Mixed-methods Cross-sectional Design Research Articles

Exploring health beliefs and care-seeking behaviors of older USA-dwelling Mexicans and Mexican-Americans

Objective. This study explored health beliefs and healthcare-seeking behaviors of older USA-dwelling Mexicans and Mexican-Americans using the Theory of Planned Behavior (TPB) as a conceptual guide. Design. A mixed-method cross-sectional design was utilized using semi-structured interviews to obtain detailed descriptions of 31 older (50 + ) participants' behavioral, normative, and control beliefs about health and healthcare utilization. An interview schedule consisting of open-ended and demographic questions and one standardized tool, the Bidimensional Acculturation Scale (BAS) for Hispanics, was used to collect data. Results. Several themes emerged for each belief area. Behavioral belief themes reflect participants' faith in, comfort with, and knowledge of traditional methods of care (e.g., herbs, teas, and use of curanderas) as well as their faith in the effectiveness of conventional care (e.g., medicine, technology, and use of physicians). Normative belief themes indicate that participants perceive that family and community contacts support participants' use of traditional methods and that family supports use of conventional methods. Control belief themes suggest that traditional methods are accessible and affordable but that conventional methods are not. BAS scored indicated that most (90.3%) participants adhered to Hispanic culture. Two (6.5%) participants adhered to non-Hispanic culture and one (3.2%) scored as bi-cultural. Conclusions. Themes from the data suggest that beliefs about healthcare impact the types of care utilized and the ways in which they are utilized. Clinicians and researchers striving to reduce health disparities and develop more culturally competent healthcare services for ethnic minority groups should work toward a better understanding of minority groups' belief systems about healthcare and its utilization. Utilization of the TPB allows for empirical model development that can better predict healthcare utilization behavior, further augmenting efforts to provide services that will help reduce health disparities for older Mexicans and Mexican-Americans and other populations.

Invasive prenatal testing decisions in pregnancy after infertility

This study assessed decisional conflict about invasive prenatal testing among women pregnant after infertility. We surveyed 180 pregnant women with a history of infertility using a mixed methods cross-sectional design. Difficulty in deciding whether to have prenatal testing was measured using the Decisional Conflict Scale. A minority of women (31%) chose to have invasive prenatal testing. Most participants (72%) reported low decisional conflict (score < 25; mean = 22.1; standard deviation = 23.2; range: 0-100). Half (53%) of the participants said that infertility made the testing decision easier. Qualitative data suggest that infertility makes the decision easier by clarifying relevant values and priorities. Most infertility characteristics studied were not significantly associated with decisional conflict. Variables associated with higher decisional conflict included infertility distress due to rejection of a childfree lifestyle, disagreement with others about testing, and choosing to have invasive testing after having had treatment for infertility. For some women, infertility may make the invasive prenatal testing decision easier. Women with the greatest need for decisional support were those who have had treatment and choose invasive testing, who disagree with others about their testing choice, or who are particularly distressed about being childless.