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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 郭貞蘭 | zh_TW |
| dc.contributor.advisor | Chen-Lan Kuo | en |
| dc.contributor.author | 管靚 | zh_TW |
| dc.contributor.author | Ching Kuan | en |
| dc.date.accessioned | 2025-02-27T16:40:58Z | - |
| dc.date.available | 2025-03-08 | - |
| dc.date.copyright | 2025-02-27 | - |
| dc.date.issued | 2025 | - |
| dc.date.submitted | 2025-02-18 | - |
| dc.identifier.citation | Barnes, D. M., Keyes, K. M., & Bates, L. M. (2013). Racial differences in depression in the United States: how do subgroup analyses inform a paradox? Social psychiatry and psychiatric epidemiology, 48(12), 1941–1949. https://doi.org/10.1007/s00127-013-0718-7
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182. Bennett, K. K., Buchanan, D. M., Jones, P. G., & Spertus, J. A. (2015). Socioeconomic status, cognitive-emotional factors, and health status following myocardial infarction: testing the Reserve Capacity Model. Journal of behavioral medicine, 38(1), 110–121. https://doi.org/10.1007/s10865-014-9583-4 Breslau, J., Aguilar-Gaxiola, S., Kendler, K. S., Su, M., Williams, D., & Kessler, R. C. (2006). Specifying race-ethnic differences in risk for psychiatric disorder in a USA national sample. Psychological medicine, 36(1), 57–68. https://doi.org/10.1017/S0033291705006161 Burke, T. P., & Morton, J. D. (1990). How firm size and industry affect employee benefits. Monthly labor review, 113(12), 35–43. Capp, R., Hardy, R., Lindrooth, R., & Wiler, J. (2016). National trends in emergency department visits by adults with mental health disorders. The Journal of emergency medicine, 51(2), 131–135.e1. https://doi.org/10.1016/j.jemermed.2016.05.002 Centers for Disease Control and Prevention. (2008). Community health and program services (CHAPS): health disparities among racial/ethnic populations. US Department of Health and Human Services. Charron-Chénier, R., & Mueller, C. W. (2018). Racial disparities in medical spending: Healthcare expenditures for Black and White households (2013–2015). Race and Social Problems, 10(2), 113–133. https://doi.org/10.1007/s12552-018-9226-4 Cole, D. A., & Maxwell, S. E. (2003). Testing mediational models with longitudinal data: questions and tips in the use of structural equation modeling. Journal of abnormal psychology, 112(4), 558–577. https://doi.org/10.1037/0021-843X.112.4.558 Commonwealth Fund. (2024, April 9). Advancing racial equity in U.S. health care: A roadmap to implement the Biden-Harris administration's plan. Commonwealth Fund. https://www.commonwealthfund.org/publications/fund-reports/2024/apr/advancing-racial-equity-us-health-care Court S. D. (1981). Inequalities in health. Report of a research working group. Archives of disease in childhood, 56(3), 161–162. https://doi.org/10.1136/adc.56.3.161 Dawson, A. Z., Bishu, K. G., Walker, R. J., & Egede, L. E. (2021). Trends in medical expenditures by race/ethnicity in adults with Type 2 Diabetes 2002-2011. Journal of the national medical association, 113(1), 59–68. https://doi.org/10.1016/j.jnma.2020.07.008 Dickerson, F. B., McNary, S. W., Brown, C. H., Kreyenbuhl, J., Goldberg, R. W., & Dixon, L. B. (2003). Somatic healthcare utilization among adults with serious mental illness who are receiving community psychiatric services. Medical care, 41(4), 560–570. https://doi.org/10.1097/01.MLR.0000053440.18761.F0 Dovidio, J. F., Penner, L. A., Edmondson, D., Dailey, R. K., Markova, T., Albrecht, T. L., & Gaertner, S. L. (2009). Disparities and distrust: The implications of psychological processes for understanding racial disparities in health and health