Latina immigrants, bridge persons, and utilization of preventive health services.

摘要

While some health indicators for Latinos tend to be more positive than socio-economic status would predict, Latina women and their young children use fewer preventive health services and are more frequently affected by preventable diseases than non-Hispanic whites. This study aims to evaluate the effect of strategies to promote the use of preventive health services by Latina immigrants and their young children.;The first component of this study is a synthesis and critique of the existing peer-reviewed literature on interventions to enroll Latina women and their young children into prenatal care, cervical cancer screening, and child immunizations. Based on results of the literature review, an agenda for intervention research on preventive care utilization is proposed for this population.;Primary data were collected for the second and third components of the dissertation. Data collection among Latinos is often impeded by the absence of an adequate sampling frame. The second component of the study tests in four North Carolina counties a church-based sampling frame for Latina immigrant women in their reproductive years. Compared against Census data for the study area, the study sample (N = 706) provided a comparable representation of different national origins. Recent immigrants were over-represented in churches, while the young (under 30), the unmarried, and women at the lowest and highest extremes of educational attainment were under-represented.;Since the mid-1990s, interventions in North Carolina have aimed to connect immigrants to other persons who can provide instrumental aid (bridge persons). The third component of the dissertation uses a combined qualitative/quantitative method to assess the role of bridge persons in promoting Latina immigrants' utilization of cervical cancer screening (N = 223). Thirty-four percent of women received help from an advocacy organization. Logistic regression results show that persons known through advocacy organizations appeared to increase probability of recent Pap screening by an average of 10.4 percentage points (p < 0.05); Promotoras appeared more effective, increasing probability by 12.9 percentage points (p < .05) but fewer women (14%) knew one. No association was found with other bridge person profiles. Qualitative results suggest that other bridge persons put forth considerable effort, which could be better channeled to promote specific preventive health goals.