals (CIs). Finally, the prediction of multiple logistic regression model was assessed using the Receiver Operating Characteristic (ROC) curve and the area under the ROC curve (AUC). According to diagnosis standards, 1234 respondents had diabetes, among which 560 were undiagnosed and 674 were previously diagnosed. Further analysis showed that the following variables were significantly associated with undiagnosed diabetes: age as the predisposing factor; medical insurance, residential places and geographical regions as enabling factors; having other chronic diseases and self-perceived health status as need factors. Moreover, the prediction of regression model was assessed well in the form of ROC and AUC. Andersen model provided a theoretical framework for detecting variables of health service utilization, which may not only explain the undiagnosed reasons but also provide clues for policy-makers to balance health services among diverse social groups in China.
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Aslam, Muhammad, Maryam Sadiq, and Tahir Mehmood. "Assessment of maternal health services utilization in Pakistan: the role of socio-demographic characteristics." Asian Biomedicine 14, no. 1 (July 13, 2020): 3–7. http://dx.doi.org/10.1515/abm-2020-0002.
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AbstractBackgroundHigh-quality prenatal care has a significant positive impact on maternal and infant health as it helps timely diagnosis and treatment of pregnancy complications.ObjectiveTo examine factors associated with the utilization of maternal health care using the optimal count regression model.MethodsA sample of 16,314 women of reproductive ages (15–49) was used. Andersen and Newman's behavioral model of health services utilization was employed for the selection of covariates. Poisson, negative binomial, zero-inflated Poisson, zero-inflated negative binomial (ZINB), Poisson hurdle, and negative binomial hurdle models were fitted and compared to identify the best model. Maternal health care utilization is found associated with maternal age and education, area of residence, domestic violence, the income level of family, access to media, knowledge about AIDS, parity, birth order, and having a child who later died.ResultsZINB model is found to be best fitted for the observed data resulting strong influence of mother's education and income level of the family on maternal health care utilization.ConclusionInterventions to improve maternal care services utilization should address individuals and systems to reduce social and economic marginalization.
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Liu, Zhongqi, Yawen Tan, Haiqing Liang, Yijun Gu, Xiaowen Wang, Yuantao Hao, Jing Gu, and Chun Hao. "Factors Influencing Residents’ Willingness to Contract With General Practitioners in Guangzhou, China, During the GP Policy Trial Phase: A Cross-Sectional Study Based on Andersen’s Behavioral Model of Health Services Use." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 56 (January 2019): 004695801984548. http://dx.doi.org/10.1177/0046958019845484.
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This study aimed to investigate the current contract rate and residents’ willingness to contract with general practitioner (GP) services in Guangzhou, China, during the policy trial phase, and also to explore the association of behavior contract and contract willingness with variables based on Andersen’s Behavioral Model of Health Services Use (ABM). In total, 160 residents from community health centers (CHCs) and 202 residents from hospitals were recruited in this study. The outcome variables were behavior contract and contract willingness. Based on the framework of ABM, independent variables were categorized as predisposing factors, enabling factors, need factors, and CHC service utilization experiences. Univariate and multivariate logistic regression analysis models were applied to explore the associated factors. Out of 362 participants, 14.4% had contracted with GP services. For those who had not contracted with GP services, only 16.4% (51 out of 310) claimed they were willing to do so. The contract rate for community-based participants was significantly higher than that for hospital-based participants. Major reasons for not choosing to contract were perceiving no benefit from the service and concerns about the quality of CHCs. Community health center experiences and satisfaction were significantly associated with contracting among hospital-based participants. A need factor (diagnosed with hypertension or diabetes) and CHC service utilization experiences (have gotten services from the same doctor in CHCs) were significantly associated with contract willingness among CHC-based participants. Intervention to improve awareness of GP services may help to promote this service. Different intervention strategies should be used for varying resident populations.
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Peng, Changmin, Jeffery A. Burr, Kyungmin Kim, and Nan Lu. "SOCIAL CAPITAL AND HOME- AND COMMUNITY-BASED SERVICE UTILIZATION AMONG URBAN OLDER CHINESE ADULTS." Innovation in Aging 3, Supplement_1 (November 2019): S637. http://dx.doi.org/10.1093/geroni/igz038.2372.
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Abstract Home- and Community-Based Services (HCBS) are increasingly important for older adults who want to maintain their independence and remain in their communities. Although HCBS systems have been developed widely in many western countries and in some countries in Asia, China is just beginning to grapple with its rapidly aging population by offering HCBS in a limited fashion. The purpose of this study was to investigate the relationship between structural (e.g., citizenship activities, volunteering) and cognitive (e.g., social trust, a sense of belonging) social capital and HCBS utilization among older Chinese adults. The study also examined the mediating effect of structural social capital for the the relationship between cognitive social capital and HCBS utilization. We frame the study within the Andersen behavioral model of health services utilization and argue that within this framework social capital is an enabling factor. We analyzed survey data from 456 community-dwelling older adults living in the Gusu district of the city of Suzhou, China in 2015. Structural equation modeling was used to test the hypothesized relationships. The results showed that both cognitive and structural social capital were significantly associated with HCBS utilization. Structural social capital also served as a mediator between cognitive social capital and HCBS utilization, even after controlling for sociodemographic characteristics and other relevant covariates. The findings supported the utility of employing Andersen’s behavioral model and social capital theory for better understanding older Chinese adults’ utilization of HCBS. Interventions for increasing social capital may be useful for improving HCBS utilization in Chinese urban communities.
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Stein, Judith A., Ronald Andersen, and Lillian Gelberg. "Applying the Gelberg-Andersen Behavioral Model for Vulnerable Populations to Health Services Utilization in Homeless Women." Journal of Health Psychology 12, no. 5 (September 2007): 791–804. http://dx.doi.org/10.1177/1359105307080612.
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Robinson, Kristen N., Heather L. Menne, and Raphael Gaeta. "Use of Informal Support as a Predictor of Home- and Community-Based Services Utilization." Journals of Gerontology: Series B 76, no. 1 (April 8, 2020): 133–40. http://dx.doi.org/10.1093/geronb/gbaa046.
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Abstract Objectives Home- and community-based services (HCBS) help older adults remain living safely in their homes by delaying or preventing the need for institutionalization. This analysis is guided by the Andersen Behavioral Model of Health Services Use to examine the association between informal support and use of HCBS. Method Health and Retirement Study data from 2011 and 2012 are used in the bivariate analyses and multivariate logistic regression models to examine differences in HCBS utilization among extremely vulnerable older adults who have informal caregivers and those who do not. Results For extremely vulnerable older adults who report difficulties with any instrumental or basic activities of daily living, use of HCBS is not strongly associated with access to informal caregivers. However, for this same population of extremely vulnerable older adults, those who live alone have roughly 3 times the odds of using any HCBS compared to those who do not live alone. Discussion Among already vulnerable older adults, this study revealed that living alone is an important enabling factor of the Andersen Behavioral Model as applied in HCBS research. Further investigation is needed to see if more resources should be allocated to senior centers and local providers to identify vulnerable older adults who live alone and may have unmet needs.
