title: Elder American Indian women's knowledge of pelvic floor disorders and barriers to seeking care.
abstract: OBJECTIVE
  The objectives of this study are to evaluate urinary incontinence and pelvic organ prolapse knowledge among elder southwestern American Indian women and to assess barriers to care for pelvic floor disorders through community-engaged research.
  
  
  METHODS
  Our group was invited to provide an educational talk on urinary incontinence and pelvic organ prolapse at an annual meeting of American Indian elders. Female attendees aged 55 years or older anonymously completed demographic information and 2 validated questionnaires, the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) and Barriers to Incontinence Care Seeking Questionnaire (BICS-Q). Questionnaire results were compared with historical controls from the original PIKQ and BICS-Q validation study.
  
  
  RESULTS
  One hundred forty-four women completed the questionnaires. The mean age was 77.7 ± 9.1 years. The mean (SD) for PIKQ of urinary incontinence score was 6.6 (3.0) (similar to historic gynecology controls 6.8 [3.3], P = 0.49), and the mean (SD) for PIKQ on pelvic organ prolapse score was 5.4 (2.9) (better than historic gynecology controls 3.6 [3.2], P < 0.01). Barriers to care seeking reported by the elder women were highest on the BICS-Q subscales of "cost" and "inconvenience."
  
  
  CONCLUSIONS
  Urinary incontinence knowledge is similar to historic gynecology controls, and pelvic organ prolapse knowledge is higher than historic gynecology controls among elder southwestern American Indian women. American Indian elder women report high levels of barriers to care. The greatest barriers to care seeking for this population were related to cost and inconvenience, reflecting the importance of assessing socioeconomic status when investigating barriers to care. Addressing these barriers may enhance care-seeking southwestern American Indian women.
authors.affiliation: From the *Division of Urogynecology, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM; †School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI; and ‡Department of Urology, Cedars-Sinai Medical Center, Beverly Hills, CA.
authors.forename: Gena C
authors.initials: GC
authors.lastname: Dunivan
authors.forename: Yuko M
authors.initials: YM
authors.lastname: Komesu
authors.forename: Sara B
authors.initials: SB
authors.lastname: Cichowski
authors.forename: Christine
authors.initials: C
authors.lastname: Lowery
authors.forename: Jennifer T
authors.initials: JT
authors.lastname: Anger
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Rogers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D007198:Indians, North American; D007349:Insurance, Health, Reimbursement; D008875:Middle Aged; D009516:New Mexico; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D056887:Pelvic Organ Prolapse / Q000175:diagnosis / Q000628:therapy; D011795:Surveys and Questionnaires; D013997:Time Factors; D014549:Urinary Incontinence / Q000175:diagnosis / Q000628:therapy