Research That Matters (January 17 - 20, 2008)

Purpose: As a group, Hispanics in the United States suffer from poorer health outcomes than non-Hispanic Whites (e.g., Kaiser Family Foundation, 2005). Poor health outcomes often lead to problems affecting older adults' ability to maintain independence in their homes and communities. Socioeconomic characteristics only partially explain why Hispanic people in general, and older Hispanic people in particular, have higher morbidity and mortality rates and poorer access to health care services than non-Hispanic Whites. This paper presents preliminary data on a portion of a larger study that, guided by the Theory of Planned Behavior (TPB; Ajzen, 1991), explores health beliefs among a group of older Latinos to better understand how beliefs influence attitudes about health, which in turn influence health-related behaviors and subsequent independence for older Latinos. Methods: Using a purposive sample of 30 Latino and Latino-American older adults (65+ who identify Mexico as their country of origin) recruited through agencies in a large Northwest city, this study employed a non-experimental, cross-sectional design to qualitatively explore participants' beliefs regarding use of Westernized (e.g., nurses, doctors, health clinics) and non-Westernized (e.g., oils, herbs, traditional healers) forms of health care. In-depth interviews were conducted to collect responses to demographic questions, the Bidimensional Acculturation Scale for Hispanics (BAS) (Marín & Gamba, 1996), and open-ended questions that explored health beliefs (as guided by the TPB). Qualitative data were analyzed using ATLAS-ti, and descriptive statistics were generated on individual demographic and acculturation variables. Results: Results from preliminary data collection indicated that respondents primarily adhered to or identified with Hispanic culture as measured by the BAS. Respondents were taking an average of 2.4 medications for a variety of common illnesses as well as remedies such as teas, herbs, and oils. With regard to participants' beliefs around the circumstances that make it difficult for them to use different types of care, respondents indicated that language barriers and lack of money, transportation, insurance, and trust in doctors were the primary issues in accessing Westernized medicine. Respondents also indicated that non-Westernized forms of care were more readily available and affordable than Westernized forms of care; therefore, respondents were more likely to use them more often. Implications: Results of this study offer a comprehensive view of respondents' beliefs about accessing various types of care. By understanding these beliefs, it is possible to better articulate the perceived competencies that influence older Latino's actions in health-related situations (e.g., to seek out care), which subsequently impact their ability to remain independent as they age. The author will discuss how this work leads to theory building in predicting older Latino's health care utilization as well as to improved approaches to education, intervention, and health care services for underserved populations that will sustain their independence. The author will discuss how an understanding of the complex belief processes that influence individual health-related behaviors will assist professionals in developing care strategies that are more accessible, cost-effective, and culturally competent, helping to reduce health disparities for minority groups and supporting their independent living in the community.