Data gathered from 1,360 respondents aged 65 years and over will be used by a multidisciplinary research team to describe the health-related needs of the non-institutionalized older adult population of eastern North Carolina. The data will also be used in the assessment of the goodness- of-fit of a multistage hierarchical structural equation model of the effects of demographic and medical profile variables, enabling, and need characteristics upon the utilization and satisfaction with mainstream and alternative sources of health care. Three data gathering waves will facilitate an assessment of the impact of net changes in the respondent's psychosocial and biomedical characteristics upon health care use. A multistage sampling procedure clustering counties according to prominent regional characteristics, randomly selecting counties within clusters, using household surveys within geographical squares to form sampling frames to meet predetermined age-race quotas will insure that the sample is representative of the regional diversity that can create structural barriers to individual access to health care sources. The age-race quotas will provide sample sizes adequate for subpopulation comparisons and reduce the affect of sample mortality in short and long-term longitudinal analysis. In-depth interviewing will be used with random subsample of those who admit using alternative practitioners in order to determine the functions and social and cognitive dynamics surrounding the use of alternative providers and remedies, planning recommendations, policy directions, and educational material will be developed by the research team and furnished to state and regional planning agencies and local governmental units.
