Sobadors in the Health Care Utilization of Mexican Americans and Immigrants

描述（由申请人提供）：获得传统医疗服务的机会有限，增加了墨西哥裔美国人和墨西哥移民的健康风险，并造成了健康差异。与一般人群相比，拉美裔人不太可能拥有医疗保险或有稳定的医疗服务提供者，而且他们所从事的职业往往使他们面临较高的肌肉骨骼疼痛和损伤风险，从而造成健康差距。很少有研究调查拉丁裔人在新移民社区如何决定是否接受传统护理或传统护理，包括使用sobadors。sobador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，然而，它表明sobador的使用是广泛的。本研究将(1)描述居住在北卡州的拉丁裔美国人报告的影响拉丁裔参与者使用sobadors的因素，包括易感特征、使能资源和需求；(2)描述sobadors的健康信念及其用于诊断患者健康状况的策略，并通过sobadors访谈和视频记录的治疗方法确定sobadors用于治疗患者健康状况的策略。(3)描述居住在北卡罗来纳州的拉美裔人的易感特征、可利用资源和需求如何影响整合或缺乏整合，以及如何影响儿童护理和传统护理的使用。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。患者参与者将被限制为18岁及以上的个人，他们在过去两年内使用过sobador。此外，还有6名sobador将接受采访。将对24名患者的Sobador治疗过程进行视频录制，随后Sobador将对录制的活动进行解释。所有的采访都将被录音、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和传统医疗保健的因素，并描述sobador的健康信念和做法。训练过手法、活动和按摩技术的脊医会仔细检查录像带并评估所使用的技术。这些结果将为R01应用程序提供基础，其中将收集主要数据，以检查使用sobador和传统护理提供者治疗美国拉丁美洲人特定症状的频率，sobador提供的治疗对拉丁美洲人福祉的影响，以及当需要对抗疗法治疗时增加拉丁美洲人获得传统提供者服务的策略。

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.