care. Social Science & Medicine, 68(11), 1889-1895. https://doi.org/10.1016/j.socscimed.2009.02.022 Druss, B. G., Bradford, D. W., Rosenheck, R. A., Radford, M. J., & Krumholz, H. M. (2000). Mental disorders and use of cardiovascular procedures after myocardial infarction. JAMA, 283(4), 506–511. https://doi.org/10.1001/jama.283.4.506 Druss, B. G., & Rosenheck, R. A. (1998). Mental disorders and access to medical care in the United States. The American journal of psychiatry, 155(12), 1775–1777. https://doi.org/10.1176/ajp.155.12.1775 DuBois W. E. (2003). The health and physique of the Negro American. 1906. American journal of public health, 93(2), 272–276. https://doi.org/10.2105/ajph.93.2.272 Due, P., Holstein, B., Lund, R., Modvig, J., & Avlund, K. (1999). Social relations: network, support and relational strain. Social science & medicine (1982), 48(5), 661–673. https://doi.org/10.1016/s0277-9536(98)00381-5 Estrella, M. L., Tarraf, W., Kuwayama, S., Gallo, L. C., Wu, B., Marquine, M. J., Perreira, K. M., Vasquez, P. M., Isasi, C. R., Lipton, R. B., Mattei, J., González, H. M., Daviglus, M. L., & Lamar, M. (2024). Psychosocial factors associated with 7-year change in cognition among middle-aged and older Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) and Sociocultural ancillary studies. Alzheimer's & dementia: the journal of the Alzheimer's Association, 20(2), 1137–1148. https://doi.org/10.1002/alz.13527 Fogarty, C. T., Sharma, S., Chetty, V. K., & Culpepper, L. (2008). Mental health conditions are associated with increased health care utilization among urban family medicine patients. Journal of the American Board of Family Medicine: JABFM, 21(5), 398–407. https://doi.org/10.3122/jabfm.2008.05.070082 Fylkesnes K. (1993). Determinants of health care utilization--visits and referrals. Scandinavian journal of social medicine, 21(1), 40–50. https://doi.org/10.1177/140349489302100107 Gallo, L. C., & Matthews, K. A. (2003). Understanding the association between socioeconomic status and physical health: Do negative emotions play a role? Psychological Bulletin, 129(1), 10–51. https://doi.org/10.1037/0033-2909.129.1.10 Gallo, L. C., Bogart, L. M., Vranceanu, A. M., & Matthews, K. A. (2005). Socioeconomic status, resources, psychological experiences, and emotional responses: a test of the reserve capacity model. Journal of personality and social psychology, 88(2), 386–399. https://doi.org/10.1037/0022-3514.88.2.386 Gallo, L. C. (2009). The Reserve Capacity Model as a framework for understanding psychosocial factors in health disparities. Applied Psychology: Health and Well-Being, 1(1), 62–72. https://doi.org/10.1111/j.1758-0854.2008.01000.x Gallo, L. C., Penedo, F. J., Espinosa de los Monteros, K., & Arguelles, W. (2009). Resiliency in the face of disadvantage: do Hispanic cultural characteristics protect health outcomes? Journal of personality, 77(6), 1707–1746. https://doi.org/10.1111/j.1467-6494.2009.00598.x Geitona, M., Zavras, D., & Kyriopoulos, J. (2007). Determinants of healthcare utilization in Greece: implications for decision-making. The European journal of general practice, 13(3), 144–150. https://doi.org/10.1080/13814780701541340 Gordon H. S., Street R. L. Jr, Sharf B. F., Kelly P. A., Souchek J. Racial differences in trust and lung cancer patients' perceptions of physician communication. J Clin Oncol. 