Sobadors in the Health Care Utilization of Mexican Americans and Immigrants

墨西哥裔美国人和移民的医疗保健利用中的索巴多人

基本信息

批准号：
8634717
负责人：
Thomas A. Arcury
金额：
$ 17.95万
依托单位：
WAKE FOREST UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-04-01 至 2016-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8634717
关键词：
Abdomen Address Affect Agricultural Workers American Area Behavioral Model Belief California Caring Characteristics Chiropractor Clinic Colorado Communities Computer Assisted Data Decision Making Development Diagnosis Disease Economics Foundations Frequencies General Population Healed Health Health Benefit Health Care Seeking Behavior Health Insurance Health Personnel Health Status Health behavior Healthcare Immigrant Incidence Income Individual Injury Interview Knowledge Latin America Latino Licensing Life Massage Medical Medicine Methods Mexican Mexican Americans Musculoskeletal Musculoskeletal Pain New Mexico North Carolina Occupations Organ Outcome Participant Patient Self-Report Patients Perception Personal Satisfaction Physicians Procedures Process Provider Psyche structure Public Health Questionnaires Reporting Research Research Design Resources Rheumatism Risk Sobador Structure Students Surveys Symptoms Techniques Texas Therapeutic Training Translating Video Recording Videotape Vulnerable Populations Work Workplace aged base conventional therapy design healing health belief health care service utilization health disparity musculoskeletal injury public health relevance response traditional care

项目摘要

DESCRIPTION (provided by applicant): Limited access to conventional health care providers increases the health risk of Mexican Americans and Mexican immigrants and contributes to health disparities. Latinos are less likely to have health insurance or a consistent healthcare provider than the general population, and they often work in occupations that place them at elevated risk for musculoskeletal pain and injuries, contributing to health disparities. Few studies have examined how Latinos make decisions regarding whether to access conventional care or traditional care, including the use of sobadors, in new immigrant communities. Sobadors are traditional healers who draw upon Mexican healing practices such as massage and therapeutic maneuvers to treat musculoskeletal pain and disorders perceived to be related to abdominal organs. Information about sobador use is limited-however, it suggests that sobador use is widespread. This research will (1) delineate factors that affect Latino participants' use of sobadors, including predisposing characteristics, enabling resources, and need, as reported by Latinos who reside in NC, (2) delineate the health beliefs of sobadors and the strategies they use to diagnose patient health conditions, and identify strategies sobadors use to treat patients' health conditions as recorded through sobador interviews and video recorded treatments, and (3) delineate how Latinos' predisposing characteristics, enabling resources, and need affect integration, or lack thereof, of sobador and conventional care use, as reported by Latinos who reside in NC. The Behavioral Model for Vulnerable Populations guides the research design and analysis. Semi-structured in-depth interviews will be conducted with 24 Latino patients living in NC. Patient participants will be restricted to individuals aged 18 and older who used a sobador during the previous two years. Six sobadors will also be interviewed. Sobador treatment sessions with 24 patients will be video recorded-sobadors will subsequently explain the recorded activity. All interviews will be audio recorded, transcribed, and translated. A computer-assisted, systematic analysis procedure will be used to delineate and compare the factors that affect Latino participants' use of sobadors and conventional health care and to delineate the health beliefs and practices of sobadors. A chiropractor trained in manipulation, mobilization, and massage techniques will carefully examine the videotapes and evaluate the techniques performed. These results will provide the foundation for an R01 application in which primary data will be collected to examine frequency of use of sobadors and conventional care providers to treat specific symptoms among US Latinos, the effect of sobador-provided treatments on Latinos' well-being, and strategies that increase Latino access to conventional providers when allopathic care is indicated.

描述（由申请人提供）：获得传统医疗保健提供者的机会有限增加了墨西哥裔美国人和墨西哥移民的健康风险，并加剧了健康差距。与普通人群相比，拉丁美洲人不太可能拥有健康保险或持续的医疗保健提供者，而且他们所从事的职业经常使他们面临肌肉骨骼疼痛和受伤的较高风险，从而导致健康差异。很少有研究探讨拉丁裔如何在新移民社区中决定是否获得传统护理或传统护理，包括使用索巴多。索巴多尔是传统的治疗师，他们利用墨西哥的治疗方法，如按摩和治疗方法来治疗肌肉骨骼疼痛和与腹部器官有关的疾病。有关索巴多尔使用的信息有限，但它表明索巴多尔的使用很广泛。这项研究将 (1) 描述影响拉丁裔参与者使用索巴多的因素，包括居住在北卡罗来纳州的拉美裔参与者报告的倾向特征、有利资源和需求，(2) 描述索巴多的健康信念和他们使用的策略诊断患者的健康状况，并通过索巴多访谈和视频记录的治疗记录确定索巴多用于治疗患者健康状况的策略，以及 (3) 描述拉丁裔的倾向特征、支持资源和需求据居住在北卡罗来纳州的拉丁裔人士报告，影响索巴多尔和传统护理使用的整合或缺乏。弱势群体行为模型指导研究设计和分析。将对居住在北卡罗来纳州的 24 名拉丁裔患者进行半结构化深度访谈。患者参与者仅限于 18 岁及以上且在过去两年内使用过索巴多尔的个人。六名索巴德也将接受采访。索巴多尔对 24 名患者的治疗过程将被录制视频——索巴多尔随后将解释录制的活动。所有采访都将被录音、转录和翻译。将使用计算机辅助的系统分析程序来描述和比较影响拉丁裔参与者使用索巴多和传统医疗保健的因素，并描述索巴多的健康信念和做法。接受过操纵、活动和按摩技术培训的脊椎按摩师将仔细检查录像带并评估所执行的技术。这些结果将为 R01 应用程序提供基础，其中将收集主要数据，以检查使用索巴多尔和传统护理提供者治疗美国拉丁裔特定症状的频率、索巴多尔提供的治疗对拉丁裔健康的影响、当需要对抗疗法护理时，增加拉丁裔获得传统医疗服务提供者的机会的策略。