Factors Influencing Gay Men's Satisfaction with Health Care Interactions
To determine whether self-advocacy, health locus of control, internalized homophobia, and self-stigma predict perception of health care interactions controlling for age, geographic location, income, partner status, educational level, and gender identification.
Rationale/Conceptual Basis/Background
Research suggests that gay men’s level of satisfaction with the health care interaction affects their utilization of health care resources. Yet we lack a clear understanding of the factors that influence gay men’s perceptions of satisfaction with health care interactions. Researchers posit that the factors influencing perception of satisfaction with health care interactions include self-advocacy skills, health locus of control, internalized homophobia, and self-stigma. However this model has not been tested.
Method
Gay males over 18 years of age in the Commonwealth of Kentucky who have had an interaction with a health care provider within the past 12 months will be eligible to participate. The will be asked to rate their perceptions of their interactions with the health care provider on a Likert scale ranging from 1 (very negative) to 5 (completely positive). Participants will also be asked specific questions concerning their health care, and the health care interaction:
- Do they have a primary care provider, or seek health care at urgent care centers or emergency departments (ED)
- The type of provider (physician, nurse practitioner, physician assistant, nurse) they last saw
- How many times during the past year they saw this provider
- If the health care interaction was with a provider they did not know
- If they shared their sexual orientation with the provider
- Whether they felt the provider welcomed them as gay men
Participants will be asked to complete the following instruments:
- SF-36v 2.0: Short Form Survey of Patient Health
- PQS-18: Patient Satisfaction Questionnaire, Short Version III
- SSS-S: Self-Stigma Scale for Concealable Minorities, Short Form
- PSAS: Patient Self-Advocacy Scale
- MHLC: Multidimensional Health Locus of Control Scale
- IHP: Internalized Homophobia Scale
Participants will be recruited through advertisements that include a weblink in monthly newsletters from two LGBT advocate organizations based in Kentucky. Participants who agree will spend approximately 20 minutes completing the Internet-based questionnaires.
Expected Results
It is predicted that gay men who report higher self-advocacy scores, internal health locus of control, lower levels of internalized homophobia, and lower levels of self-stigma, will report higher levels of satisfaction with health care interactions. Conversely, gay men with lower self-advocacy scores, external health locus of control, higher levels of internalized homophobia, and higher levels of self-stigma will also have more negative satisfaction with health care interactions.
Implications
The knowledge to be gained from this study will be helpful for LGBT advocacy organizations as a foundation for programs to empower gay men in their interactions with health care providers. It will help guide researchers and providers as they attempt to increase gay men’s utilization of health care systems in order to improve health outcomes.