2006 Feb 20;24(6):904-9. https://doi.org/10.1200/JCO.2005.03.1955 Gray A. M. (1982). Inequalities in health. The Black Report: a summary and comment. International journal of health services: planning, administration, evaluation, 12(3), 349–380. https://doi.org/10.2190/XXMM-JMQU-2A7Y-HX1E Green, C. R., Anderson, K. O., Baker, T. A., Campbell, L. C., Decker, S., Fillingim, R. B., Kalauokalani, D. A., Lasch, K. E., Myers, C., Tait, R. C., Todd, K. H., & Vallerand, A. H. (2003). The unequal burden of pain: confronting racial and ethnic disparities in pain. Pain medicine (Malden, Mass.), 4(3), 277–294. https://doi.org/10.1046/j.1526-4637.2003.03034.x Guimond, E., Getachew, B., Nolan, T. S., Miles Sheffield-Abdullah, K., Conklin, J. L., & Hirschey, R. (2022). Communication between Black patients with cancer and their oncology clinicians: exploring factors that influence outcome disparities. Oncology nursing forum, 49(6), 509–524. https://doi.org/10.1188/22.ONF.509-524 Halbert C. H., Armstrong K., Gandy O. H. Jr., Shaker L. Racial differences in trust in health care providers. Arch Intern Med. 2006 Apr 24;166(8):896-901. https://doi.org/10.1001/archinte.166.8.896 Hazel-Fernandez, L., Li, Y., Nero, D., Moretz, C., Slabaugh, L., Meah, Y., Baltz, J., Costantino, M., Patel, N. C., & Bouchard, J. (2015). Racial/ethnic and gender differences in severity of diabetes-related complications, health care resource use, and costs in a Medicare population. Population health management, 18(2), 115–122. https://doi.org/10.1089/pop.2014.0038 Horenstein, A., & Heimberg, R. G. (2020). Anxiety disorders and healthcare utilization: A systematic review. Clinical psychology review, 81, 101894. https://doi.org/10.1016/j.cpr.2020.101894 Hughes, M., Kiecolt, K. J., Keith, V. M., & Demo, D. H. (2015). Racial identity and well-being among African Americans. Social Psychology Quarterly, 78(1), 25-48. https://doi.org/10.1177/0190272514554043 Institute of Medicine. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. National Academies Press. https://doi.org/10.17226/10260 Iturralde, E., Chi, F. W., Grant, R. W., Weisner, C., Van Dyke, L., Pruzansky, A., Bui, S., Madvig, P., Pearl, R., & Sterling, S. A. (2019). Association of Anxiety With High-Cost Health Care Use Among Individuals With Type 2 Diabetes. Diabetes care, 42(9), 1669–1674. https://doi.org/10.2337/dc18-1553 Kysar-Moon, A. (2020). Childhood adversity and internalizing problems: evidence of a race mental health paradox. Society and mental health, 10(2), 136-162. https://doi.org/10.1177/2156869319843325 Kaiser Family Foundation. (2023, February 24). Survey on racism, discrimination, and health. KFF. https://www.kff.org/racial-equity-and-health-policy/poll-finding/survey-on-racism-discrimination-and-health/ Krull, J. L., & MacKinnon, D. P. (2001). Multilevel modeling of individual and group level mediated effects. Multivariate behavioral research, 36(2), 249–277. https://doi.org/10.1207/S15327906MBR3602_06 Lee, K., & Rispoli, K. (2017). Racial disparities in perceived social support and social service use: Associations with maternal depression and head start participation. Journal of Community Psychology, 45(8), 1080–1093. https://doi.org/10.1002/jcop.21912 Lee, J. A., Liu, C. F., & Sales, A. E. (2006). Racial and ethnic differences in diabetes care and health care use and costs. Preventing chronic disease, 3(3), A85. Link, B. G., & Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of health and social behavior, 80–94. https://doi.org/10.2307/2626958 Lutfey, K., & Freese, J. (2005). Toward Some Fundamentals of Fundamental Causality: Socioeconomic Status and Health in the Routine Clinic Visit for Diabetes. American Journal of Sociology, 110(5), 1326–1372. https://doi.org/10.1086/428914 MacKinnon, D. P., & Dwyer, J. H. (1993). Estimating mediated effects in prevention studies. Evaluation Review, 17(2), 144-158. https://doi.org/10.1177/0193841X9301700202 