Health Care Utilization among Mexican-, Cuban-, and Puerto Rican-American Adolescents: Examining Andersen's Behavioral Model of Health Services Use

Persistent Link:
http://hdl.handle.net/10150/195162
Title:
Health Care Utilization among Mexican-, Cuban-, and Puerto Rican-American Adolescents: Examining Andersen's Behavioral Model of Health Services Use
Author:
Wilkinson-lee, Ada M.
Issue Date:
2008
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
The present study consisted of two parts: (1) The examination of whether demographic differences in utilization of multiple forms of health services existed among Non-Hispanic Whites, Mexican-, Cuban-, and Puerto Rican-American adolescents. (2) The examination of whether the Andersen model, revised for Latino adolescents, fit equally well for Mexican-, Cuban-, and Puerto Rican-Americans. Data for this study were drawn from the first two waves of the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative sample of 7th through 12th-grade students in the United States collected between 1994 and 1996.Logistic regression analyses indicated that there were significant differences in routine physical exams based on ethnicity. Mexican-American adolescents were less likely than Non-Hispanic White, Cuban-American, and Puerto Rican-American adolescents to receive routine physical exams. Finding based both on the logistic regressions and on the latent mean comparisons suggested that Cuban- and Puerto Rican-American adolescents are more likely to utilize health services than Mexican-American adolescents. Cuban-American adolescents were also less likely to indicate the need for medical services, whereas Mexican-American adolescents were more likely to state that they needed medical services but were unable to receive them.The results of multi-group confirmatory factor analyses provide mixed evidence toward the indication that the revised Andersen's conceptual model is an appropriate overall framework to utilize with Mexican-, Cuban-, and Puerto Rican-American adolescents. Based on the structural equation model findings, it appears that the major link between need and use of health care services is not supported in the three Latino subgroups. The Andersen model only partially addressed health care needs among the adolescent Latino subgroups. Although there are connections from the main predisposing predictors (including Latino adolescent-specific characteristics) to enabling resources and need, these indirect associations do not necessarily predict use of health services with Mexican-, Cuban-, and Puerto Rican-American adolescents. Clearly there is a great need for health care services among Latino adolescents, particularly given their health disparities in adolescent risk behavior; however current models need further revision, such as including key cultural factors and social context, to predict use of health care services.
Type:
text; Electronic Dissertation
Keywords:
Adolescents; health care access; Mexican-American; Cuban-American; Puerto Rican-American; Andersen's Model
Degree Name:
PhD
Degree Level:
doctoral
Degree Program:
Family & Consumer Sciences; Graduate College
Degree Grantor:
University of Arizona
Advisor:
Russell, Stephen T.
Committee Chair:
Russell, Stephen T.

Full metadata record

DC FieldValue Language
dc.language.isoENen_US
dc.titleHealth Care Utilization among Mexican-, Cuban-, and Puerto Rican-American Adolescents: Examining Andersen's Behavioral Model of Health Services Useen_US
dc.creatorWilkinson-lee, Ada M.en_US
dc.contributor.authorWilkinson-lee, Ada M.en_US
dc.date.issued2008en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractThe present study consisted of two parts: (1) The examination of whether demographic differences in utilization of multiple forms of health services existed among Non-Hispanic Whites, Mexican-, Cuban-, and Puerto Rican-American adolescents. (2) The examination of whether the Andersen model, revised for Latino adolescents, fit equally well for Mexican-, Cuban-, and Puerto Rican-Americans. Data for this study were drawn from the first two waves of the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative sample of 7th through 12th-grade students in the United States collected between 1994 and 1996.Logistic regression analyses indicated that there were significant differences in routine physical exams based on ethnicity. Mexican-American adolescents were less likely than Non-Hispanic White, Cuban-American, and Puerto Rican-American adolescents to receive routine physical exams. Finding based both on the logistic regressions and on the latent mean comparisons suggested that Cuban- and Puerto Rican-American adolescents are more likely to utilize health services than Mexican-American adolescents. Cuban-American adolescents were also less likely to indicate the need for medical services, whereas Mexican-American adolescents were more likely to state that they needed medical services but were unable to receive them.The results of multi-group confirmatory factor analyses provide mixed evidence toward the indication that the revised Andersen's conceptual model is an appropriate overall framework to utilize with Mexican-, Cuban-, and Puerto Rican-American adolescents. Based on the structural equation model findings, it appears that the major link between need and use of health care services is not supported in the three Latino subgroups. The Andersen model only partially addressed health care needs among the adolescent Latino subgroups. Although there are connections from the main predisposing predictors (including Latino adolescent-specific characteristics) to enabling resources and need, these indirect associations do not necessarily predict use of health services with Mexican-, Cuban-, and Puerto Rican-American adolescents. Clearly there is a great need for health care services among Latino adolescents, particularly given their health disparities in adolescent risk behavior; however current models need further revision, such as including key cultural factors and social context, to predict use of health care services.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectAdolescentsen_US
dc.subjecthealth care accessen_US
dc.subjectMexican-Americanen_US
dc.subjectCuban-Americanen_US
dc.subjectPuerto Rican-Americanen_US
dc.subjectAndersen's Modelen_US
thesis.degree.namePhDen_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineFamily & Consumer Sciencesen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorRussell, Stephen T.en_US
dc.contributor.chairRussell, Stephen T.en_US
dc.contributor.committeememberTaylor, Angela R.en_US
dc.contributor.committeememberCard, Noel A.en_US
dc.contributor.committeememberRomero, Andrea J.en_US
dc.identifier.proquest2897en_US
dc.identifier.oclc659749943en_US
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