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Yang, M., and JC Barner. "PHP11: USE OF THE ANDERSEN HEALTH CARE SERVICES UTILIZATION BEHAVIORAL MODEL TO UNDERSTAND THE RELATIONSHIP BETWEEN HEALTH INSURANCE COVERAGE AND HEALTH CARE SERVICES UTILIZATION AMONG THE ELDERLY." Value in Health 4, no. 2 (September 2001): 172. http://dx.doi.org/10.1046/j.1524-4733.2001.40202-271.x.
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Chen, Honglin, Iris Chi, and Ruotong Liu. "Hospital Utilization Among Chinese Older Adults: Patterns and Predictors." Journal of Aging and Health 31, no. 8 (June 17, 2018): 1454–78. http://dx.doi.org/10.1177/0898264318780546.
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Objectives: Our study aimed to explore patterns and predictors of hospital utilization among Chinese older adults in the context of a rapidly aging population and increasing health care costs in contemporary China. Methods: This study used a national representative sample aged 60 years or older ( N = 11,511) from the China Longitudinal Aging Social Survey in 2014. We applied Andersen’s social behavioral model and stepwise logistic regression to identify predictors of hospital utilization. Results: About 25% of the respondents were hospitalized in the previous year. Level of literacy, rural residence, social support, intergenerational relationships, and negative perceptions of aging were significant factors predicting hospital utilization. However, major variations existed across provinces in the use of hospitals. Discussion: Conclusions regarding how to integrate the complex range of hospital services more effectively and evenly are described. Social services should be developed in response to the hospital services utilization needs of older people.
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McKernan, S. C., J. C. Reynolds, A. Ingleshwar, M. Pooley, R. A. Kuthy, and P. C. Damiano. "Transportation Barriers and Use of Dental Services among Medicaid-Insured Adults." JDR Clinical & Translational Research 3, no. 1 (June 9, 2017): 101–8. http://dx.doi.org/10.1177/2380084417714795.
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This study explores how travel distance and other transportation barriers are associated with dental utilization in a Medicaid expansion population. We analyzed data from the Iowa Dental Wellness Plan (DWP), which provides comprehensive dental benefits for low-income adults aged 19 to 64 y as part of Iowa’s Medicaid expansion. Transportation and geographical characteristics were evaluated as enabling factors within the framework of Andersen’s behavioral model of health services use. In March 2015, a random sample of DWP members ( n = 4,800) was surveyed; adjusted survey response rate was 30% ( n = 1,258).The questionnaire was based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Dental Plan Survey and assessed need for dental care, use of dental services and transportation to visits, and self-perceived oral health status. Respondent and dentist addresses were geocoded and used to calculate distance to the nearest DWP general dentist. A logistic regression model predicting utilization of dental care was developed using variables representing each domain of the behavioral model. Most respondents (57%) reported a dental visit since enrolling. Overall, 11% of respondents reported unmet dental need due to transportation problems. Median distance to the nearest general dentist was 1.5 miles. In the adjusted model, travel distance was not significantly associated with the likelihood of dental utilization. However, other transportation-related issues were significantly associated with utilization, including concern about cost of transportation and driver/passenger status. As concern about transportation cost increased, likelihood of having a dental visit decreased. Targeted approaches to assisting low-income populations with transportation barriers should be considered in designing policies and interventions to improve access to dental care. Knowledge Transfer Statement: The results of this study can be used by policy makers and public health planners when designing programs and interventions to improve access to dental care. Consideration of transportation availability and costs could improve utilization of routine dental care, especially among low-income populations.
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Rojjananukulpong, Rattanakarun, Mokbul Morshed Ahmad, and Shahab E. Saqib. "Disparities in Physical Accessibility among Rural Thais Under Universal Health Coverage." American Journal of Tropical Medicine and Hygiene 105, no. 3 (September 15, 2021): 837–45. http://dx.doi.org/10.4269/ajtmh.20-1627.
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ABSTRACT. This study aims to explore various barriers in accessing outpatient care among the participants from different age groups and to identify determinants associated with physician visits. The study had adopted Andersen’s Behavioral Model (ABM) of Health Services Use. A cross-sectional study design was adopted to collect data from 417 participants through a questionnaire survey. Poisson regression models were used to explore determinants for explaining the differences in outpatient care use. The regression results revealed that divergent relationships existed among age groups. Children and elderly participants tended to decrease the probability of seeking care. Elderly participants confronted more difficulties in access and were dependent on family members. Despite free care provisions, participants visited and spent their out-of-pocket expenditure mostly at non-universal health coverage (non-UHC) facilities. Convenience and the availability of specialist physicians led the higher-income parents to seek care of their children at non-UHC facilities. Highly educated people of working age preferred more self-care or institutionalized care to save time. Children up to the primary level of education were more likely to visit a doctor. We concluded that investments in education or well-informed health services provision would improve health care utilization. Findings of Andersen’s Behavioral Model variables suggested that improvements in the quality of services, medical professional skills, and efficient resource allocation may induce seeking care at UHC facilities. Consequently, it will reduce the number of referred cases, caseloads at tertiary care units, and visits to non-UHC facilities at longer distances.
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Mbalinda, Scovia N., Dan K. Kaye, Mathew Nyashanu, Noah Kiwanuka, and Robert Gaspar. "Using Andersen’s Behavioral Model of Health Care Utilization to Assess Contraceptive Use among Sexually Active Perinatally HIV-Infected Adolescents in Uganda." International Journal of Reproductive Medicine 2020 (September 28, 2020): 1–9. http://dx.doi.org/10.1155/2020/8016483.
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Background. Contraceptive practices of perinatally HIV-infected adolescents (PHIAs) have implications related to pregnancy prevention, risks of HIV heterosexual transmission, reinfection, and vertical transmission. The study assessed contraceptive use among sexually active PHIAs in Uganda. Methods. Mixed methods consisting of a survey and in-depth interviews were employed among 213 sexually active PHIAs who were attending antiretroviral therapy (ART) clinics. The study was guided by Andersen’s Behavioral Model of Health Service Use as a theoretical framework to identify factors that influence contraceptive use. These factors include health care factors, personal characteristics, enabling factors, and needs. The outcome was contraceptive use. Multivariable logistic regression was used to establish determinants of contraceptive use. Qualitative data were analyzed by thematic analysis. Results. Most PHIAs were female (67.6%); the mean (SD) and median (IQR) age was 17.5 (±1.4) and 18 (17-19) years. The mean age of sexual debut and at marriage were 15 (±1.7) and 17 (±1.1), respectively. Condoms were the most known method of family planning (indicated by 55.4%). Only 16.9% of the participants knew about dual protection (condom use for FP as well as HIV/STI prevention). Of the PHIAs, 43.6% had ever used modern contraception and 56.9% of the females had ever been pregnant. The odds of contraceptive ever-use were significantly higher among adolescents aged 17-19 years (OR 5.1, 95% CI: 2.1-13.3) compared to those aged 10-16 years, those in school (OR 1.8, 95% CI: 1.07-3.2) compared to those out of school, and those with perceived need to use FP (OR 2.0, 95% CI: 1.1-3.9) compared to their counterparts. The odds of contraceptive used were lower among females (OR 0.13, 95% CI: 0.06-0.28) compared to males. From the in-depth interviews, the attitude of health workers, availability of health workers, having a friend using family planning, and waiting time were viewed to affect contraceptive use. Conclusion. Contraceptive use among sexually active perinatally HIV-infected adolescents was (43.6%). However, out of those who used family planning majority were using short-term methods. The unmet need for family planning was high (47%) with high reports of pregnancy (56.9%). The factors associated with contraceptive use included education, age, sex (predisposing factors), and perceived need of family planning (need factors). Other factors that could affect contraceptive use from qualitative analysis included attitude of health workers, availability of health workers, having a friend using family planning (predisposing factors), and waiting time (health system factors). HIV care for adolescents should be promoted using SRH approach. There is a need to provide training for all providers to cater for SRH services. We should continue to provide youth-responsive adolescent sexual and reproductive health services across all ART facilities and build a supportive environment and continue to integrate SRH services into HIV care.
