A Structural Equation Modeling Approach to Exploring the Determinants of Regular Medical Checkups in a United States-Mexico Border Community: An Application of Andersen's Behavioral Model of Health Service Use.

Determining Prevalence and Correlates of Psychiatric Treatment With Andersen's Behavioral Model of Health Services Use

Despite its effectiveness as a preventive measure, minority women are less likely to obtain screening mammograms. Although numerous studies have examined factors associated with mammography utilization and women's adherence to mammography screening guidelines, less attention has been directed to mammography adherence among Asian Americans and how nativity influences adherence. Asian Americans may be one of the fastest growing racial/ethnic groups in the United States, but remains one of the most poorly understood minorities in terms of screening mammography adherence. Using an adapted Andersen's Behavioral Model of Health Services Use and data from the California Health Interview Survey (2001-2009), this study sought to determine the relationship between predisposing, enabling, and need factors on mammography adherence among Asian Americans and to determine if it varied by nativity. The sample included 8,353 Asian Americans with 80.2% foreign-born. A multivariate logistic regression models were used to explore the association between enabling, predisposing, and need factors to screening mammography. The factors associated with screening mammography varied by nativity. Among U.S.-born Asian females, mammography adherence was associated with current smokers, prior cancer prevention health service use, Asians over the age of 65 years old, household size, speaking English very good or well and being uninsured. Among foreign-born Asian females, mammography adherence is associated with being overweight, sedentary, prior cancer prevention health service use, age (50-64 years old), household size, marital status, health insurance, and having one or more chronic conditions. Understanding the factors that impact mammography adherence may inform intervention strategies. Citation Format: ThuyQuynh Ngoc Do, M. Kristen Peek. Factors associated with screening mammography in Asian Americans: Test of the Andersen's Behavioral Model of Health Services Use. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A78. doi:10.1158/1538-7755.DISP13-A78

Predictors of Likelihood and Intensity of Past-Year Mental Health Service Use in an Active Canadian Military Sample

Mental health service use among those with depression: an exploration using Andersen's Behavioral Model of Health Service Use

BackgroundIn Nepal, sexual relationships outside of the traditional arranged marital system are increasingly common. Despite the availability of modern sexual health care, research on how to effectively deliver sexual health services to unmarried young adults in Nepal is limited.ObjectiveThis study examined key theoretical correlates between Andersen's Behavioral Model of Health Service Use and actual sexual health service use among unmarried young adults (aged 18 to 25) in Kathmandu, Nepal.MethodsUnmarried young adults between 18 and 25 were recruited from colleges and universities in the Kathmandu area. A total of 110 women and 93 men completed the survey (n = 203). Using a cross-sectional correlational design, the analysis involved descriptive statistics, bivariate analysis, and logistic regression.Findings and conclusionsApproximately 37% of participants reported engaging in sexual intercourse, with 55.7% reporting condom use during most recent intercourse. Less than half (39.1%) were aware of available sexual health services, and less than one-third (26.6%) were aware of Human Papillomavirus (HPV). Over a third of participants (40.9%) reported experiencing unwanted sexual contact, and 5.9% had a history of forced sexual intercourse. The actual reported sexual health service use within the past 12 months was 13.9%. Logistic regression analyses showed higher perceived youth friendliness of the health system (OR: 1.19; CI: 1.01–1.39; p < .05), sexual attraction to the same or both sexes (OR: 2.91; 95%; CI: 1.54–5.50; p < .01), higher perceived sexual risk (OR: 1.33; 95%; CI: 1.11–1.59; p < .01), as well as prior health awareness and behaviors (e.g., cigarette consumption, dating app use), were statistically significant correlates of sexual health service use. These findings indicate a need for further research to understand the experiences of Nepalese young adults with sexual healthcare and essential elements of youth-friendly health systems.