Mark, T. L., Palmer, L. A., Russo, P. A., & Vasey, J. (2003). Examination of treatment pattern differences by race. Mental health services research, 5(4), 241–250. https://doi.org/10.1023/a:1026281118990 Matthews, K. A., Räikkönen, K., Gallo, L., & Kuller, L. H. (2008). Association between socioeconomic status and metabolic syndrome in women: testing the reserve capacity model. Health psychology: official journal of the Division of Health Psychology, American Psychological Association, 27(5), 576–583. https://doi.org/10.1037/0278-6133.27.5.576 Matthews, K. A., Gallo, L. C., & Taylor, S. E. (2010). Are psychosocial factors mediators of socioeconomic status and health connections? A progress report and blueprint for the future. Annals of the New York Academy of Sciences, 1186, 146–173. https://doi.org/10.1111/j.1749-6632.2009.05332.x Mulvaney-Day, N. E., Alegría, M., & Sribney, W. (2007). Social cohesion, social support, and health among Latinos in the United States. Social science & medicine (1982), 64(2), 477–495. https://doi.org/10.1016/j.socscimed.2006.08.030 Nelson, S. C., & Hackman, H. W. (2013). Race matters: perceptions of race and racism in a sickle cell center. Pediatric blood & cancer, 60(3), 451–454. https://doi.org/10.1002/pbc.24361 Oyserman, D., Fryberg, S. A., & Yoder, N. (2007). Identity-based motivation and health. Journal of personality and social psychology, 93(6), 1011–1027. https://doi.org/10.1037/0022-3514.93.6.1011 Palmer, N. R., Kent, E. E., Forsythe, L. P., Arora, N. K., Rowland, J. H., Aziz, N. M., Blanch-Hartigan, D., Oakley-Girvan, I., Hamilton, A. S., & Weaver, K. E. (2014). Racial and ethnic disparities in patient-provider communication, quality-of-care ratings, and patient activation among long-term cancer survivors. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 32(36), 4087–4094. https://doi.org/10.1200/JCO.2014.55.5060 Pandit, A. A., Gressler, L. E., Halpern, M. T., Kamel, M., Payakachat, N., & Li, C. (2022). Racial/Ethnic disparities in patient care experiences among prostate cancer survivors: A SEER-CAHPS study. Current oncology (Toronto, Ont.), 29(11), 8357–8373. https://doi.org/10.3390/curroncol29110659 Parast, L., Mathews, M., Martino, S., Lehrman, W. G., Stark, D., & Elliott, M. N. (2022). Racial/Ethnic differences in emergency department utilization and xxperience. Journal of general internal medicine, 37(1), 49–56. https://doi.org/10.1007/s11606-021-06738-0 Penner, L. A., Hagiwara, N., Eggly, S., Gaertner, S. L., Albrecht, T. L., & Dovidio, J. F. (2013). Racial healthcare disparities: A social psychological analysis. European review of social psychology, 24(1), 70–122. https://doi.org/10.1080/10463283.2013.840973 Penner, L. A., Blair, I. V., Albrecht, T. L., & Dovidio, J. F. (2014). Reducing racial health care disparities: A social psychological analysis. Policy insights from the behavioral and brain sciences, 1(1), 204–212. https://doi.org/10.1177/2372732214548430 Phelan, J. C., & Link, B. G. (2015). Is racism a fundamental cause of inequalities in health? Annual Review of Sociology, 41, 311–330. https://doi.org/10.1146/annurev-soc-073014-112305 Pullen, E., Fischer, M. W., Morse, G., Garabrant, J., Salyers, M. P., & Rollins, A. L. (2023). Racial disparities in the workplace: The impact of isolation on perceived organizational support and job satisfaction. Psychiatric rehabilitation journal, 46(1), 45–52. https://doi.org/10.1037/prj0000543 Riley W. J. (2012). Health disparities: gaps in access, quality and affordability of medical care. Transactions of the American Clinical and Climatological Association, 123, 167–174. Saha S, Arbelaez JJ, Cooper LA. Patient-physician relationships and racial disparities in the quality of health care. Am J Public Health. 