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Investigating Psychological Service Utilization Employing an Integrative Sociostructural, Cultural, and Behavioral Framework
Investigating Psychological Service Utilization Employing an Integrative Sociostructural, Cultural, and Behavioral Framework
Authors
Salinas-Oñate, Natalia
Betancourt, Hector M.
Flynn, Patricia Michele
Baeza-Rivera, María José
Ortiz, Manuel S.
Betancourt, Hector M.
Flynn, Patricia Michele
Baeza-Rivera, María José
Ortiz, Manuel S.
Profesor Guía
Authors
URI
Date
Datos de publicación:
10.1037/pro0000465
Professional Psychology: Research and Practice, 53 (6), 584-574, 2022
Tipo de recurso
Artículo
Facultad de Ciencias de la Salud
Keywords
Culture - Emotions - Expectations - Psychological Services Utilization
Materia geográfica
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Abstract
Building on research that has identified factors relevant to psychological services utilization, this study examines some of those variables within the context of cultural beliefs about psychological care among primary care patients in Chile, a country with high rates of depression and low mental health services utilization. Guided by an integrative conceptual framework, the structure of relations among sociostructural, cultural, and psychological factors influencing mental health services utilization was tested. Participants included 201 women referred for colocated psychological services at 13 primary care centers. Cultural beliefs about psychological care were measured employing a scale developed using a mixed-methods cultural research approach to instrument development. Additional scales assessed sociostructural factors (age, ethnicity, socioeconomic status; SES), outcome expectations and emotions, and intention to utilize psychological services. A structural equation model including the hypothesized structure of relations among the study variables fit the data well (comparative fit index [CFI] =.99, χ2[68] = 78.44, p =.18; χ2/df = 1.15; root-mean-square error of approximation [RMSEA] =.03, 90% CI [.00,.05]). As proposed, cultural beliefs about psychological care predicted intention to utilize psychological services, directly and indirectly, through outcome expectations and emotions (ab′ =.07, CI [.01,.14]). Specifically, positive cultural beliefs about receiving psychological care influenced outcome expectations (β =.30, p =.00) and positive emotions (β =.43, p =.00), which in turn predicted intention to utilize psychological services (β =.23, p =.01; β =.18, p =.03). Integrative approaches including sociostructural, cultural, and psychological determinants may result in more effective and culturally appropriate interventions aimed at reducing disparities in psychological services utilization. This research could contribute to the internationalization of knowledge on mental health services utilization. © 2023 Elsevier B.V., All rights reserved.