title: Race and ethnic differences in health beliefs about lower urinary tract symptoms.
abstract: BACKGROUND
  Health beliefs are an important mediator between the experience of symptoms and health behaviors, and these beliefs can vary by race or ethnicity.
  
  
  OBJECTIVE
  The aim of this study was to better understand the gap between experiencing symptoms and not seeking medical care by examining health beliefs about lower urinary tract symptoms across race and ethnic groups.
  
  
  METHODS
  Qualitative, semistructured interviews were conducted with 35 Black, Hispanic, and White people who reported at least one urinary symptom but had not spoken with a healthcare provider about the symptom(s). Drawing on Shaw's framework of health behavior and outcomes, a range of beliefs was examined: cause, consequence, continuation, and treatability. Interviews were transcribed, coded, and analyzed for themes according to race or ethnic background.
  
  
  RESULTS
  The belief that lower urinary tract symptoms are a typical part of aging and not amenable to medical treatment was most common among White respondents. Black respondents more commonly attributed their symptoms to personal behaviors over which they had control and therefore did not require medical care. Hispanic respondents appeared more often to live with uncertainty about the cause of their symptoms and an accompanying concern about a future health consequence.
  
  
  CONCLUSIONS
  The combination of a range of health beliefs to form a cognitive representation made sense of the behavior of not seeking medical care. The finding that sociocultural differences shaped these cognitive representations underscores the need for cultural competency in patient assessment and education. Results have implications for theories of health behavior and indicate further research with larger samples, additional psychosocial influences, and other symptoms.
authors.affiliation: New England Research Institutes, Watertown, Massachusetts 02472, USA. lwelch@neriscience.com
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Welch
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Botelho
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Tennstedt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health / Q000208:ethnology*; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D036301:Qualitative Research; D044469:Racial Groups; D014555:Urination Disorders / Q000453:epidemiology*