Barriers to and Correlates of Retention in Behavioral Health Treatment Among Latinos in 2 Different Host Countries: The United States and Spain.
Barriers to and Correlates of Retention in Behavioral Health Treatment Among Latinos in 2 Different Host Countries: The United States and Spain.
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DOI：
10.1097/phh.0000000000000391
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Alegría M
中科院分区：
文献类型：
--
作者：
Falgas I;Ramos Z;Herrera L;Qureshi A;Chavez L;Bonal C;McPeck S;Wang Y;Cook B;Alegría M
拉丁美洲移民构成了西班牙和美国移民人口的很大一部分，但缺乏研究存在关于保留行为卫生保健的障碍。识别和比较波士顿、马德里和巴塞罗那的第一代和第二代拉丁美洲人与行为医疗保健相关的感知障碍，并评估去年行为医疗保健使用频率是否与这些障碍相关。数据来自国际拉丁美洲研究伙伴关系项目。第一代或第二代自我认定的18岁以上的拉丁美洲移民在东道国居住超过一年，从社区机构和初级保健，精神卫生，药物滥用和艾滋病毒诊所招募。对11个障碍进行了评估，并在各研究中心进行了比较。在过去的一年内的障碍和行为服务访问之间的关系进行了评估，调整社会人口统计学，临床措施，健康素养，文化和社会因素的程度。想要自己处理问题，认为治疗无效，不确定去哪里或去看谁是拉丁美洲移民最常见的障碍。在波士顿，以前的治疗失败、交通或日程安排困难以及语言障碍更有可能被报告;在巴塞罗那和马德里，试图自己处理心理健康问题的报告更常见。与访问次数有关的两个障碍是对服务费用的关切和不确定去哪里或见谁。在调整社会人口统计学、临床措施、健康素养程度、文化和社会因素后，各地点的障碍仍然存在显著差异。改善行为健康服务的努力必须适合移民的情况，注意改变自力更生的态度，并扩大范围，以改善获得和保留护理的机会。
Latino immigrants constitute a large portion of the Spanish and U.S. immigrant populations, yet a dearth of research exists regarding barriers to retention in behavioral health care. To identify and compare perceived barriers related to behavioral health care among first and second generation Latinos in Boston, Madrid, and Barcelona, and evaluate whether the frequency of behavioral health care use in the last year was related to these barriers. Data come from the International Latino Research Partnership project. First or second generation self-identified Latino immigrants ages 18+ who resided more than one year in the host country were recruited from community agencies and primary care, mental health, substance abuse, and HIV clinics. Eleven barriers were assessed and compared across sites. The relationship between barriers and behavioral services visits within the last year was evaluated, adjusting for socio-demographics, clinical measures, degree of health literacy, cultural and social factors. Wanting to handle the problem on one's own, thinking that treatment would not work, and being unsure of where to go or who to see were the most frequently reported barriers for Latino immigrants. Previous treatment failure, difficulties in transportation or scheduling, and linguistic barriers were more likely to be reported in Boston; trying to deal with mental health problems on one's own was more commonly reported in Barcelona and Madrid. Two barriers associated with number of visits were concerns about the cost of services and uncertainty about where to go or who to see. After adjusting for socio-demographics, clinical measures, degree of health literacy, cultural and social factors, barriers still differed significantly across sites. Efforts to improve behavioral health services must be tailored to immigrants' context, with attention to changing attitudes of self-reliance and outreach to improve access to and retention in care.