Introduction One in three Americans is sleep deprived, sleep disturbances are associated with greater health service utilization and costs. This study examined factors associated with Emergency Department visits (ED) and overnight admission hospitalization (OA) in a large representative sample of adults aged ≥18 in the US. Methods Guided by Andersen's Behavioral Model of Health Service Use, zero-inflated negative binomial and multivariable logistic regressions were used to examine associations between predisposing, enabling, and health needs factors and health service utilization (α=0.05). Results ED visits significantly increased with age, female sex, Black race, and less than high school education (15%, 36%, and 85%, respectively). Enabling factors analysis found that those who were unemployed, had problems paying medical bills, lived under the federal poverty line, and did not have private insurance were more likely to have ED visits. ED visits also increased by health needs including adults reporting poor/fair health, increased number of chronic conditions, and very short or long sleep. Regarding OA, significant risk predisposing factors included female sex and foreign-born nativity. Factors for OA found adults who were unemployed and had with problems paying bills were more likely to be hospitalized. Adults with Medicaid, Medicare, and other insurance were more likely (70%, 34%, 44%, respectively) to be hospitalized. Of the health needs factors examined, OA odds increased for those with less than excellent health status, without a usual source of care, and an increased number of chronic conditions. Adults with very short or short sleep were also more likely to be hospitalized (48% and 22%, respectively). Conclusion This is the first-time sleep duration is examined as a health needs component of Andersen's Behavioral Model of Health Service Use. When determining predictors associated with hospital utilization, sleep duration should be considered a key factor as it significantly increases the odds of ED visits and overnight hospital admissions. Future studies should investigate the influence of other dimensions of sleep health and sleep disorders. Support (if any) Programs to Increase Diversity among individuals engaged in Health-Related Research (PRIDE) training grant from the National Institutes of Health (NIH) National Heart, Lung, and Blood Institute (NHLBI): R25HL-10-5444 (PIs: G Jean-Louis, OG Ogedegbe).

The health care of adolescents and young males is an urgent task, since demographic, socio-economic, intellectual, scientific, manufacturing, cultural and defense resources of the Russian Federation depends on it. Objective. To analyze the problems of organization of the regular medical check-up of young males aged 15—17 years with cardiometabolic diseases. Material and methods. The coverage of young males aged 15—17 years with cardiovascular diseases, obesity and diabetes mellitus by the regular medical check-up in children’s outpatient clinics of Saint-Petersburg was analyzed. The source of information was the annual reporting forms of the federal statistical observation №12 «Data on the number of diseases registered in patients living in the service area of the health facility» for 2015—2022. Content analysis of the regulatory documents governing the organization of regular medical check-up in young males aged 15—17 years was done. Results. The proportion of young males aged 15—17 years with diseases of the circulatory system, who were under regular medical check-up in children’s outpatient clinics in 2015—2022, varied from 30.7% to 41.3%. The increase of the coverage of young males aged 15—17 years with diseases of the circulatory system by the regular medical check-up was 27.8% in the analyzed period. Thus, there has been a tendency of gradual increase of this indicator (R2=0.99). The proportion of young males aged 15—17 years with arterial hypertension, who were under regular medical check-up in children’s outpatient clinics, ranged from 61.0% to 76.9%, and the increase in the indicator for the analyzed period was 26.1%. It has been established that the coverage of obese young males by the regular medical check-up varied from 36.5% to 37.0%, and this indicator has not changed in 2015—2022 (R2=0.44). The growth in the coverage indicator of young males with diabetes mellitus aged 15—17 years by the regular medical check-up increased by 6.6%, and its values in different years ranged from 74.3% to 84.5%. According to the regression analysis, there has been no significant improvement over the past period, and the trend line had a multidirectional character due to the change of the positive trend to negative (R2=0.85). The target values of the coverage of young males aged 15—17 years with cardiometabolic diseases by regular medical check-up established in regional and federal regulations are not reached in Saint-Petersburg. Correlation relationship between the coverage of young males by regular medical check-up in children’s outpatient-polyclinic facilities in the districts of Saint-Petersburg in the 2020—2022 period and the proportion of individuals, considered not suitable for military service by the results of the military physician board in the same period, has been found (r=–0.28; p&lt;0.05). Conclusion. The obtained data show the importance of qualitative regular medical check-up in children’s outpatient-polyclinic network for training of young males for military service. The study demonstrated the expediency of preventive activity enhancement in children’s outpatient-polyclinic facilities of Saint-Petersburg to increase the coverage of young males with cardiometabolic diseases by the regular medical check-up.