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Jin, Seok Won, Hee Yun Lee, and Jongwook Lee. "Analyzing Factors of Breast Cancer Screening Adherence among Korean American Women Using Andersen’s Behavioral Model of Healthcare Services Utilization." Ethnicity & Disease 29, Supp2 (June 13, 2019): 427–34. http://dx.doi.org/10.18865/ed.29.s2.427.
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Objectives: Regular uptake of mammography screening reduces the risk of advanced stage diagnosis of breast cancer (BC). However, BC screening rates remain suboptimal among Korean American (KA) women. Using the Andersen’s Behavioral Model of Healthcare Services Utilization, this study examined factors associated with mammography screening among KA women aged 50 to 80 years in the state of Georgia, USA.Methods: We used purposive sampling to recruit study participants in the Atlanta metropolitan area from May 2015 to February 2016. A total of 303 KA women completed a cross-sectional, self-report survey about their sociodemographics, health care access information, knowledge, self-efficacy, decisional balance, and mammography history.Results: Descriptive analyses confirmed low rates of mammography screening in the participants. Multiple logistic regression analyses showed that having a mammogram within the past year was associated with greater BC knowledge, higher scores of decisional balance and fewer annual health check-ups among KA women without any cancer history.Conclusions: The findings offer implications for health policy aimed at increasing BC screening by leveraging enabling factors among medically underserved KA women at both structural and cultural levels.Ethn Dis.2019;29(Suppl 2):427-434; doi:10.18865/ed.29.S2.427
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Finlayson, Marcia, and Julie DalMonte. "Predicting the Use of Occupational Therapy Services among People with Multiple Sclerosis in Atlantic Canada." Canadian Journal of Occupational Therapy 69, no. 4 (October 2002): 239–48. http://dx.doi.org/10.1177/000841740206900408.
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This secondary analysis examined the factors that predicted the use of occupational therapy services since diagnosis and over the past year among people with multiple sclerosis in Atlantic Canada. Data were gathered through a mail-out survey of members of the Multiple Sclerosis Society of Canada (Atlantic Division) in the winter of 1997/98. The Behavioral Model of Health Services Utilization (Andersen & Newman, 1973) was used to guide the analysis. Seeing greater numbers of health professionals, having a hospitalization in the past year, and having more functional limitations all increased the likelihood of seeing an occupational therapist, both since diagnosis and over the past year. These findings suggest that the organization and structure of the service system play a large role in the likelihood that a person with multiple sclerosis will see an occupational therapist in Atlantic Canada.
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Thurn, Tamara, Monika Brandstätter, Veronika Fensterer, Helmut Küchenhoff, and Martin Johannes Fegg. "Existential behavioral therapy for informal caregivers of palliative patients: Barriers and promoters of support utilization." Palliative and Supportive Care 13, no. 3 (June 6, 2014): 757–66. http://dx.doi.org/10.1017/s1478951514000546.
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AbstractObjective:Several interventions have been developed during recent years to support informal caregivers of palliative patients. However, these trials reported low enrollment rates. Employing a newly developed group intervention, existential behavioral therapy (EBT), one study reported that only 13.6% of approached informal caregivers participated. The purpose of our present study was to identify the reasons for this low enrollment rate in order to improve future support designs.Method:All participants in the EBT trial (intervention vs. standard-care control group) as well as those who declined participation during a 4-month recruitment period were studied prospectively over 12 months. Andersen's behavioral model of healthcare service use was employed to identify group differences between acceptors and decliners: predisposing (age, gender, education, family status, relationship), enabling (social support, distance to hospital, caring vs. bereaved), and need factors (psychological distress, quality of life) were evaluated in a binary-logistic model.Results:Some 94 decliners were compared to 160 EBT participants (n = 81 intervention, n = 79 control). Caregivers who took part were significantly more distressed and suffered from a lower quality of life compared to decliners. Not only these need factors but also predisposing (age <55 years) and enabling (use of social/professional support, familiarity with caregiving institution) factors were associated with EBT utilization. At the 12-month follow-up, EBT intervention participants reported greater quality of life improvements than decliners or controls (p = 0.05). While all groups had mean anxiety scores below the cutoff at 12-month follow-up, decliners showed better improvement in anxiety compared to EBT participants (intervention p = 0.04, controls p = 0.03).Significance of results:On average, decliners are less burdened: they may be more resilient, may have better coping strategies, or already have a sufficient support network in place. Screening caregivers with regard to their experienced quality of life and targeting those in need, especially younger caregivers with low levels of quality of life, may help to allocate resources more appropriately.
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Nelson, Cecelia I., Casey D. Wright, Jamey T. Brumbaugh, Katherine Neiswanger, Richard J. Crout, Christa L. Lilly, Mary L. Marazita, and Daniel W. McNeil. "Predictors of use of dental care by children in north-central Appalachia in the USA." PLOS ONE 16, no. 7 (July 22, 2021): e0250488. http://dx.doi.org/10.1371/journal.pone.0250488.
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Use of dental services in childhood, especially preventive care, is associated with many important oral health outcomes throughout life. The Andersen behavioral model of healthcare utilization posits that predisposing characteristics, enabling resources, and need factors predict utilization in oral and other healthcare domains. Inequities that produce lower utilization of dental services in north-central Appalachia have been documented in comparison to the USA generally. Additionally, within Appalachia, there are disparities, such as those across different states related to varying public policies and resources supporting healthcare. Predictors of dental utilization in Appalachia have been a focus in adults, but less so in children. The aim of the current study was to understand predictors of dental utilization in children in north-central Appalachia in order to inform future research about how to intervene to address these disparities. In this study, there were 1,178 children, ages 1 through 10 years, from selected representative counties in West Virginia and Pennsylvania, along with a parent/caregiver, who were part of the Center for Oral Health Research in Appalachia (COHRA1) cohort. Use of dental services by their child was indicated by parents/caregivers, who also reported on sociodemographic, dental care-related anxiety and fear, and values and attitudes associated with oral healthcare. Results indicated that use of professional dental services by children was related to child age, dental anxiety and fear, and parental oral health values and attitudes. Older children in this age group, those who evidenced more dental care-related anxiety and fear, and whose parent/caregiver placed higher value on oral health and healthcare for themselves, were more likely to have had a dental visit in the past year.
