Caregiver characteristics and their relationship to health service utilization in minority patients with first episode stroke.

The purpose of the current study was to investigate the contribution of caregivers' characteristics to health service utilization by minority persons with first episode stroke. Participants were 61 primary caregivers of minority persons (41% African American; 59% Hispanic) with first episode symptomatic stroke consecutively admitted to an inpatient rehabilitation unit at a county hospital. Caregiver characteristics included resources for daily living, general health, social support, and health beliefs. Health service utilization was defined as the percentage of medical and therapy appointments attended for the first 6 months following discharge from inpatient rehabilitation. There was no difference in percentage of appointments attended between African American and Hispanic caregivers. There was a significant difference between caregivers on the External Control by Powerful Others subscale of the Multidimensional Health Locus of Control Scale (MHLC), with Hispanic caregivers reporting a greater belief that powerful others exerted control over their health. There was a trend for Hispanics to score higher on the External Control by Chance subscale of the MHLC. Results of logistic regression analyses indicated that persons with stroke were less likely to attend appointments if their caregiver believed that health was related to chance factors. These results suggest that caregiver health beliefs play an important role in patient adherence to medical recommendations. Education of caregivers may result in improved follow-through with medical recommendations.

Determinants of low-fat eating behaviors among midlife African American women.

OBJECTIVE: The purpose of this study was to explore midlife African American women's low-fat eating habits in the context of health attitudes, social support, and food preferences. DESIGN: A cross-sectional design was used. SETTINGS: One Midwestern and 1 national African American women's organization were targeted for data collection. PARTICIPANTS: African American women between the ages of 45 and 64. MAIN OUTCOME MEASURES: Health Attitudes Scale, Social Support Scale, Eating Behaviors subscale, and Low-Fat Eating subscale. ANALYSIS: A hierarchical multiple regression analysis was performed. RESULTS: Highly educated women did not engage in better eating habits than women with less education. Family members provided more criticism and friends provided more encouragement for healthful eating. However, only family encouragement and criticism for healthful eating and food preferences remained predictive of low-fat eating habits in midlife African American women in the final regression model. CONCLUSIONS AND IMPLICATIONS: Changing attitudes may not influence changes in behaviors. Women experience family support as a significant influence to eating habits. Future nutrition interventions should be inclusive of women at every educational level and have a multidimensional focus that targets family involvement and changing behaviors.