Black and Hispanic Women's Views on LUTS Treatment and a Home-Based Intervention.

Abstract

Objective: This study aimed to examine facilitators and barriers to treatment for lower urinary tract symptoms among care-seeking Black and Hispanic women and to explore perspectives on "SUPPORT," a self-directed, 8-week, home-based intervention combining education, bladder retraining, pelvic floor muscle training, and cognitive behavior therapy.

Study design: This was a qualitative observational study. We recruited a convenience sample of care-seeking women with lower urinary tract symptoms who self-identified as Black race or Hispanic ethnicity and were English or Spanish speaking. We conducted focus groups in the participants' primary language. Two authors analyzed the focus group transcripts using modified grounded theory techniques.

Results: We enrolled 27 participants and conducted 7 focus groups. There were 13 non-Hispanic Black and 14 Hispanic participants. The mean ± SD age of the cohort was 49 ± 14 years. Barriers reported by both Black and Hispanic participants included (1) unfamiliarity with treatment options and negative perceptions of procedural treatments, (2) unsatisfactory interactions with the health care team, (3) travel distance for treatment, and (4) resources. Barriers distinct to Spanish-speaking and Black participants were inadequate interpreter services and feeling blocked from accessing care by clinic staff, respectively. Facilitators of treatment included (1) patient-centered clinical environments, (2) streamlined financial assistance services, and (3) shared treatment decision making. Most participants found the SUPPORT intervention concept promising for reducing psychosocial stress related to lower urinary tract symptoms and potentially overcoming various barriers to treatment.

Conclusion: Participants reported multilevel barriers to lower urinary tract treatments. The concept of the SUPPORT intervention was acceptable to participants and may overcome barriers to treatment.