Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2002 Oct;37(5):1221-42.
doi: 10.1111/1475-6773.01053.

Expanding the Andersen model: the role of psychosocial factors in long-term care use

Elizabeth H Bradley  1 , Sarah A McGraw, Leslie Curry, Alison Buckser, Kinda L King, Stanislav V Kasl, Ronald Andersen
Affiliations
Comparative Study

Expanding the Andersen model: the role of psychosocial factors in long-term care use

Elizabeth H Bradley et al. Health Serv Res. 2002 Oct.

Abstract

Objective: To examine a prevailing conceptual model of health services use (Andersen 1995) and to suggest modifications that may enhance its explanatory power when applied to empirical studies of race/ethnicity and long-term care.

Study setting: Twelve focus groups of African-American (five groups) and white (seven groups) individuals, aged 65 and older, residing in Connecticut during 2000.

Study design: Using qualitative analysis, data were coded and analyzed in NUD-IST 4 software to facilitate the reporting of recurrent themes, supporting quotations, and links among the themes for developing the conceptual framework. Specific analysis was conducted to assess distinctions in common themes between African-American and white focus groups.

Data collection: Data were collected using a standardized discussion guide, augmented by prompts for clarification. Audio taped sessions were transcribed and independently coded by investigators and crosschecked to enhance coding validity. An audit trail was maintained to document analytic decisions during data analysis and interpretation.

Principal findings: Psychosocial factors (e.g., attitudes and knowledge, social norms, and perceived control) are identified as determinants of service use, thereby expanding the Andersen model (1995). African-American and white focus group members differed in their reported accessibility of information about long-term care, social norms concerning caregiving expectations and burden, and concerns of privacy and self-determination.

Conclusions: More comprehensive identification of psychosocial factors may enhance our understanding of the complex role of race/ethnicity in long-term care use as well as the effectiveness of policies and programs designed to address disparities in long-term care service use among minority and nonminority groups.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The Role of Psychosocial, Need, and Enabling Factors in Long-term Care Use
See this image and copyright information in PMC

References

    1. Ajzen I. “The Theory of Planned Behavior.”. Organizational Behavior and Human Decision Processes. 1991;50:179–211.
    1. Andersen R. “Revisiting the Behavioral Model and Access to Medical Care: Does it Matter?”. Journal of Health and Social Behavior. 1995;36(1):1–10. - PubMed
    1. Andersen RM, Davidson PL. “Ethnicity Aging and Oral Health Outcomes: A Conceptual Framework.”. Advances in Dental Research. 1997;11(2):203–9. - PubMed
    1. Andersen RM, Newman JF. “Societal and Individual Determinants of Medical Care Utilization in the United States.”. Milbank Quarterly. 1973;51(1):95–124. - PubMed
    1. Aday LA, Awe WC. “Health Service Utilization Models.”. In: Gochman David S., editor. Handbook Behavior of Health Behavior Research I: Personal and Social Determinants. New York: Plenum Press; 1997. pp. 153–72.

Publication types