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Using Structural Equation Modeling to Explore Relationships between Access, Accessibility, and Health Status
Wednesday, November 19, 2014
: 9:10 AM - 9:30 AM
Katharine Nimmons, MSc, MPH
Center for Community Health Development - National CHW Training Center, TX A&M School of Rural Public Health, College Station, TX
Kenneth R. McLeroy, PhD
Center for Community Health Development, School of Rural Public Health, College Station, TX
Center for Community Health Development, Texas A&M School of Rural Public Health, College Station, TX
Monica Wendel, Dr.P.H., M.A.
School of Rural Public Health, Texas A&M Health Science Center, College Station, TX
Background: The State of Texas ranks last in the United States for access to health care. A recent health assessment, conducted in a nine-county region of east-central Texas, revealed that 23.8 percent of residents reported that they had trouble getting the health care services they needed; in fact in one of the rural counties, 20.2 percent of residents said that their access was poor or very poor. Since lack of access is largely due to environmental and policy-related issues, this research study seeks to understand the relationship between various factors related to access to health care within both rural and urban populations through structural equation modeling (SEM). Methods: Researchers estimated three SEMs to measure the relationships between access, accessibility, and health status. SEMs were constructed using data gathered from a self-report regional health survey (n=5,230) conducted with both rural and urban populations within the region. The SEMs seek to determine the best-estimated measurement model for rural populations and for urban populations regarding the relationship between access, accessibility, and health status. Researchers are currently conducted analyses to determine the model with best fit for rural and urban populations; however, data analysis will be completed by the annual meeting. Conclusion: These SEMs provide insight into factors that are likely to be significant determinants of access to health care in rural and urban populations.
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Public health or related public policy
Public health or related research
Social and behavioral sciences
Describe the geographic context and population of the reported region of Texas;
Discuss research questions and hypotheses regarding the differences between access to health care within urban and rural populations;
Describe the three estimated structural equation models that were developed to test research hypotheses;
Differentiate the resulting fit statistics for each model; and
Present the best-estimated model for both rural and urban populations within the region.
Keyword(s): Accessibility, Health Care Access
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I was on the research team that collected this data. I constructed study research questions and hypotheses, as well as analyzed data.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.