Sobadors in the Health Care Utilization of Mexican Americans and Immigrants

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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.