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Soleimanvandi Azar, Neda, Seyed Hossein Mohaqeqi Kamal, Homeira Sajadi, Gholam Reza Ghaedamini Harouni, Salaheddin Karimi, and Ameneh Setareh Foroozan. "Barriers and Facilitators of the Outpatient Health Service Use by the Elderly." Salmand 15, no. 3 (October 1, 2020): 258–77. http://dx.doi.org/10.32598/sija.15.3.551.3.
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Objectives: Increasing care needs for the elderly are an important concern for different countries, especially those with an aging population. It is important for health policy making to have knowledge of the factors affecting the use of health services in the elderly to identify the potential problems and develop appropriate interventions for improving utilization and increasing access to health services. This study aims to investigate the barriers and facilitators of the outpatient health service use in the elderly Methods & Materials: In this systematic review, studies in English published from 1996 to 2019 were searched in Web of Science, PubMed and Scopus databases using PRISMA guidelines and related keywords. After eliminating duplicate and irrelevant articles, the quality of remaining articles was evaluated by two evaluators independently, based on STROBE checklist. Narrative synthesis method was used to combine the data Results: Forty-four eligible studies were included for the review. The determinants of the health service use were divided into three categories of predisposing factors (e.g. age, gender, marital status, ethnicity), enabling factors (e.g. income, insurance coverage, education level, employment status, social network, social support), and need factors (e.g. having chronic disease, self-assessed health status, severity of disease, number of diseases, comorbid diseases, physical disability, unhealthy lifestyle). Findings showed that age >80 years, ethnic minority, being unemployed and retired, low educational level, small and limited social network, and physical disability were the barriers to using outpatient health services, while being female, married, having insurance, social support, having a companion during a disease, having children, high income level, and shorter distance to the health care centers were the facilitators of using outpatient health services in the elderly Conclusion: A group of factors are associated with the outpatient health service use by the elderly. These factors include predisposing, enabling, and need-related factors according to Andersen’s behavioral model of health service use. Interventions to increase the use of health services by the elderly should be based on these factors, and should be taken into account by the policymakers to reduce the burden of health services caused by diseases.
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Asano, Miho, Abby Eitzen, Karli Hawken, Lindsay Delima, and Marcia Finlayson. "Factors Associated with Postrelapse Rehabilitation Use in Multiple Sclerosis." International Journal of MS Care 21, no. 3 (May 1, 2019): 93–99. http://dx.doi.org/10.7224/1537-2073.2017-092.
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Abstract Background: Most people with multiple sclerosis (MS) have periodic and unpredictable relapses as part of their disease course. Relapses often affect functional abilities, resulting in diminished productivity and lower quality of life. Considering the effects, rehabilitation can play an important role in facilitating recovery; yet, the current literature suggests a lack of postrelapse rehabilitation services use. This study aims to document postrelapse rehabilitation services use and estimate the extent to which predisposing characteristics, perceived need, and enabling resources were associated with postrelapse rehabilitation services use in adults with MS. Methods: This cross-sectional study used convenience sampling, and data from 73 adults with MS who recently had a relapse in the United States and Canada were analyzed. Results: A total of 25 participants (34.2%) reported using postrelapse rehabilitation services. The regression model identified three variables associated with postrelapse rehabilitation services use: age (odds ratio [OR], 1.075), self-reported quality of life (considerably affected by the most recent relapse [OR, 5.717]), and presence of helpful health care providers (for obtaining postrelapse rehabilitation services [OR, 5.382]). Conclusions: Most participants experienced a range of symptoms or limitations because of their most recent relapse, affecting their daily activity and quality of life. However, only one-third of the participants reported using postrelapse rehabilitation services, which focused on the improvement of their physical health. Regression modeling revealed that three population characteristics of the Andersen Behavioral Model of Health Services Utilization were associated with postrelapse rehabilitation services use.
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Choi, Sunha. "Experiencing Financial Hardship Associated With Medical Bills and Its Effects on Health Care Behavior: A 2-Year Panel Study." Health Education & Behavior 45, no. 4 (November 8, 2017): 616–24. http://dx.doi.org/10.1177/1090198117739671.
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Using 2-year panel data, this study examined (1) whether experiencing financial hardship associated with out-of-pocket medical expenditures affected delaying/missing necessary health care in the following year; (2) whether such financial hardship mediated the effects of predisposing, enabling, and need characteristics on timely health care access (i.e., significant indirect effects); and (3)whether such mediating effects are different by chronic health status (i.e., moderated mediation) among U.S. adults. The 2011 National Health Interview Survey was linked to the 2012 Medical Expenditure Panel Survey. The sample includes 8,993 adults aged between 26 and 64 years. Among them, 1,089 reported having at least one chronic health condition that had caused activity limitations. Multiple-group path analysis was conducted using Mplus 7.2. Approximately 35% experienced financial difficulties paying medical bills, including 28% who were currently paying off medical debts. Almost 14% of the respondents reported delayed/missed necessary medical treatments. In addition to direct effects, predisposing, enabling, and need factors affected access to care indirectly via financial hardship, although significant moderated mediation was found by chronic health status. However, different from the Andersen’s behavioral model of health service utilization, the effect of financial hardship due to medical bills as a barrier to the timely use of necessary health services was not smaller among adults with chronic health conditions. Policy alternatives should be explored to provide affordable financing programs and adequate safety net health services to reduce the financial burden of health care for those who are financially vulnerable, especially those suffering from chronic health conditions.
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Stein, Judith A., Ronald M. Andersen, Marjorie Robertson, and Lillian Gelberg. "Impact of hepatitis B and C infection on health services utilization in homeless adults: A test of the Gelberg-Andersen behavioral model for vulnerable populations." Health Psychology 31, no. 1 (2012): 20–30. http://dx.doi.org/10.1037/a0023643.
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Bazargan, Mohsen, James Smith, Sharon Cobb, Lisa Barkley, Cheryl Wisseh, Emma Ngula, Ricky Thomas, and Shervin Assari. "Emergency Department Utilization among Underserved African American Older Adults in South Los Angeles." International Journal of Environmental Research and Public Health 16, no. 7 (April 2, 2019): 1175. http://dx.doi.org/10.3390/ijerph16071175.
