Date of Conferral

2021

Degree

Ph.D.

School

Public Health

Advisor

Aaron B. Mendelsohn

Abstract

Serious psychological distress (SPD) is an important individual and public health concern, but inconsistent results exist in the literature in terms of help-seeking behaviors and health-related outcomes among persons with SPD. The purpose of this study was to address this issue and understand clinical factors, access and quality of care factors, and sociodemographic factors associated with help-seeking behaviors among adults with SPD using the California Health Interview Survey (CHIS). CHIS data were collected in 2015 as a part of a two-year cycle (2015-2016) and surveyed 42,089 adults. For multivariable analyses, logistic regression analyses were performed. Participants with chronic health conditions had nearly twice the odds of having had a doctor visit compared to those who did not (adjusted odds ratio [aOR] 1.94, 95% confidence interval [CI] [1.08, 3.48], p = 0.03). Those with a general health condition had lower odds of delaying care (aOR 0.72, 95% CI [0.61, 0.84], p < 0.001). The odds of having a doctor visit among those who had issues with access to healthcare were 2.68 times higher than for those who did not (aOR 2.68, 95% CI [1.38, 5.19], p < 0.004). The odds of forgoing care among those who were not insured were 13% higher than for those that were insured (aOR 1.13, 95% CI [1.04, 1.24], p < 0.005). Females had lower odds than males in terms of delaying care (aOR 0.71, 95% CI [0.51, 0.99], p = 0.04). Compared to White Americans, Asians and African Americans had higher odds of forgoing care (aOR 4.34, 95% CI [1.48-12.76]; aOR 2.80, 95% CI [1.34, 5.86] respectively). To promote positive health outcomes and prevent disease, it is important to devise optimal intervention programs that incorporate factors associated with healthcare seeking decisions for adults with SPD.

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