In many European countries including Germany, migrants utilize preventive services less frequently than the majority population. This is also true for the utilization of dental checkups. Little is known about which demographic, social, behavioral, and health-related factors influence the decision of migrants to seek preventive dental health care and how these factors differ from those in non-migrants. The aim of the present study was to examine the role of these factors among migrants and non-migrants residing in Germany. Data from cross-sectional national health surveys are used, providing information on preventive dental health behavior from n = 41,220 individuals, of which 15.0% are migrants. Andersen's Behavioral Model of Health Services Use is the conceptual framework of the investigation. Multiple logistic regression models were applied to examine the role of different predisposing and enabling factors. Interaction terms were included in order to examine whether determinants differ between migrants and non-migrants. Average marginal effects (AMEs) are reported in addition to odds ratios (ORs) as measures of effect size which are robust against bias arising from unobserved heterogeneity. Migrants are at an about 36% lower chance of utilizing regular dental checkups than non-migrants [OR = 0.64 (95% confidence interval, 95% CI: 0.61, 0.68); AME = -0.081 (95% CI = -0.093, -0.069)]. Differences are partly explained by the influence of demographic, social, behavioral, and health-related factors [adjusted OR = 0.69 (95% CI: 0.64, 0.73); AME = -0.065 (95% CI = -0.076, -0.053)]. Younger age, being male, lower socioeconomic status, a non-statutory health insurance, not living in a relationship, living in the Western part of Germany and in an urban setting, and poor limited social support were associated with a lower chance of utilizing regular dental checkups. Interaction effects could be observed for age and for the type of health insurance. The study identifies different enabling and predisposing factors that are relevant for the utilization of dental checkups among the population in Germany, some of which differ between migrants and non-migrants. Differences are particularly pronounced for younger ages. This differs from findings on other preventive services where older migrants tend to be more disadvantaged. Additional explanatory factors such as barriers that migrants experience in the dental health care system need to be considered in order to implement patient-oriented services and to reduce disparities in access to dental prevention.

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.

Sleep duration associated with acute care utilization: Revisiting Andersen's Behavioral Model of Health Services Use.

Community-based palliative care and hospice is essential for meeting the preferences of terminally ill patients and reducing healthcare costs. However, systematic research on the decision-making factors concerning the patients and family caregivers remains limited. This study aimed to identify and categorise the factors related to the patients' and family caregivers' decision-making in the use of palliative care or hospice within the community. This systematic review (PROSPERO: CRD42024612049) was conducted using the CINAHL, Cochrane Library, EMBASE, and Medline databases. Studies focusing on the patients' and family caregivers' decisions regarding palliative care and hospice were included, excluding the studies focusing solely on healthcare professionals. Four authors independently assessed the eligible studies and resolved discrepancies through discussion. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool 2018. The data were qualitatively synthesised using a narrative approach and a constant comparison model. Decision-making factors were categorised based on Andersen's behavioural model of health services use taking into consideration predisposing, enabling, and need factors. Seven studies, four quantitative and three qualitative, were included. Sixteen factors, including five predisposing factors (age, education level, people in the household, experiences with institutional care, and death experience), four enabling factors (physician's disclosure, communication partner, communication context, and information about options), and seven need factors (acknowledgement of terminal status, knowledge, perception, end-of-life wishes, caregiver's commitment, preference for dying at home, and health condition), were identified. Patient and caregiver characteristics, personal experience, communication context, knowledge, preferences, and physical condition were the key factors related to the decision to use palliative care and hospice. This study highlights the importance of addressing these factors to support informed and patient-centred decision-making in end-of-life care.

Factors associated with the health care cost in older Australian women with arthritis: an application of the Andersen's Behavioural Model of Health Services Use

Factors associated with breast cancer screening services use among women in the United States: An application of the Andersen's Behavioral Model of Health Services Use

To explore whether Andersen's Behavioral Model of Health Services Use can aid understanding of self-care behaviour and inform development of interventions to promote self-care for minor illness. Qualitative interviews were conducted with 24 Scottish participants about their experience and management of minor symptoms normally associated with analgesic use. Synthesised data from the interviews were mapped onto the Behavioral Model. All factors identified as influencing decisions about how to manage the symptoms discussed, mapped onto at least one domain of Andersen's model. Individual characteristics including beliefs, need factors and available resources were associated with health behaviour, including self-care. Outcomes such as perceived health status and consumer satisfaction from previous experience of managing symptoms also appeared to feed back into health behaviour. The Behavioral Model seems relevant to self-care as well as formal health services. Additional work is needed to explore applicability of the Behavioral Model to different types of symptoms, different modalities of self-care and in countries with different health care systems. Future quantitative studies should establish the relative importance of factors influencing the actions people take to manage minor symptoms to inform future interventions aimed at optimising self-care behaviour.

Perceived Need for Mental Health Care and Service Use Among Adults in Western Europe: Results of the ESEMeD Project