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Objectives: Using the Andersen’s Behavioral Model of Health Services Use, we explored social, behavioral, and health factors that are associated with emergency department (ED) utilization among underserved African American (AA) older adults in one of the most economically disadvantaged urban areas in South Los Angeles, California. Methods: This cross-sectional study recruited a convenience sample of 609 non-institutionalized AA older adults (age ≥ 65 years) from South Los Angeles, California. Participants were interviewed for demographic factors, self-rated health, chronic medication conditions (CMCs), pain, depressive symptoms, access to care, and continuity of care. Outcomes included 1 or 2+ ED visits in the last 12 months. Polynomial regression was used for data analysis. Results: Almost 41% of participants were treated at an ED during the last 12 months. In all, 27% of participants attended an ED once and 14% two or more times. Half of those with 6+ chronic conditions reported being treated at an ED once; one quarter at least twice. Factors that predicted no ED visit were male gender (OR = 0.50, 95% CI = 0.29–0.85), higher continuity of medical care (OR = 1.55, 95% CI = 1.04–2.31), individuals with two CMCs or less (OR = 2.61 (1.03–6.59), second tertile of pain severity (OR = 2.80, 95% CI = 1.36–5.73). Factors that predicted only one ED visit were male gender (OR = 0.45, 95% CI = 0.25–0.82), higher continuity of medical care (OR = 1.39, 95% CI = 1.01–2.15) and second tertile of pain severity (OR = 2.42, 95% CI = 1.13–5.19). Conclusions: This study documented that a lack of continuity of care for individuals with multiple chronic conditions leads to a higher rate of ED presentations. The results are significant given that ED visits may contribute to health disparities among AA older adults. Future research should examine whether case management decreases ED utilization among underserved AA older adults with multiple chronic conditions and/or severe pain. To explore the generalizability of these findings, the study should be repeated in other settings.
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Conserve, Donaldson F., Juliet Iwelunmor, Guy-Lucien Whembolua, Yewande Sofolahan-Oladeinde, Michelle Teti, and Pamela J. Surkan. "Factors Associated With HIV Testing Among Men in Haiti: Results From the 2012 Demographic and Health Survey." American Journal of Men's Health 11, no. 5 (March 9, 2016): 1322–30. http://dx.doi.org/10.1177/1557988316635247.
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HIV testing serves as the gateway to HIV prevention and treatment. However, research examining men’s HIV testing behaviors in the Caribbean remains limited. The Andersen Behavioral Model of Health Services Utilization was used to examine factors associated with HIV testing among 7,354 men who participated in the 2012 Demographic and Health Survey conducted in Haiti. Few men (35%) reported having ever been tested for HIV. Logistic regression analyses revealed that HIV testing increased with education and wealth. Marital status was associated with HIV testing, with married men more likely to have been tested (adjusted odds ratio: 2.57, 95% CI [2.07, 3.19]) than unmarried men. Positive attitudes toward people living with HIV, indicated by willing to care for a relative who has HIV/AIDS, was also correlated with higher odds of having been tested (adjusted odds ratio: 1.28, 95% CI [1.08, 1.51]). Men who reported condom use during last sex were more likely to have been tested (odds ratio: 1.58, 95% CI [1.33, 1.88). The findings indicate that HIV testing rates remain low among men in Haiti and more efforts are needed to increase HIV testing among men who are not married, have low level of education, and engage in unprotected sex.
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Hlebec, Valentina. "Individual and Contextual Determinants of Social Homecare Usage in Slovenia/ Dispozicijski In Kontekstualni Dejavniki Uporabe Socialne Oskrbe Na Domu." Slovenian Journal of Public Health 53, no. 4 (December 1, 2014): 311–17. http://dx.doi.org/10.2478/sjph-2014-0034.
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Abstract Theory. Social homecare is important for older people, as it enables them to remain in their own homes during worsening health, thus relieving the burden on institutional facilities such as homes for the elderly or nursing homes and hospitals. Method. A representative survey of social homecare users was employed to assess determinants of the scope of social homecare in Slovenia. Multiple regression analysis was used to evaluate determinants defined by Andersen’s behavioral model that affect the scope of social homecare. Results. As expected, need (Functional impairment B = .378, P = 0.000) was the most important explanatory component, followed by availability of informal care network (Lives alone B = -.136, P = 0.000; Has children B = - .142; P = 0.000) and other contextual factors such as total costs of the services (B = -.075; P = 0.003) and temporal availability of services (B=-.075, P=0.012). The model explained 18% of variability in the scope of social homecare. Conclusion. This study showed that data on the individual level, as opposed to data on an aggregated level, show different determinants of social homecare utilization. Moreover, the results showed that social homecare is especially important in two circumstances: when older people have a high level of need and when they do not have access to informal care networks. Contextual factors had a moderate effect on the scope of social homecare, which shows universal access to the latter at the individual level.
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Baek, Suyon, Eun-Hi Choi, and Jungeun Lee. "Unmet Healthcare Needs of Children in Vulnerable Families in South Korea: Finding from the Community Child Center Child Panel Survey." International Journal of Environmental Research and Public Health 17, no. 21 (November 7, 2020): 8241. http://dx.doi.org/10.3390/ijerph17218241.
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Presented in this paper is a study that examined the status of unmet healthcare needs of children in vulnerable families and identified factors affecting such unmet needs. The Community Child Center (CCC) Child Panel Survey data in Korea were used. A multiple stepwise logistic regression analysis was performed to examine factors influencing unmet healthcare needs of children. Influencing factors comprised predisposing, enabling, and need factors based on the Andersen Behavioral Model of Health Services Utilization. A total of 340 sixth-graders from vulnerable families participated, and 96 (28.2%) children had unmet healthcare needs. Factors included absence of an after-school caregiver (OR = 1.95, 95% CI [1.16, 3.27]), perceived physical symptoms (OR = 1.33, 95% CI [1.02, 1.73]), parental indifference (OR = 1.33, 95% CI [1.002, 1.77]), duration of daily stay at CCCs (OR = 1.32, 95% CI [1.01, 1.71]), and satisfaction with CCC teachers (OR = 0.65, 95% CI [0.49, 0.85]). The relationship with parents and CCC teachers had the strongest influence on unmet healthcare needs of children. In order to reduce the unmet healthcare needs of children in vulnerable families, existing support structures should be expanded to offer financial and administrative support for children’s parents and CCC teachers.
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Bajracharya, Rashmita, and Danya Qato. "PATTERNS OF PSYCHOACTIVE MEDICATION USE IN COMMUNITY-DWELLING OLDER ADULTS IN THE UNITED STATES IN 2015." Innovation in Aging 3, Supplement_1 (November 2019): S710. http://dx.doi.org/10.1093/geroni/igz038.2608.