2003 Oct;93(10):1713-9. http://dx.doi.org/10.2105/ajph.93.10.1713 Saha, S., Jacobs, E. A., Moore, R. D., & Beach, M. C. (2010). Trust in physicians and racial disparities in HIV care. AIDS Patient Care and STDs, 24(7), 415-420. https://doi.org/10.1089/apc.2009.0288 Shavers, V. L., & Brown, M. L. (2002). Racial and ethnic disparities in the receipt of cancer treatment. Journal of the National Cancer Institute, 94(5), 334–357. https://doi.org/10.1093/jnci/94.5.334 Sohn H. (2017). Racial and ethnic disparities in health insurance coverage: dynamics of gaining and losing coverage over the life-course. Population research and policy review, 36(2), 181–201. https://doi.org/10.1007/s11113-016-9416-y Spencer, K. L., & Grace, M., (2016). Social foundations of health care inequality and treatment bias. Annual Review of Sociology,42, 101-120. http://dx.doi.org/10.1146/annurev-soc-081715-074226 Steers, M. N., Chen, T. A., Neisler, J., Obasi, E. M., McNeill, L. H., & Reitzel, L. R. (2019). The buffering effect of social support on the relationship between discrimination and psychological distress among church-going African-American adults. Behaviour research and therapy, 115, 121–128. https://doi.org/10.1016/j.brat.2018.10.008 Thomas Tobin, C. S., Erving, C. L., Hargrove, T. W., & Satcher, L. A. (2022). Is the Black-White mental health paradox consistent across age, gender, and psychiatric disorders? Aging & mental health, 26(1), 196–204. https://doi.org/10.1080/13607863.2020.1855627\\ Walen, H. R., & Lachman, M. E. (2000). Social support and strain from partner, family, and friends: Costs and benefits for men and women in adulthood. Journal of Social and Personal Relationships, 17(1), 5–30. https://doi.org/10.1177/0265407500171001 Williams, D. R., & Collins, C. (1995). US socioeconomic and racial differences in health: Patterns and explanations. Annual Review of Sociology, 21(1), 349-386. https://doi.org/10.1146/annurev.so.21.080195.002025 Williams, D. R., & Rucker, T. D. (2000). Understanding and addressing racial disparities in health care. Health care financing review, 21(4), 75–90. Williams, D. R., & Collins, C. (2001). Racial residential segregation: a fundamental cause of racial disparities in health. Public health reports (Washington, D.C.: 1974), 116(5), 404–416. https://doi.org/10.1093/phr/116.5.404 Williams, D. R. (2018). Stress and the mental health of populations of color: advancing our understanding of race-related stressors. Journal of health and social behavior, 59(4), 466-485. https://doi.org/10.1177/0022146518814251 Yang, Y. C., Schorpp, K., & Harris, K. M. (2014). Social support, social strain and inflammation: evidence from a national longitudinal study of U.S. adults. Social science & medicine (1982), 107, 124–135. https://doi.org/10.1016/j.socscimed.2014.02.013 You, J., Zhu, Y., Liu, S., Wang, C., Wang, P., & Du, H. (2021). Socioeconomic disparities in psychological health: Testing the Reserve Capacity Model in a population-based sample of Chinese migrants. Journal of health psychology, 26(10), 1538–1548. https://doi.org/10.1177/1359105319882763 2022 National Healthcare Quality and Disparities Report. Content last reviewed July 2023. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/research/findings/nhqrdr/nhqdr22/index.html | - |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/97208 | - |
