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Primary Submission Category: Methodological approaches to studying public health

Psychological Science Approaches to Healthcare Utilization in Underrepresented Populations: Emerging Insights for Primary Care and Public Health Systems

Authors:  Olusheyi Lawoyin, Latrice Maric, Elizabeth Stierman, Atim George,

Presenting Author: Olusheyi Lawoyin*

Background: Several approaches have been implemented to strengthen quality care delivery in historically underrepresented populations. However, investments aimed at strengthening service delivery in resource limited settings are of limited value if they do not account for the socioecological environment. The purpose of this paper is to present the findings of an exploratory study that examined the socioecological factors influencing prenatal care engagement in an understudied population with one of the highest birth rates, in Southern California in the United States.

Methods: This study was grounded in Bronfenbrenner’s ecological systems theory and the theory of social constructivism. The sample used in this study included two focus groups that consisted of non-acculturated Hispanic women who were selected through purposive snowball sampling. Participants were further screened for acculturation using an adaptation of the 12-point acculturation scale for Hispanics by Marin et al. (1987), which measured the degree of acculturation in the population. An in-depth questionnaire adapted from the social ecological model (SEM) was used to gather information on the subjective, lived experiences and perspectives of participants. Thematic analysis using a phenomenological approach was used to analyze the narratives of participants in the study.

Findings: Sixty-four percent of the study’s sample (n = 14) were between the ages 35-44 years (Mage =35.5 years), and 72% had a secondary school education. Ninety-three percent of the sample were married or with long term partners and 79% were stay at home mothers. Four main themes arose based on an analysis of the findings.  Overall, the study’s significant findings showed us the individual, familial, economic, political and socio-cultural factors from the lens of the participants that served as barriers and facilitators to prenatal care engagement and the perceptions of appropriate care delivery within the population, considering the role of the health system.

Conclusion: The findings from this study contribute to a paucity of original research on the socioecological environment and its effect on the engagement of prenatal care in this population. The study’s findings have implications for further interdisciplinary research and the design of responsive, integrated health systems that would support appropriate prenatal care delivery in underrepresented populations.