Sobadors in the Health Care Utilization of Mexican Americans and Immigrants

描述(由申请人提供)：接触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，拉美裔人不太可能拥有医疗保险或始终如一的医疗保健提供者，而且他们从事的职业往往会增加他们肌肉骨骼疼痛和受伤的风险，从而导致健康差距。很少有研究研究拉美裔人如何在新移民社区中决定是获得传统护理还是传统护理，包括使用Sobador。Sobadors是传统的治疗师，他们借鉴墨西哥的治疗方法，如按摩和治疗手法，治疗肌肉骨骼疼痛和被认为与腹部器官有关的疾病。关于索巴多使用的信息是有限的--然而，它表明索巴多的使用很普遍。这项研究将(1)描述居住在北卡罗来纳州的拉丁裔报告的拉丁裔参与者使用Sobador的因素，包括易感特征、使能资源和需求；(2)描述Sobador的健康信念及其用来诊断患者健康状况的策略，并确定Sobador用来治疗通过索巴托访谈和录像治疗记录的患者健康状况的策略；以及(3)描述居住在北卡罗来纳州的拉丁裔报告的易患特征、使能资源和需求如何影响Sobador和传统护理使用的整合或缺乏。脆弱人群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。患者参与者将仅限于在前两年内使用索巴尔的18岁及以上个人。六名肥皂剧演员也将接受采访。索巴多与24名患者的治疗过程将被录像-索巴多随后将解释所记录的活动。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Sobador和传统保健的因素，并描述Sobador的健康信念和做法。受过手法、动感和按摩技巧训练的脊骨神经医师将仔细检查录像带，并评估所使用的技术。这些结果将为R01应用程序奠定基础，在该应用程序中，将收集主要数据，以检查在美国拉丁裔中使用Sobador和传统护理提供者来治疗特定症状的频率、Sobator提供的治疗对拉丁裔人福祉的影响，以及在指示对抗疗法时增加拉丁裔接触传统护理提供者的策略。

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.