The influence of perceived barriers and self-efficacy on care-seeking behavior and health responsibility and among African-American men
Abstract
The purposes of this study were: (1) to examine the relationship between perceived barriers, self-efficacy, and sociodemographic characteristics among African American males; (2) to examine the relationship between each of the perceived barriers, self-efficacy, and care-seeking behavior while controlling for sociodemographic characteristics; and (3) to examine the relationship between each of the perceived barriers, self-efficacy, and health responsibility while controlling for sociodemographic characteristics. The model used to direct the study was a combination of three models: The Health Belief Model; The Health Promotion Model; and The Theory of Care-Seeking Behavior. Components of the model included perceived barriers to preventive health care, self-efficacy, health responsibility, and sociodemographic characteristics (age and SES). A self-selected sample of 400 African American men was surveyed using a self-report questionnaire. Two-hundred fourteen questionnaires were returned for a response rate of 54%. Data analysis procedures included bivariate correlations and hierarchial stepwise multivariate regressions using care-seeking behavior and health responsibility as dependent variables. Findings suggested that African American men in this study with a high SES index, that is, education, income, and occupational status, experienced a greater sense of self-efficacy, perceived fewer barriers to obtaining preventive services, assumed more responsibility for their own health care, and sought health care sooner than African American males with less education, income and occupational status. Age was not related to perceived barriers or self-efficacy, but significantly related to socioeconomic status. Older men demonstrated higher SES levels. African American men in this study had relatively high levels of self-efficacy. Individuals with low self-efficacy perceived barriers to preventive health care related to the site of care, provider consumer relationships, costs, inconvenience, and fear. The probability of engaging in preventive health behavior was not influenced by SES, age, self-efficacy or perceived barriers. However, probability of assuming responsibility for health was significantly influenced by age, SES, and fear.Description
University of Maryland, Baltimore. Nursing. Ph.D. 1996Keyword
Black StudiesHealth Sciences, Public Health
Sociology, Ethnic and Racial Studies
Health Sciences, Health Care Management
perceived barriers
Health Services Accessibility
Preventive Health Services
Self Efficacy
Socioeconomic Factors
African American men
Identifier to cite or link to this item
http://hdl.handle.net/10713/1483Related items
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Development of a measure of the content and quality of prenatal care services in a Medicaid populationStatement of the problem. The purpose of this study was to develop an instrument to measure the content and quality of prenatal care services in a population of low income women. Dimensions of performance as proposed by the Joint Commission on Accreditation of Healthcare Organizations were used to define the quality of prenatal care. The United States Public Health Service Expert Panel Guidelines on the Content of Prenatal Care were used as the standard for the content of care. Methods. The Content and Quality of Prenatal Care Measure (CQPM), a prenatal care record review measure, was developed in this study. An assessment of content validity and intra- and inter-rater reliability was completed. Data collected for the validity sample of 163 records at two county health department sites was scored by content area. The Adequacy of Prenatal Care Utilization Index (APNCU) developed by Kotelchuck was used to categorize each record in the validity sample. Criterion-related validity was assessed with ANOVA using the CQPM scores as the dependent variable and the APNCU groups as the independent variable and by discriminant function analysis using the CQPM content scores as predictors for group membership in APNCU groups. Results. The mean percent agreement for each of the content areas for intra- and inter-rater reliability ranged from 72% to 95% with medical risk assessment having the highest reliability and health promotion having the lowest. Intra and inter-rater percent agreement for items ranking the quality of care was 70% and 51.6%. A significant difference between the groups was found in ANOVA, F(3,157):16.23, p < .00001, confirming criterion-related validity. The discriminant function analysis found an overall Lambda =.451941 (chi2 = 110.79, df 15, p < .00001). The prediction equation accounted for 62% of grouped cases being correctly classified also confirming criterion-related validity. Discussion. These results show that the Content and Quality of Prenatal Care Measure is reliable and valid and may be used to monitor care provided to low income populations and to conduct research on the content of prenatal care. Further research on weighting each item score in the CQPM and the reliability of items for special populations may be indicated.
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