Although continuity of cancer-related care increases the use of early detection cancer screening exams (Doescher, Saver, Fiscella, & Franks, 2004), and thereby improves treatment outcomes (Mandelblatt et al., 2009), Latino (Latina) women in the U.S. currently report lower continuity of care than non-Latino White (Anglo) women (American Cancer Society, 2010; Doescher, Saver, Fiscella, & Franks, 2001). Such disparities may be due, in part, to interpersonal healthcare mistreatment (Smedley, Stith, & Nelson, 2003), as well as mistreatment-related attributions and emotions (Betancourt, Flynn, & Ormseth, 2011; Tucker, 2008). Therefore, according to Weiner's model of attribution and emotion (1986) as well as Betancourt's Integrative model of Culture, Psychological Processes, and Health Behavior (2009), the aim of this research was to examine the impact of mistreatment-related attributions of intentionality and controllability, as well as negative emotions, on continuity of care among Latino and Anglo women. Two hundred and fourteen Latino and Anglo women who perceived at least one instance of interpersonal healthcare mistreatment were recruited from Southern California using multi-stage stratified sampling. Structural equation modeling confirmed the expected relationships between attributions, negative emotions, and continuity of care, with ethnicity moderating these associations. For Anglos, higher attributions of intentionality were associated with higher attributions of controllability, r = .46, p < .001, and were directly related to lower continuity of care, Î² = -.38, p < .01. For Latinos, higher attributions of controllability were indirectly related to lower continuity of care through mistreatment-related negative emotions, Î²indirect = -.12, p < .05. These findings have implications for improving continuity of care in Latino American women, as well as educating healthcare professionals on how attributions and emotions related to patient-professional relationships can impact cancer-related health disparities.
School of Behavioral Health
Doctor of Philosophy (PhD)
Year Degree Awarded
Date (Title Page)
Library of Congress/MESH Subject Headings
Healthcare disparities; Cancer; Mammography; Health Behavior - ethnology; Hispanic Americans; Attitude to Health - Hispanic Americans; Breast neoplasms - prevention & control;
Subject - Local
Interpersonal Healthcare mistreatment; Continuity of care
Loma Linda University Libraries
This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.
Northington, Daniel Joel, "Attributions for Interpersonal Healthcare Mistreatment and Continuity of Care" (2012). Loma Linda University Electronic Theses, Dissertations & Projects. 89.
Loma Linda University Electronic Theses & Dissertations
Loma Linda University. Del E. Webb Memorial Library. University Archives