Theodossiou Isabelle, McLean Kristen, Sundstrom Beth, Delay Cara
College of Charleston, Charleston, USA.
University of South Carolina, Columbia, USA.
J Immigr Minor Health. 2025 Jul 12. doi: 10.1007/s10903-025-01736-4.
Migrant and minority women in the United States face a high likelihood of experiencing poor reproductive health outcomes. Hispanic/Latina women are an especially high-risk population. Comprehensive and high-quality sexual and reproductive healthcare (SRHC) is desperately needed among this population, yet many Latina women face substantial barriers in accessing care. This study builds upon the three-delays model to better understand why Latina women experience delays in accessing quality SRHC in the state of South Carolina. Data for this study were drawn from semi-structed interviews with 14 adult women identifying as either Hispanic or Latina. Findings reveal that structural factors, including long distances to facilities, high costs of care, and difficulties navigating local healthcare and insurance systems, served as barriers to accessing quality SRHC. Socio-cultural factors, such as communication challenges and low cultural competency among healthcare providers, further inhibited access to care, even among women who spoke fluent English. These findings indicate a need for SRHC education and services to be more culturally-centered, by accounting for cultural knowledge and historical dynamics, and by giving patients more agency with respect to their care. Regarding the three-delays model, future applications should seek to better incorporate preventive services and consider that perceptions of quality SRHC are both individually- and contextually-mediated. This will be an important step toward developing policies and programs that are appropriately tailored to specific populations' cultural backgrounds and contextual needs.
美国的移民妇女和少数族裔妇女面临着生殖健康状况不佳的高风险。西班牙裔/拉丁裔妇女是一个特别高危的群体。这一人群迫切需要全面、高质量的性与生殖健康保健（SRHC），然而许多拉丁裔妇女在获得保健服务方面面临重大障碍。本研究以三延迟模型为基础，以更好地理解为什么拉丁裔妇女在南卡罗来纳州获得高质量SRHC时会出现延迟。本研究的数据来自对14名自认为是西班牙裔或拉丁裔的成年女性进行的半结构化访谈。研究结果表明，结构因素，包括到医疗机构的距离远、护理成本高以及在当地医疗保健和保险系统中导航困难，成为获得高质量SRHC的障碍。社会文化因素，如沟通挑战和医疗服务提供者文化能力低，进一步阻碍了获得护理服务，即使是那些说流利英语的女性也是如此。这些研究结果表明，SRHC教育和服务需要更加以文化为中心，考虑文化知识和历史动态，并给予患者在护理方面更多的自主权。关于三延迟模型，未来的应用应寻求更好地纳入预防服务，并考虑到对高质量SRHC的认知是由个体和背景因素共同调节的。这将是朝着制定适合特定人群文化背景和背景需求的政策和计划迈出的重要一步。
