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Health Care Utilization among Mexican-, Cuban-, and Puerto Rican-American Adolescents: Examining Andersen's Behavioral Model of Health Services UseWilkinson-lee, Ada M. January 2008 (has links)
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.
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