Sobadors in the Health Care Utilization of Mexican Americans and Immigrants

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，并导致健康差距。 与普通人群相比，拉丁美洲人不太可能拥有健康保险或一致的医疗保健提供者，他们经常从事使他们面临肌肉骨骼疼痛和受伤风险升高的职业，从而导致健康差异。 很少有研究探讨拉丁美洲人如何决定是否获得传统护理或传统护理，包括在新移民社区使用sobadors。 Sobadors是传统的治疗师，他们利用墨西哥的治疗方法，如按摩和治疗手法来治疗肌肉骨骼疼痛和被认为与腹部器官有关的疾病。关于sobador使用的信息是有限的，但是，它表明sobador使用是广泛的。 这项研究将（1）描述影响拉丁美洲参与者使用sobadors的因素，包括易感特征，使能资源和需求，正如居住在NC的拉丁美洲人所报告的那样，（2）描述sobadors的健康信念和他们用来诊断患者健康状况的策略，并确定sobador使用的策略，以治疗病人的健康状况，记录通过sobador访谈和视频记录的治疗，和（3）描绘如何拉丁美洲人的易感特征，有利的资源，需要影响整合，或缺乏，sobador和传统的护理使用，如居住在北卡罗来纳州的拉丁美洲人所报告的。 弱势群体行为模式指导研究设计和分析。 半结构化的深入访谈将与24个拉丁美洲患者生活在NC进行。 患者参与者将仅限于18岁及以上在过去两年中使用sobador的个人。 六名索巴多人也将接受采访。 Sobador对24名患者的治疗过程将被录像，Sobador随后将解释所记录的活动。 所有的采访都将被录音，转录和翻译。 一个计算机辅助的，系统的分析程序将被用来描绘和比较影响拉丁美洲参与者使用sobadors和传统的医疗保健的因素，并描绘sobadors的健康信念和做法。 一位受过操作、活动和按摩技术训练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，在R01应用程序中，将收集主要数据，以检查使用sobador和传统护理提供者治疗美国拉丁美洲人的特定症状的频率，sobador提供的治疗对拉丁美洲人的福祉的影响，以及在指示对抗疗法护理时增加拉丁美洲人获得传统提供者的策略。

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.