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Abstract Per the 2015 Beer’s Criteria, most psychoactive medications are identified as potentially inappropriate for use in older adults as this population is especially vulnerable to the potential adverse effects associated with psychoactive medications, including sedation, anticholinergic effects, and falls. Past studies found increasing use of psychoactive medications in community-dwelling older adults; however, patterns of use by other sociodemographic, socioeconomic, and clinical subgroups have not been explored. This is a cross-sectional analysis of 2015 Medical Expenditure Panel Survey in a sample of 6122 older adults (60-85 years). We utilized Andersen’s Behavioral Model of Health Services Utilization to guide logistic regression model development and estimated odds ratios (OR) with 95% confidence intervals (CI) to quantify the association between psychoactive use and predisposing(sex and race); enabling(marital status, education, poverty, insurance); and need-based[multi-morbidity and activities of daily living (ADL) limitations] factors. Over 30% of older adults in the U.S. reported taking a psychoactive medication in 2015. Prevalence of use was significantly higher in women (35.9%), the unmarried(34.1%), low-income(35.7%), white(34.0%), multimorbid (32.0%), and ADL limitation groups (45.9%) compared to men, married, high-income, other races, not multimorbid, and no ADL limitations groups, respectively. Female sex [OR=1.62(1.38-1.91)], low-income [OR=1.30(1.04-1.6)], multimorbidity [OR=3.2(2.6-3.9)], and ADL limitations [OR=2.2(1.7-2.8)] were identified as independent predictors of psychoactive use. There is differential use of psychoactive medications by sociodemographic, socioeconomic, and clinical factors. Given the increased complexity of pharmacotherapy regimens, especially in those with multimorbidity and ADL limitations, improved efforts aimed at prudent use of psychoactive medications should be intensified.
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Yang, Kyung Eun, and Il Sung Nam. "Factors Associated with Health Examination Service Utilization among Elderly Immigrants: Using the Andersen’s Behavioral Model." Contemparary Society and Multiculture 10, no. 4 (November 30, 2020): 147–77. http://dx.doi.org/10.35281/cms.2020.11.10.4.147.
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Dhingra, Satvinder S., Matthew Zack, Tara Strine, William S. Pearson, and Lina Balluz. "Determining Prevalence and Correlates of Psychiatric Treatment With Andersen's Behavioral Model of Health Services Use." Psychiatric Services 61, no. 5 (May 2010): 524–28. http://dx.doi.org/10.1176/ps.2010.61.5.524.
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THIND, AMARDEEP. "ANALYSIS OF HEALTH SERVICES USE FOR RESPIRATORY ILLNESS IN INDONESIAN CHILDREN: IMPLICATIONS FOR POLICY." Journal of Biosocial Science 37, no. 2 (March 16, 2004): 129–42. http://dx.doi.org/10.1017/s002193200300645x.
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Respiratory illness continues to be a leading cause of paediatric morbidity and mortality in Indonesia. The Indonesian government is moving towards a more managed care-based approach as it reforms its health care system following the 1997 financial crisis. In order to better design contractual relationships between the payor and different providers, there needs to be a better understanding of the patterns and predictors of health services utilization for respiratory illness. This study uses the Indonesia Demographic and Health Survey to study the determinants of private, public and non-formal provider utilization for respiratory illness. Multinomial logistic regression models for predicting use were constructed using the Andersen Behavioural Model as the conceptual framework. The findings indicate that age, household size, maternal education, religion, the asset index, location and illness severity play a role in determining use of private, public or non-formal providers. The results indicate that from a policy perspective, the Indonesian government needs be inclusive rather than exclusive in the choice of providers that are contracted by the managed care plans, in order to safeguard the health of the under-five population.
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Porteous, Terry, Sally Wyke, Philip Hannaford, and Christine Bond. "Self-care behaviour for minor symptoms: can Andersen's Behavioral Model of Health Services Use help us to understand it?" International Journal of Pharmacy Practice 23, no. 1 (April 15, 2014): 27–35. http://dx.doi.org/10.1111/ijpp.12116.
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Tareke, Asenake Abebaw, Yohannes Moges Mittiku, Animut Tagele Tamiru, Bayew Kelkay Rade, and Temesgen Worku Gudayu. "Underutilization of the recommended frequency of focused antenatal care services in Northwest Ethiopia: Using Andersen's healthcare service utilization model approach." Clinical Epidemiology and Global Health 11 (July 2021): 100746. http://dx.doi.org/10.1016/j.cegh.2021.100746.
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Roh, Soonhee, Yeon-Shim Lee, and Heehyul Moon. "Predictors of Breast Cancer Screening Behaviors Among American Indian Women in the Northern Plains." Innovation in Aging 4, Supplement_1 (December 1, 2020): 107. http://dx.doi.org/10.1093/geroni/igaa057.354.
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Abstract Purpose: This study examined predictive models of the utilization of mammograms among American Indian women adapting Andersen’s behavioral model. Using a sample of 143 American Indian women residing in the Northern Plains. Methods: Data were collected using a self-administered survey completed by 143American Indian women over the age of 45 in the Midwest. Logistic regression analyses were conducted to assess predisposing (age and marital status), need (personal and family cancer history), and enabling factors (education, monthly household income, mammogram screening awareness, breast cancer knowledge, self-rated health, and cultural practice to breast cancer screening). Results: Nested logistic regression analyses indicated that only 55.5% of participants reported having had a breast cancer screening within the past 2 years, whereas 21.0% never had a mammogram test. After controlling for predisposing and need factors, higher education, greater awareness of mammogram, and higher utilization of traditional Native American approaches were significant predictors of mammogram uptake. Conclusions: The findings highlight important implications for intervention strategies aimed at improving breast cancer screening and service use among American Indian women. Educating health professionals and American Indian community members about the importance of breast cancer screening is highly needed. It is critical to assess a woman’s level of traditional beliefs and practices and its possible influence on screening participation and future screening intention. Given the findings, prevention and intervention strategies, including public awareness and education about breast cancer screening are promising avenues to reduce screening disparities among American Indian women.
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Roh, Soonhee, Yeon-Shim Lee, Kyoung Hag Lee, and Jung Sim Jun. "CORRELATES OF BREAST CANCER SCREENING BEHAVIORS AMONG INDIGENOUS WOMEN." Innovation in Aging 3, Supplement_1 (November 2019): S246. http://dx.doi.org/10.1093/geroni/igz038.923.
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Abstract Cervical cancer remains a significant cause of morbidity and mortality among women globally; yet cancer burden is unevenly distributed among racial/ethnic groups. With 12,820 new cases in 2017 in the U.S., cervical cancer is the top cause of death among Indigenous women. Indeed, cervical cancer mortality rates among AI women in South Dakota are five times the national average and 79% higher compared to Whites in that region. This study examined predictive models of utilization of mammograms among Indigenous women adapting Andersen’s behavioral model. Using a sample of 285 Indigenous women residing in South Dakota, nested logistic regression analyses were conducted to assess predisposing (age and marital status), need (personal and family cancer history), and enabling factors (education, monthly household income, mammogram screening awareness, breast cancer knowledge, self-rated health, and cultural practice to breast cancer screening). Results indicated that only 55.5% of participants reported having had a breast cancer screening within the past 2 years, whereas 21.0% never had a mammogram test. After controlling for predisposing and need factors, higher education, greater awareness of mammogram, and higher utilization of traditional Native American approaches were significant predictors of mammogram uptake. The results provide important implications for intervention strategies aimed at improving breast cancer screening and service use among Indigenous women. Educating health professionals and Indigenous community members about the importance of breast cancer screening is highly needed. It is critical to assess a woman’s level of traditional beliefs and practices and its possible influence on screening participation and future screening intention.
