Healthcare mistreatment and continuity of cancer screening among Latino and Anglo American women in southern california

Abstract

The aim of this research was to examine the relation of perceptions of healthcare mistreatment and related emotions to continuity of cancer screening care among women who reported healthcare mistreatment. The structure of relations among cultural beliefs about healthcare professionals, perceptions of mistreatment, mistreatment-related emotions, and continuity of screening was investigated. Participants included 313 Anglo and Latino American women of varying demographic characteristics from southern California who were recruited using multi-stage stratified sampling. Structural equation modeling confirmed the relation of perceptions of mistreatment to continuity of care for both Anglo and Latino American women, with ethnicity moderating this association. For Anglo Americans, greater perceptions of mistreatment were negatively related to continuity of screening. However, for Latinas the relation was indirect, through mistreatment-related anger. While greater perceptions of mistreatment were associated with higher levels of anger for both ethnic groups, anger was negatively related to continuity of care for Latino but not for Anglo women. Furthermore, cultural beliefs about professionals were indirectly related to continuity of screening through perceptions of mistreatment and/or mistreatment-related anger. These findings highlight the importance of the role of cultural and psychological factors in research and interventions aimed at improving patient-professional relations with culturally diverse women.

Figure 1

Betancourt’s model of culture and behavior adapted for the study of health behavior (Betancourt & Flynn, 2009)

Figure 2

Final model with estimated path coefficients and factor loadings for Latino and Anglo subgroups. *p < .05; **p < .01; ***p < .001. Note. Paths for Anglo Americans are represented in parentheses. Variance from a number of covariates (see Table 3) were controlled for prior to SEM.