WAIT, WON'T! WANT: BARRIERS TO HEALTH CARE AS PERCEIVED BY MEDICALLY AND SOCIALLY DISENFRANCHISED COMMUNITIES.

OBJECTIVES: We explored barriers to healthcare as perceived by members of medically and socially disenfranchised communities. METHODS: We conducted focus groups with 28 women and 32 men from Northeast Ohio who identified themselves as African-American, Hispanic/Latino, lesbian/gay/bisexual/transgendered, and/or Russian immigrant. RESULTS: Participants described their experiences of waiting, things they won't tolerate, when they won't participate, and what they want from providers. They described behaviors, actions and relationship characteristics that they want from their providers and characteristics that they prefer in health systems. CONCLUSIONS: The themes of Wait, Won't, and Want have healthcare practice and policy implications. Patient-provider interactions are known to be significant determinants of healthcare outcomes and these exploratory findings suggest that they might also affect patient self-management strategies. Future efforts should focus on developing and testing patient-centered strategies that address the themes identified to increase engagement to increase self-management of health.

Are health beliefs related to adherence among adolescents with mood disorders?

This study explored the illness perceptions, attitudes towards mental health services and adherence behaviors among a group of adolescents in treatment for mood disorders in an urban city in the United States. Seventy adolescents completed a battery of questionnaires assessing demographics (e.g., gender, family income), perceptions of illness (e.g., consequences, treatment control) and overall attitudes towards mental health services. Adolescents and their parents also reported on the youth's adherence to both psychotropic medication and mental health appointments. Simultaneous logistic regression analyses revealed that attitudes and family income made a significant and unique contribution in explaining adolescents' adherence behaviors. Interventions that help adolescents become aware of their attitudes toward mental health services and provide information on dimensions of mood disorders, such as the chronic nature of depression and the effectiveness of treatment, may impact adherence behavior. Also, among a group of families with access to services, yearly family income remained a significant barrier to attending appointments all of the time. Policy implications are discussed.

Social Support: A Mixed Blessing for Women in Substance Abuse Treatment.

Using a personal social network framework, this qualitative study sought to understand how women in substance abuse treatment describe their network members' supportive and unsupportive behaviors related to recovery. Eighty-six women were interviewed from residential and outpatient substance abuse treatment programs. Positive and negative aspects of women's social networks were assessed via open-ended questions. Analysis was guided by grounded theory techniques using three coders. The findings extend classic social support concepts such as emotional, tangible, and informational support. Practice implications are presented in light of the potential roles network members may play in substance use and recovery.

Attitudes Toward Mental Health Services and Illness Perceptions Among Adolescents with Mood Disorders.

The present study describes how adolescents perceive their mood disorders (MD; e.g., acute vs. chronic) and their attitudes toward mental health services. The study also explores the relationships between demographics, clinical characteristics, perceptions of illness and attitudes. Finally, we examine the psychometric properties of the Illness Perception Questionnaire-Revised (Moss-Morris et al. in Psychology & Health 17(1):1-16, 2002). Seventy adolescents were recruited from the greater Cleveland area. Structured interviews were conducted utilizing standardized instruments. Results show that adolescents with MD have fairly positive attitudes, with Caucasian youth reporting more positive attitudes than their nonwhite ounterparts. Illness perceptions were related to psychological openness and indifference to stigma. Implications are discussed.