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You, Hua, Ting Yu, Hai Gu, Yun Kou, Xin-peng Xu, Xiao-lu Li, Nan Cui, and Lan Bai. "Factors Associated With Prescribed Antenatal Care Utilization: A Cross-Sectional Study in Eastern Rural China." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 56 (January 2019): 004695801986543. http://dx.doi.org/10.1177/0046958019865435.
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With relatively sufficient antenatal health service supplies in eastern rural China, the utilization still needs to be improved. The objective of this study was to identify factors that correlate with antenatal care (ANC) utilization from the demand-side in Jiangsu, China. In a cross-sectional survey, a sample of 896 rural women who had a childbearing history in the previous 5 years answered ANC questions and formed the final analysis. Questionnaire was designed based on Andersen’s behavioral model. The outcome variables included receiving times and items of prescribed ANC utilization, and the explanatory variables were organized into 3 hierarchical levels: predisposing, enabling, and need factors. Univariate analysis and multivariate logistic regression analysis were conducted. In the results of multivariate logistic regression, factors significantly associated with ANC examination times included income, odds ratio (OR) (95% confidence interval [CI]) = 2.90 (1.92-4.39); the distance from the nearest hospital, OR (95% CI) = 0.67 (0.47-0.95); chronic disease, OR (95% CI) = 1.77 (1.15-2.72); and parity, OR (95% CI) = 0.66 (0.46-0.95), while factors significantly associated with ANC examination items included education, OR (95% CI) = 8.02 (1.08-59.67); income, OR (95% CI) = 3.90 (1.72-8.85); female medical staff in towns and villages, OR (95% CI) = 2.64 (1.39-5.02); and parity, OR (95% CI) = 0.41 (0.23-0.75). In reducing inadequate ANC utilization in rural area, efforts should be made not only to target the rural women with lower income, lower educational level, and multi-parity, but also to further improve the accessibility of the primary medical facilities and female staff at the grassroots level.
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Hoff, Alexandra, Cheyenne Hughes-Reid, Erica Sood, and Meghan Lines. "Utilization of Integrated and Colocated Behavioral Health Models in Pediatric Primary Care." Clinical Pediatrics 59, no. 14 (July 19, 2020): 1225–32. http://dx.doi.org/10.1177/0009922820942157.
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Integrating behavioral health services within pediatric primary care may help address barriers to these services for youth, especially the underserved. Models of primary care behavioral health include coordinated, colocated, integrated, and collaborative care. This study began exploring the comparative utility of these models by investigating differences in the demographics and diagnoses of patients seen for a behavioral health warm handoff (integrated model) and a scheduled behavioral health visit (colocated model) across 3 pediatric primary care sites. The 3 sites differed in their rates of warm handoff usage, and there were differences in certain diagnoses given at warm handoffs versus scheduled visits. Depression diagnoses were more likely to be given in warm handoffs, and disruptive behavior, trauma/adjustment, and attention-deficit/hyperactivity disorder–related diagnoses were more likely to be given in scheduled visits. These results have implications for the influence of office structure and standardized procedures on behavioral health models used in pediatric primary care.
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Başar, Dilek, Selcen Öztürk, and İsmail Cakmak. "An application of the behavioral model to the utilization of health care services in Turkey: A focus on equity." Panoeconomicus, no. 00 (2020): 6. http://dx.doi.org/10.2298/pan171121006b.
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The aim of this study is to investigate the equity phenomenon, which can be defined as an equal treatment for equal need irrespective of socio-economic status, in the utilization of health care services in Turkey (for out-patient and in-patient treatment services, separately) in the context of the behavioral model. We have used the ?Health Surveys? obtained from the Turkish Statistical Institute for 2010, 2012 and 2014. The equity phenomenon and the determinants of the health care utilization are investigated by using the probit model. The findings indicate that the need variable has the largest marginal effect in magnitude for all types of health care. This implies that the health system structure in Turkey is based on need and, therefore, equity exists in the utilization of health care services. We have also found that health insurance has the second largest marginal effect after the need variable. This means that policy makers should focus on enabling factors, especially the coverage of health insurance and the level of income to increase health care utilization of the disadvantaged segments of the population.
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O'Connor, Genevieve Elizabeth. "The impact of insurance coverage on consumer utilization of health services." International Journal of Bank Marketing 33, no. 3 (May 18, 2015): 276–97. http://dx.doi.org/10.1108/ijbm-05-2014-0061.
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Purpose – The purpose of this paper is to identify how need for service, enabling factors and pre-disposing characteristics influences access to service. In addition, the authors seek to examine the moderating influence of pre-disposing variables on the relationship between insurance and health services utilization. Design/methodology/approach – The authors utilize data from a major metropolitan hospital in the USA to test and extend the behavioral model of health care. Findings – Results indicate that insurance and pre-disposing variables have a direct impact on type of health service utilization. However, the insurance effect is found to vary by demographic factors. Research limitations/implications – This paper is limited to secondary data. Future work can incorporate both attitudinal and behavioral measures to obtain a more comprehensive evaluation of services access. Practical implications – The research offers a tactical framework for management to segment consumer markets more effectively. Social implications – Through the framework, management will have the requisite knowledge to target segmented populations based on need, insurance, and pre-disposing variables which will help improve access to services and clinical outcome. Originality/value – The findings of this paper will serve as a basis for future research exploring the influence of insurance on access to services.
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Lee, Mi Hwa, Joseph R. Merighi, and Hee Yun Lee. "Factors Associated with Mammogram Use in Korean American Immigrant Women." American Journal of Health Behavior 43, no. 6 (November 1, 2019): 1075–85. http://dx.doi.org/10.5993/ajhb.43.6.6.
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Objectives: In this study, we assessed breast cancer screening in Korean American immigrant women and identified factors associated with adherence to American Cancer Society mammography screening guidelines. Methods: We carried out a cross-sectional survey with 182 Korean American immigrant women in Los Angeles County, California. Andersen's Behavioral Model of Health Services Use guided this study's design and analysis. We used hierarchical logistic regression to identify predisposing, enabling, and need factors associated with mammography adherence. Results: Nearly all respondents (95.1%) had a mammogram at some point in their lifetime. Mammography adherence based on age was 22.2% (45-49 years), 29.0% (50-54 years), and 67.7% (55 years and older). The strongest correlates of mammogram adherence were having a regular primary care check-up and hearing about a mammogram experience from family members, friends, or neighbors. Awareness of free or low-cost mammogram service, family cancer history, and having fatalistic beliefs also were associated with mammogram adherence. Conclusions: The findings highlight the primacy of health education messages that emphasize the importance of regular check-ups and personal screening experiences to promote mammography use in this population. Additional research is needed to understand Korean American immigrant women's perspectives on breast cancer and breast cancer screening in relation to fatalism.
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Washington, Tiffany, Eunhye Kim, George Mois, and Matthew Smith. "Factors Associated With Health Care Utilization Among Working Caregivers." Innovation in Aging 4, Supplement_1 (December 1, 2020): 721. http://dx.doi.org/10.1093/geroni/igaa057.2551.
