Peter Veazie1, Alina Denham2. 1. Department of Public Health Sciences, University of Rochester, 265 Crittenden Blvd, CU 420644, Rochester, NY, 14642-0644, USA. Electronic address: peter_veazie@urmc.rochester.edu. 2. Department of Public Health Sciences, University of Rochester, 265 Crittenden Blvd, CU 420644, Rochester, NY, 14642-0644, USA. Electronic address: alina_denham@urmc.rochester.edu.
Abstract
RATIONALE: Research has identified psychosocial factors related to the use of health services among the older population; however, the specific roles by which these factors drive behavior have not been identified and empirically tested. OBJECTIVE: This study tested whether previously identified psychosocial factors decrease or increase the motivational potential to seek care, the motivational sensitivity to perceived access, or the motivational sensitivity to perceived need. METHODS: The 2014 U.S. Health and Retirement Study was used. Analysis was based on 2589 older noninstitutionalized respondents (age greater than 64). The dependent variable was the number of healthcare provider visits in the preceding two years. Psychosocial factors included were life satisfaction, social network indicators, optimism, pessimism, positive social support, hopelessness, loneliness, self-efficacy, health efficacy, positive affect, negative affect, and purpose in life. Covariates included age and sex. Maximum likelihood estimation of an interpretable structural model was used. RESULTS: Results of the study provide evidence that psychosocial variables are related to health care seeking through both motivational potential and sensitivity parameters. Some psychosocial variables are related to multiple roles. For example, pessimism is related to a lower motivational potential and is more sensitive to access at higher levels of access, whereas hopelessness is related to a higher motivational potential and more sensitive to need and access at lower levels of each. CONCLUSIONS: Findings imply psychosocial characteristics are related to health care seeking and utilization of older adults via different roles that can countervail each other, and therefore the influence of interventions can be complex. To address this, complex interventions may be required.
RATIONALE: Research has identified psychosocial factors related to the use of health services among the older population; however, the specific roles by which these factors drive behavior have not been identified and empirically tested. OBJECTIVE: This study tested whether previously identified psychosocial factors decrease or increase the motivational potential to seek care, the motivational sensitivity to perceived access, or the motivational sensitivity to perceived need. METHODS: The 2014 U.S. Health and Retirement Study was used. Analysis was based on 2589 older noninstitutionalized respondents (age greater than 64). The dependent variable was the number of healthcare provider visits in the preceding two years. Psychosocial factors included were life satisfaction, social network indicators, optimism, pessimism, positive social support, hopelessness, loneliness, self-efficacy, health efficacy, positive affect, negative affect, and purpose in life. Covariates included age and sex. Maximum likelihood estimation of an interpretable structural model was used. RESULTS: Results of the study provide evidence that psychosocial variables are related to health care seeking through both motivational potential and sensitivity parameters. Some psychosocial variables are related to multiple roles. For example, pessimism is related to a lower motivational potential and is more sensitive to access at higher levels of access, whereas hopelessness is related to a higher motivational potential and more sensitive to need and access at lower levels of each. CONCLUSIONS: Findings imply psychosocial characteristics are related to health care seeking and utilization of older adults via different roles that can countervail each other, and therefore the influence of interventions can be complex. To address this, complex interventions may be required.