title: A national study of health care service utilization and substance use after the 2010 Chilean earthquake.
abstract: OBJECTIVE
  A national epidemiological survey in Chile assessed adaptive (health care utilization) and maladaptive (substance use) postearthquake behaviors.
  
  
  METHODS
  Three months after the 8.8-magnitude 2010 Bio-Bio earthquake, face-to-face interviews were conducted with a representative sample of 2,108 adults. Logistic regression analyses examined predictors of health care service utilization and substance use.
  
  
  RESULTS
  Few participants utilized available government- and community-based psychosocial resources (16.6%). A minority reported increased substance use (13.2%). Lower self-efficacy was correlated with increased health care utilization (odds ratio [OR]=.92, 95% confidence interval [CI]=.88-.96) and use of tranquilizers, illicit and psychotropic drugs, and alcohol (OR=.95, CI=.91-.99); this pattern was not limited to residents of areas with the heaviest impacts.
  
  
  CONCLUSIONS
  Self-efficacy beliefs elucidate variability in survivors' behaviors postdisaster and may provide an avenue to encourage salubrious responses. Postdisaster interventions should broadly target the population; those less heavily affected may need, and be as likely to use, available resources.
authors.affiliation: Dr. Garfin, Dr. Juth, and Dr. Silver are with the Department of Psychology and Social Behavior, University of California, Irvine. Dr. Ugalde, Mr. Linn, and Dr. Inostroza are with the Instituto de Salud Pública, Universidad Andrés Bello, Santiago, Chile. Send correspondence to Dr. Silver (e-mail: rsilver@uci.edu ).
authors.forename: Dana Rose
authors.initials: DR
authors.lastname: Garfin
authors.forename: Vanessa
authors.initials: V
authors.lastname: Juth
authors.forename: Roxane Cohen
authors.initials: RC
authors.lastname: Silver
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Ugalde
authors.forename: Heiko
authors.initials: H
authors.lastname: Linn
authors.forename: Manuel
authors.initials: M
authors.lastname: Inostroza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002677:Chile / Q000453:epidemiology; D004190:Disasters; D055866:Earthquakes; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D036301:Qualitative Research; D019966:Substance-Related Disorders / Q000453:epidemiology*; D017741:Survivors / Q000523:psychology*; D055815:Young Adult