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Abstract This study examined factors associated with health care utilization among working family caregivers using data from the 2013 Regional Healthcare Partnership – Region 17 Health Assessment survey. Anderson’s Behavioral Model of Health Services Use guided the selection of variables. Chi-square or t-test were computed to compare statistically significant differences between caregivers who did and did not utilize health care, and logistic regression was employed to identify factors associated with health care utilization. Of the 220 working caregivers, 41.8% put off their health care primarily because they could not miss work. Age, days pain limited activity, and days not having enough rest or sleep were associated with health care utilization. Paid family leave could mitigate the challenge of simultaneously managing employment responsibilities, caregiving tasks, and health needs of working family caregivers.
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Han, Woojae, and Allison Redlich. "Racial/Ethnic Disparities in Community Behavioral Health Service Usage: A Comparison of Mental Health Court and Traditional Court Defendants." Criminal Justice and Behavior 45, no. 2 (November 10, 2017): 173–94. http://dx.doi.org/10.1177/0093854817739045.
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Mental health courts (MHCs) are diversion programs for offenders with mental illness. Research has demonstrated that MHC participants receive more treatment than traditional court participants. However, little is known about racial/ethnic disparities in community treatment utilization among MHC participants compared with traditional court participants. The present study aimed to fill this gap. Data are from the MacArthur MHC Project which includes objective and subjective information from four MHC samples with traditional court samples at each site. Within the traditional court sample, African Americans were less likely than Whites to receive mental health and substance abuse services. However, significant racial/ethnic disparities were not found for the MHC sample. In an interaction model, African Americans were still less likely to use substance abuse services (but not mental health services) compared with the Whites. However, African American MHC participants utilized more substance abuse services than their counterparts. Policy and practice implications are discussed.
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Kissi, Jonathan, Baozhen Dai, Courage SK Dogbe, Jonathan Banahene, and Oyeh Ernest. "Predictive factors of physicians’ satisfaction with telemedicine services acceptance." Health Informatics Journal 26, no. 3 (December 19, 2019): 1866–80. http://dx.doi.org/10.1177/1460458219892162.
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Despite the significant increase in telemedicine services technology, its adoption and use have been quite slow in some healthcare settings. It is generally accepted in today’s globalizing world that the success of telemedicine services relies on users’ satisfaction. Satisfying physicians and patients is one of the crucial objectives of telemedicine success. This study seeks to evaluate physicians’ satisfaction with telemedicine services adoption and utilization using the technology acceptance model. A structured questionnaire based on the construct of technology acceptance model was used to solicit for data from participants in four different government health institutions. Purposive and convenience sampling techniques were employed to select healthcare professionals from various medical fields. Structural equation modeling was utilized in the data analysis. Perceived ease of use and perceived usefulness of telemedicine services were found to influence physicians’ behavioral intentions. This resulted in increased efficiency, quality of services, quality patient care delivery, and satisfaction among physicians in using telemedicine services. We noted that the adoption of telemedicine services in clinical settings depends on physicians’ and patients’ satisfaction with the use of the service. The study contributes to empirical knowledge by identifying the vital predictive factors affecting telemedicine services satisfaction among physicians.
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Mody, Makarand, Courtney Suess, and Tarik Dogru. "Restorative Servicescapes in Health Care: Examining the Influence of Hotel-Like Attributes on Patient Well-Being." Cornell Hospitality Quarterly 61, no. 1 (October 8, 2019): 19–39. http://dx.doi.org/10.1177/1938965519879430.
Full textAbstract:
This study examines how 527 patients across different health states assessed the influence of hotel-like attributes on their well-being. Using theoretical mechanisms of attention restoration underlying restorative servicescapes, we postulated that hotel-like products and services will enhance patients’ perceived well-being, which, in turn, will favorably affect their behavioral intentions. We also tested an alternative model that included additional direct relationships between hotel-like products and services and behavioral intentions, based on the tenets of cue utilization theory. After conducting a series of nested model comparison procedures, we confirmed that the alternative model provided a theoretically and empirically stronger explanation for the dynamics of hotel-like restorative servicescapes. Although the differences between less healthy and more healthy patients were not statistically significant, the less healthy group demonstrated the same pattern of relationships as in the overall model, indicating that such patients may be more likely to derive greater restorative benefits from hotel-like hospital rooms, which may also make them more likely to pay higher out-of-pocket expenses for such rooms. The study furthers the empirical research agenda on evidence-based design (EBD) and the role of hospitality in health care.
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DeBate, Rita DiGioacchino, Amy Gatto, and Gregor Rafal. "The Effects of Stigma on Determinants of Mental Health Help-Seeking Behaviors Among Male College Students: An Application of the Information-Motivation-Behavioral Skills Model." American Journal of Men's Health 12, no. 5 (May 11, 2018): 1286–96. http://dx.doi.org/10.1177/1557988318773656.
Full textAbstract:
Considered a public health issue, the prevalence and severity of poor mental well-being on college campuses has continued to rise. While many college campuses offer mental health counseling services, and utilization rates are increasing, their proportional usage is low especially among males, who often deal with poor mental well-being by adopting unhealthy coping strategies. The purpose of this study was to use the Information-Motivation-Behavioral Skills (IMB) model to assess the relationship between the determinants as factors that may impact help-seeking behaviors in a large sample ( n = 1,242) of male college students. Employing a cross-sectional study design, a 71-item online survey assessed information via total mental health literacy (MHL), motivation via attitudes toward mental health and subjective norms regarding mental health, and behavioral skills via intentions regarding help-seeking behaviors, and stigma. Results revealed correlations between information and motivation ( r = .363, p < .01), information and behavioral skills ( r = .166, p < .01), and motivation and behavioral skills ( r = .399, p < .01). Multiple regression was used to determine stigma is a mediator for all relationships. These findings represent an opportunity to take a public health approach to male mental health through developing multilayered interventions that address information, motivation, behavioral skills, and stigma.
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Sorrell, Tanya R., and Rosario Medina. "177 Treating Chronic Pain and Preventing Opioid Use Disorders in the Underserved: An Integrated Primary Care Model." CNS Spectrums 25, no. 2 (April 2020): 312. http://dx.doi.org/10.1017/s1092852920000929.
Full textAbstract:
Abstract:This poster builds on the CDC pain management guidelines and the current ASAM recommendations for substance use assessment to build an integrated primary care model for holistic chronic pain management in an urban, underserved primary care clinic. Using a case from our Federally Qualified Health Care Center, which operates in a southwest Denver clinic, a program of integrated care assessment, diagnosis, and holistic treatment planning is outlined for this client with chronic pain, physical, and behavioral health issues. Using a comprehensive care approach for complex clients, which are typical presentations for urban, underserved clients, we discuss the utilization of best practices in medication management for chronic pain (Alternatives to Opioids (ALTOS), prescribed and complementary and alternative practices (e.g., PT, acupuncture, etc), and behavioral health services (psychiatric assessment and treatment, psychotherapy, support groups, etc) to improve outcomes for our clients.