Identifying Barriers in Seeking Care Among Low-Income Minority Adolescents

Objective: This qualitative study utilizes participant experiences to identify a thematic structure that substantiates the barriers that rural minority adolescents face when seeking preventative dental and medical care.

Method: In this pilot study, efforts were focused on low-income Black/African American adolescents from rural North Florida. N=16 (7 male and 9 female) participants aged 12-18. We used the Theory of Planned Behavior (TPB) and its constructs (Attitudes, Normative Beliefs, and Self-Efficacy) to explore (i) health care utilization among participants and their family; (ii) perceived access; and (iii) their perceptions of dentists. Individual interviews were audiotaped and consisted of 15 questions and lasted an average of 16 minutes. Participants were compensated for their time.

Result: After controlling for socioeconomic status (SES), we found that all participants expressed positive attitudes towards seeing a dentist and believe that regular visits are beneficial. Seventy-eight percent of all the females sampled reported seeing a dentist within the past year, whereas only 22% of the males reported the same. When exploring Self-Efficacy and access to care, we found that approximately 56.25% of all participants reported not having a primary dentist, and 18% of those reported never seeing a dentist. Of those that had seen a dentist, 18.75% reported the visit being greater than one year ago. When exploring the impact of Subjective Norms, 50% of the participants reported family members seeing a dentist regularly and only 43.75% reported discussing dental visits with friends. We found that perceived access and utilization were significantly higher when asked the same questions about seeing a physician.

Conclusion: These data serve as the introductory step in targeting healthcare disparities among this vulnerable population.  The themes that emerged will be used to test hypotheses in a follow-up project involving 100 adolescents, the next step in intervention planning.