title: Barriers to urinary incontinence care seeking in White, Black, and Latina women.
abstract: OBJECTIVE
  We compared barriers to urinary incontinence (UI) healthcare seeking between white, black, and Latina women.
  
  
  METHODS
  This is a cross-sectional study using a convenience sample of white, black, and Latina women. Women completed the Barriers to Incontinence Care Seeking Questionnaire (BICS-Q), the Incontinence Quality of Life Instrument (I-QOL), the Questionnaire for Urinary Incontinence Diagnosis, and the Incontinence Severity Index (ISI). The primary objective was to assess barriers to UI care seeking among groups, as measured by the BICS-Q. Secondary objectives were to assess factors associated with barriers to incontinence care and to compare specific barriers using BICS-Q subscale scores. Regression analyses were used to further assess for differences among groups while adjusting for potential confounding variables.
  
  
  RESULTS
  We included a total of 93 subjects, including 30 white, 33 black, and 30 Latina women. Mean I-QOL, Questionnaire for Urinary Incontinence Diagnosis, and ISI scores were not significantly different among our 3 groups. Barriers, based on BICS-Q scores, were lowest in white women and higher in blacks and Latinas (2.9 vs 7.3 vs 10.9, respectively; P < 0.001). When adjusting for potential confounders such as age, income, education, presence of UI, ISI score, and I-QOL score, Latinas continued to demonstrate higher barriers compared with white or black women (β = 7.4; 95% CI, 2.2-12.7; P = 0.006). There were no significant differences between black women compared with other groups in the adjusted analyses.
  
  
  CONCLUSIONS
  Latinas experience more barriers to UI healthcare seeking compared with white and black women.
authors.affiliation: From the *Department of Obstetrics and Gynecology, Duke University Medical Center; †Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center; and ‡Departments of Medicine, Psychiatry, and School of Nursing, Duke University, Durham, NC.
authors.forename: Marcella G
authors.initials: MG
authors.lastname: Willis-Gray
authors.forename: Juan S
authors.initials: JS
authors.lastname: Sandoval
authors.forename: Jean
authors.initials: J
authors.lastname: Maynor
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
authors.forename: Nazema Y
authors.initials: NY
authors.lastname: Siddiqui
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014481:United States; D014549:Urinary Incontinence / Q000208:ethnology* / Q000628:therapy*; D044465:White People / Q000523:psychology*; D055815:Young Adult