Institutional members access full text with Ovid®

Share this article on:

Variables Impacting Care-Seeking for Pelvic Floor Disorders Among African American Women

Washington, Blair B. MD, MHA*; Raker, Christina A. ScD; Mishra, Kavita MD; Sung, Vivian W. MD, MPH

Female Pelvic Medicine & Reconstructive Surgery: March/April 2013 - Volume 19 - Issue 2 - p 98–102
doi: 10.1097/SPV.0b013e31827bfee8
Original Articles

Objectives This study aimed to identify variables impacting care-seeking for pelvic floor disorders (PFDs) among (1) a general population of professional African American (AA) women and (2) professional AA women with prevalent PFD symptoms.

Methods A cross-sectional survey of women registered for the 37th National Assembly of the Links, Inc, a volunteer service organization of professional AA women, was conducted. Our de-identified questionnaire addressed several domains including PFD symptoms, history of PFD diagnoses, attitudes regarding PFDs, and help-seeking. We asked what respondents would do if they experienced PFD symptoms and defined our outcome as the response “I would not seek care.” Barriers were covariates associated with not seeking care.

Results Of 568 questionnaires distributed, 362 (64%) with complete data were returned; 6.4% (23/362) of respondents reported they “would not seek care” if experiencing a PFD symptom. On logistic regression, attitude that PFDs are a normal part of aging [adjusted odds ratio (AOR), 5.56; 95% confidence interval (CI), 1.46–21.23] and concerns about insurance (AOR, 3.80; 95% CI, 1.39–10.33) were barriers to care-seeking, adjusting for health status and embarrassment about discussing PFDs.

Thirty percent (110/362) of women reported having current PFD symptoms. In this subset, only 26% had accessed care. On logistic regression, prolapse symptoms in the previous 3 months and age 65 years or older were negatively associated with not seeking care (ie, were predictors of care-seeking) (AOR, 0.11; 95% CI, 0.02–0.67) and (AOR, 0.17; 95% CI, 0.03–0.85), respectively, adjusting for pelvic floor distress inventory scores.

Conclusions Among educated and insured AA women, attitudes about aging and insurance complexity are barriers to care-seeking for PFDs. In women with current PFD symptoms, recent prolapse symptoms and age 65 years or older were predictors of care-seeking.

Among educated and insured AA women, attitudes about aging and insurance complexity are barriers to care-seeking for PFDs.

From the *Sections of Gynecology and Urology, Virginia Mason Medical Center, Seattle, WA; †Division of Research, Women & Infants’ Hospital of Rhode Island; and ‡Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI.

Reprints: Blair B. Washington, MD, MHA, Sections of Gynecology and Urology, Virginia Mason Medical Center, Lindeman Pavilion, Floor 8, 1100 Ninth Ave, Seattle, WA 98101. E-mail: blair.washington@vmmc.org.

Supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Grant K23HD060665 (Dr Sung).

The authors have declared they have no conflicts of interest.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development or the National Institutes of Health.

© 2013 by Wolters Kluwer Health | Lippincott Williams & Wilkins