Racial differences in self-reported healthcare seeking and treatment for urinary incontinence in community-dwelling women from the EPI study

• Published in: Neurourology and urodynamics 2011-11, Vol.30 (8), p.1442-1447
• Main Authors: Berger, Mitchell B., Patel, Divya A., Miller, Janis M., DeLancey, John O., Fenner, Dee E.
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adult; Black or African American - psychology; bladder control; coping strategies; Female; fluid intake; Health Behavior - ethnology; health knowledge; Health Knowledge, Attitudes, Practice - ethnology; Health Literacy; healthcare treatment; Humans; Kegel exercises; Logistic Models; Michigan; Middle Aged; obesity; Odds Ratio; Patient Acceptance of Health Care - ethnology; Patient Education as Topic; Physician-Patient Relations; population study; Self Care; Self Report; treatment barriers; treatment seeking; Urinary Incontinence - ethnology; Urinary Incontinence - psychology; Urinary Incontinence - therapy; White People - psychology
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.21145

Aims Objectives of this study are: (1) to examine the prevalence of healthcare seeking among black and white women with self‐reported urinary incontinence (UI), (2) to investigate barriers to treatment for incontinence, and (3) To investigate commonly used therapeutic modalities for UI. Methods This is a planned secondary analysis of responses from 2,812 black and white community‐dwelling women living in southeastern Michigan, aged 35–64 years, who completed a telephone interview concerning UI, healthcare‐seeking behaviors and management strategies. The study population was 571 subjects (278 black, 293 white) who self‐identified as having urinary incontinence. Results Of these women with UI, 51% sought healthcare with no statistically significant difference between the two races (53% black, 50.6% white, P = 0.64). In multivariate logistic regression analysis, a higher likelihood of seeking healthcare was associated with increased age, body mass index lower than 30 kg/m2, prior surgery for UI, having regular pelvic exams, having a doctor, and worsening severity of UI. There was no significant association between hypothesized barriers to care seeking and race. Almost 95% of the subjects identified lack of knowledge of available treatments as one barrier. Black and white women were similar in percentage use of medications and some self‐care strategies, for example, pad wearing and bathroom mapping, but black women were significantly more likely to restrict fluid intake than white women and marginally less likely to perform Kegels. Conclusions Black and white women seek healthcare for UI at similar, low rates. Improved patient‐doctor relationships and public education may foster healthcare seeking behavior. Neurourol. Urodynam. Neurourol. Urodynam. 30: 1442–1447, 2011. © 2011 Wiley Periodicals, Inc.