| dc.description.abstract | 本研究旨在探討社會心理資源在美國種族間醫療照護資源使用不平等中所扮演之角色。本研究使用美國全國青年長期追蹤調查（NLSY1997），並以受限能力模型（Reserved Capacity Model）發展新的理論模型，用於探索個人內部與人際間的社會心理資源如何分別影響非拉丁美洲裔白人、拉丁美洲裔與非裔美國人所感知道自己對醫療照護資源的需求，以及其實際使用醫療照護資源之行為。透過多層次非線性迴歸分析與多層次中介分析，本研究發現拉丁美洲裔與非裔美國人平均而言回報較少的醫療照護資源的需求，也較少使用其所能近用的資療照護資源，而這樣的行為傾向受到心理健康與工作福利支持等因素中介。相對於原先的受限能力模型，本研究發現較心理健康較差者反而較多地使用醫療照護資源，顯示心理壓力有可能使個人的就醫行為更傾向於積極。如此發現不僅彰顯醫療資源不平等之議題複雜性，更暗示後續政策應有機會利用社會心理資源之力量來縮減種族之間的醫療資源使用行為之差異。 | zh_TW |
| dc.description.abstract | This study investigates the role of psychosocial resources in the racial-ethnic disparities of healthcare utilization. Using data from the National Longitudinal Survey of Youth 1997, the study applies the Reserve Capacity Model to explore how intrapersonal and interpersonal psychosocial resources impact the perceived needs and behaviors of healthcare utilization among African American, Hispanic, and Non-Hispanic White populations. The results of multilevel non-linear regression and mediation analysis reveal that while racial-ethnic minorities generally report fewer healthcare needs and less frequent utilization, certain psychosocial factors significantly mitigate the observed racial-ethnic gaps in healthcare utilization. Contrary to the RCM’s predictions, increased mental distress was associated with heightened healthcare utilization, suggesting that intense psychological states may drive more active healthcare-seeking behaviors. The findings underscore the complexity of healthcare disparities and suggest that policies should leverage psychosocial factors, particularly institutional support, to address these gaps and promote equitable healthcare access across racial-ethnic groups. | en |
| dc.description.provenance | Submitted by admin ntu (admin@lib.ntu.edu.tw) on 2025-02-27T16:40:58Z No. of bitstreams: 0 | en |
| dc.description.provenance | Made available in DSpace on 2025-02-27T16:40:58Z (GMT). No. of bitstreams: 0 | en |
| dc.description.tableofcontents | Verfication Letter from the Oral Examination Committee ii
摘要 iii Abstract iv Content v Table of Figures vii List of Tables viii 1. Introduction 1 2. Literature Review 2 2.1 Racial Healthcare Disparities 3 2.2 The Social Psychology Approach in Understanding Racial Healthcare Disparities 7 2.3 Reserve Capacity Model 12 3. Theoretical Framework and Hypothesis 16 4. Data & Method 18 4.1 Data 19 4.2 Measurement 19 4.3 Analytical Strategy 24 5. Results 29 5.1 Descriptive Statistics of Analytical Sample from 2005 to 2009 29 5.2 Stage 1: Multilevel Linear Regression 30 5.2.1 Race-ethnicity and Healthcare Utilization 30 5.2.2 Race-ethnicity and Psychosocial Resources 31 5.2.3 Psychosocial Resources and Healthcare Utilization 34 5.3 Stage 2: Multilevel Mediation Analysis 36 6. Discussion and Conclusion 41 References 62 Appendix A. Multilevel Linear Results in Multilevel Mediation Analysis 73 | - |
| dc.language.iso | en | - |
| dc.title | 社會心理資源做為種族醫療不平等之中介因素：美國全國縱貫資料之分析 | zh_TW |
| dc.title | Psychosocial Resources as Mediators of Racial Healthcare Disparities: Evidence from National Panel Study | en |
| dc.type | Thesis | - |
| dc.date.schoolyear | 113-1 | - |
| dc.description.degree | 碩士 | - |
| dc.contributor.oralexamcommittee | 陳端容;林孟瑢 | zh_TW |
| dc.contributor.oralexamcommittee | Duan-Rong Chen;Meng-Jung Lin | en |
| dc.subject.keyword | 種族醫療資源使用不平等,受限能力模型,社會心理資源,中介分析,美國全國青年長期追蹤調查, | zh_TW |
| dc.subject.keyword | Racial Healthcare Disparities,Reserved Capacity Model,Psychosocial Resources,Mediation Analysis,NLSY97, | en |
| dc.relation.page | 82 | - |
| dc.identifier.doi | 10.6342/NTU202500318 | - |
| dc.rights.note | 同意授權(全球公開) | - |
| dc.date.accepted | 2025-02-18 | - |
| dc.contributor.author-college | 社會科學院 | - |
| dc.contributor.author-dept | 社會學系 | - |
| dc.date.embargo-lift | 2025-03-08 | - |
| 顯示於系所單位： | 社會學系 | |
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