title: Urinary Incontinence and Health-Seeking Behavior Among White, Black, and Latina Women.
abstract: Fewer than half of women with urinary incontinence (UI) seek care for their condition. Our objective was to qualitatively assess the themes surrounding treatment-seeking behaviors.
  
  
  
  We conducted 12 focus groups with women and, using purposive sampling, we stratified by racial or ethnic group (white, black, Latina) and by UI frequency. All sessions were transcribed and coded for common themes. Comparative thematic analysis was used to describe similarities and differences among groups.
  
  
  
  In total, 113 (39 white, 41 black, and 33 Latina) community-dwelling women participated in focus groups. There were no differences in treatment-seeking themes between groups with different UI frequency. However, certain themes emerged when comparing racial/ethnic groups. Women from all groups shared experiences of embarrassment and isolation because of UI, which were impediments to care seeking. White and black women described discussions with close friends or family that led to normalization of symptoms and prevented care seeking. Latina women maintained more secrecy about UI and reported the longest delays in seeking care. Women articulated a higher likelihood of seeking care if they had knowledge of treatment options, but white women were more likely to seek UI-related knowledge compared with black or Latina women. Physician communication barriers were identified in all groups.
  
  
  
  Despite similar experiences, there are different perceptions about care seeking among white, black, and Latina women. Culturally relevant educational resources that focus on a range of treatment options may improve knowledge and thus improve care-seeking behaviors in women with UI.
authors.affiliation: From the *Department of Obstetrics and Gynecology and †School of Nursing, Duke University Medical Center, Durham; ‡Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill; and §Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center; Departments of Medicine, Psychiatry, and School of Nursing, Duke University Medical Center, Durham, NC.
authors.forename: Nazema Y
authors.initials: NY
authors.lastname: Siddiqui
authors.forename: Natalie
authors.initials: N
authors.lastname: Ammarell
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Wu
authors.forename: Juan S
authors.initials: JS
authors.lastname: Sandoval
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
mesh_terms: D000328:Adult; D001741:Black or African American; D000704:Analysis of Variance; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D057226:Information Seeking Behavior; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D036301:Qualitative Research; D014549:Urinary Incontinence / Q000208:ethnology / Q000523:psychology* / Q000628:therapy; D044465:White People