title: Variables impacting care-seeking for pelvic floor disorders among African American women.
abstract: OBJECTIVE
  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.
authors: Sections of Gynecology and Urology, Virginia Mason Medical Center, Seattle, WA, USA. blair.washington@vmmc.org
authors: Blair B
authors: BB
authors: Washington
authors: Christina A
authors: CA
authors: Raker
authors: Kavita
authors: K
authors: Mishra
authors: Vivian W
authors: VW
authors: Sung
mesh_terms: D001741:Black or African American; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007348:Insurance, Health; D016015:Logistic Models; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D059952:Pelvic Floor Disorders / Q000175:diagnosis / Q000628:therapy