PA 03-108 NIH Small Research Grant Program Unmarried middle-aged and older women are more likely to experience adverse health events than married women. When adverse events occur, fewer family members may be available to provide care. Timely use of preventive care is thus particularly important among older unmarried women. Research suggests that unmarried women have lower utilization of preventive health services, including cancer screenings tests. The reasons for the association between marital status and cancer screening utilization are being examined through ongoing research, but no such research has been conducted among Latina women with limited English proficiency (LEP). The proposed research is an exploratory qualitative study to investigate the barriers to preventive care among unmarried Latinas, focusing on cancer screening tests as an example of needed care. A media-based sampling strategy (through Spanish-language radio) will be tested for this study. Up to sixty LEP Latina women, aged 40 to 75, from various countries of origin, will be recruited for in- depth interviews in Spanish. The sample will include married and unmarried women. A photo-narrative method will be used. This method has been shown to be particularly effective in overcoming the problem of socially desirable answers among Latina women. Photographic prompts will be used to elicit detailed narratives related to health care use and cancer screening utilization. A sub-sample of twenty women will be asked to participate in the project as community photographers. They will take photographs related to themes discussed or hinted at during in-depth interviews. Photographs will then be used as the focus of discussion in a second in-depth interview with each community photographer. A content analysis approach will be used to compare the narratives of married and unmarried women, distinguishing between different domestic situations (living with a partner or not; whether previously married) and different origins (Caribbean vs. Central/South American). Findings will help to improve our understanding of the barriers to preventive care affecting unmarried older Latina women. Relevance To Public Health: This study can teach us how to connect middle-aged and older unmarried women with needed preventive health care. The focus for this study is on Latina women, because their use of preventive health services is particularly low. ? ? ?
