Betty Hsiao1, Sonal Bhalla2, Kristin Mattocks3, Liana Fraenkel4. 1. Yale University School of Medicine, New Haven, Connecticut. 2. Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire. 3. VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts, and University of Massachusetts Medical School, Worcester. 4. Yale University School of Medicine, New Haven, Connecticut, and VA Connecticut Healthcare System, West Haven, Connecticut.
Abstract
OBJECTIVE: To explore the factors that influence risk tolerance among women from different racial/ethnic groups. METHODS: In-depth individual interviews of non-Hispanic African American, non-Hispanic white, and Hispanic women ages 20-45 years were conducted by a trained interviewer using a semi-structured interview guide to elicit the factors that influence risk tolerance among minority women. The interviews were audiotaped and professionally transcribed, with a final sample size of 36 determined by thematic saturation. The members of the research team used open coding to review and develop a list of codes, which was modified as new codes emerged. A final list of 35 codes was applied to the transcripts and combined into broader themes. RESULTS: The study included 30.6% non-Hispanic African American, 33.3% non-Hispanic white, and 36.1% Hispanic women, with a mean ± SD age of 34.8 ± 6.8 years. Several major themes explaining risk aversion among minority women emerged: discrepancies in quality of health care, perceived prejudice, lack of knowledge and education, medication beliefs, risk perception, and constrained resources. The latter was discussed most frequently. CONCLUSION: While our findings identify several concerns that may be addressed through implementation of more effective communication strategies by medical providers, they also highlight that disparities are strongly influenced by the complex ways financial and social constraints impact health care decisions of minority women.
OBJECTIVE: To explore the factors that influence risk tolerance among women from different racial/ethnic groups. METHODS: In-depth individual interviews of non-Hispanic African American, non-Hispanic white, and Hispanic women ages 20-45 years were conducted by a trained interviewer using a semi-structured interview guide to elicit the factors that influence risk tolerance among minority women. The interviews were audiotaped and professionally transcribed, with a final sample size of 36 determined by thematic saturation. The members of the research team used open coding to review and develop a list of codes, which was modified as new codes emerged. A final list of 35 codes was applied to the transcripts and combined into broader themes. RESULTS: The study included 30.6% non-Hispanic African American, 33.3% non-Hispanic white, and 36.1% Hispanic women, with a mean ± SD age of 34.8 ± 6.8 years. Several major themes explaining risk aversion among minority women emerged: discrepancies in quality of health care, perceived prejudice, lack of knowledge and education, medication beliefs, risk perception, and constrained resources. The latter was discussed most frequently. CONCLUSION: While our findings identify several concerns that may be addressed through implementation of more effective communication strategies by medical providers, they also highlight that disparities are strongly influenced by the complex ways financial and social constraints impact health care decisions of minority women.
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