|Pelvic floor disorders (PFD) encompass a number of highly prevalent conditions that affect women, including pelvic organ prolapse and urinary and fecal incontinence. Their prevalence increase with advancing age and it is expected to affect 43.8 million American women by 2050. Latinas bear a disproportionate burden of symptomatic PFDs compared with other ethnic groups and disparities have been identified across the continuum of care from diagnosis, treatment and surgical outcomes. Little is known about the reasons underlying these disparities. We hypothesize that there are cultural, ethnic, and provider specific barriers that uniquely affect Latinas' likelihood to seek and/or be offered care for PFD.
The main objective of the proposed pilot studies is to better understand determinants of PFDs diagnosis, barriers to care, and overall knowledge, attitudes, behaviors and beliefs (KABB) about PFDs among Latina women by three specific aims that will 1) assess health literacy, beliefs, social stigmas, and barriers to care through focus groups of women in community clinics and in LA-USC identified during their annual well-woman examinations, 2) assess the prevalence and severity of PFD symptoms, barriers to seeking care (KABB and acculturation) and practitioner specific barriers (inquiring about or assessing symptoms) in women receiving regular gynecological check-ups in community clinics in Boyle Heights, 3) assess determinants of seeking care by evaluating severity of PFD symptoms, KABB, and acculturation in patients being evaluated for PFD in specialty clinics at Keck and LA-USC. Thus we will identify potential differences among Latinas who have/have not sought care for these conditions. This pilot studies will inform our long term goal of designing culturally appropriate interventions to improve the care and quality of life of Latinas affected by PFDs which we will pursue as a future multidisciplinary R01 application in response to PA-17-043 (Addressing Health Disparities through Effective Interventions among Immigrant Populations).