Milkie Vu, MA Research Specialist The University of Chicago Relationships between Religiosity and Delayed Healthcare Seeking among American Muslims Milkie Vu, MA Research Specialist The University of Chicago Tala Radejko, Alia Azmat, Sohad Murrar, Zahra Hosseinian, Brigid Adviento, Aasim Padela

Background Patient delays (the time lapse between recognizing that an illness requires medical care and deciding to act) lead to more adverse health outcomes Poorer prognosis and longer hospitalization Higher mortality rates American Muslim women have lower utilization across a range of health services compared to other groups Cancer screening HPV vaccination Mental health help-seeking

Background Religion-related factors might impact American Muslim women’s decision to delay care seeking Lack of female providers Modesty Fatalistic beliefs about health Religious discrimination Usage of alternative medicine and worship practices for health

OBJECTIVE Quantify the prevalence of delayed care seeking among American Muslim women due to a perceived lack of female clinicians Explore religion-related factors and socio-demographic characteristics associated with this decision

METHODS CBPR approach Partnership with the Council of Islamic Organizations of Greater Chicago (CIOGC) Community Advisory Board Study population Self-identified Muslim Women English-speaking Recruited from mosques and community events Self-administered surveys

Methods (CONT.) Independent variable: Respondents indicated levels of agreement with the following statement: “I have delayed seeking medical care when no woman doctor is available to see me.” Dependent variables: (assessed using previously validated survey instruments) Religiosity Religious fatalism (RHFQ) Perceived religious discrimination Modesty Alternative medicine and worship practices use Socio-demographic characteristics (age, ethnicity, education, income, duration of living in the U.S., insurance status, PCP status)

RESULTS (N=254)

RESULTS (CONT.) 129 (53%) participants reported delayed care seeking due to a perceived lack of female clinicians Religiosity Participants with highest level of self-rated religiosity had higher odds of delaying care (OR=5.2, p<.01) Modesty Participants with higher level of modesty had higher odds of delaying care (OR=1.4, p<.001) Socio-demographic characteristics Participants who had lived in the United States for more than 20 years had lower odds of delaying care (OR=.22, p<.05)

DISCUSSION A substantial number of Muslim women (53% of our sample) chose to delay or forgo care due to a perceived lack of female clinicians Implications for health outcomes in this population Women with highest level of self-rated religiosity reported higher odds of delaying seeking care Religious guidelines for doctors of same gender Preference for gender-segregated environments

DISCUSSION (CONT.) Highly modest women have higher odds of delaying care Perception that having a male doctor will compromise modesty Longer duration of living in the United States is associated with lower odds of delaying care Social and economic demands of adjustment Longer duration of living leads to more knowledge of healthcare system and comfort with navigation

CONCLUSION & FUTURE DIRECTIONS Benefits of gender-concordant care for Muslim women Part of culturally competent care Context of delayed care seeking Urgent/acute, preventive, or primary care Policy implications More female staff in ambulatory care Longer gowns in emergency rooms Cultural competency training for all healthcare providers

ACKNOWLEDGEMENTS Community Partners and Advisors Grant Support American Cancer Society Institutional Research Grant (#58-004) Cancer Center Support Grant (#P30CA14599) Community Partners and Advisors Ahlam Jbara (CIOGC) Zaher Sahloul (CIOGC) Itedal Shalabi (AAFS) Bamade Shakoor-Abdulla (CMECCA)