The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #60853

Roger Vaughan, DrPH¹, Andrea Nye, MPH¹, Lorraine Tiezzi, MS², and Vaughn I Rickert, PsyD². (1) Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Ave, B-3, New York, NY 10032, 212-304-5211, rdv2@columbia.edu, (2) Center for Community Health and Education, Mailman School of Public Health, Columbia University, 60 Haven Ave, B-3, New York, NY 10032

Recent immigrants and men are medically underserved populations that could benefit from improved access to reproductive heath care. To provide that access, it is essential to understand the barriers that exist, as well as to recognize the enabling factors that help overcome difficulties accessing needed reproductive health care. Through the rigorous development and field-testing of a valid and reliable data collection instrument and the implementation of a case-control study it was possible to specify factors that differentiate reproductive health care seekers (i.e. cases) from those who do not access care (i.e. controls). Data were obtained from 800 cases and 800 controls in schools, community clinics, and community based organizations (CBOs). Bivariate analyses were conducted to differentiate cases from controls using chi-squared analysis for discrete antecedents and t-tests for continuous variables. Multivariable logistic regression models were constructed and performed separately for males and for recent immigrants. Our theoretical framework provided the model-building strategy to account for cultural factors, social norms, and behavioral intentions that distinguish cases from controls. Odds ratios and 95% confidence intervals were calculated for significantly related variables. Our results allow for a better understanding of the issues affecting access to reproductive health care for males and for recent immigrants. Consequently, we are able to recommend effective interventions and outreach in order to enhance enabling factors and overcome existing barriers to reproductive health care, thus making sexual and reproductive health care more accessible overall. Detailed project description and results of data analysis for this effort will be presented.

Learning Objectives:

• At the conclusion of the session, participants will be able to recognize and describe alternative factors affecting access to care, identify potential changes in services delivery and outreach for recent immigrants and men, and apply these concepts to their own investigations.

Keywords: Barriers to Care, Access and Services

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.