Steven Stellman - A qualitative examination of health and health care utilization after the September 11th terror attacks among World Trade Center Health Registry enrollees

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      Publication Details (including relevant citation   information):

      Welch, A. E., Caramanica, K., Debchoudhury, I., Pulizzi, A.,   Farfel, M. R., Stellman, S. D., Cone, J. E. 12 721-

      Abstract: BACKGROUND: Many individuals who have   9/11-related physical and mental health symptoms do not use or   are unaware of 9/11-related health care services despite   extensive education and outreach efforts by the World Trade   Center (WTC) Health Registry (the Registry) and various other   organizations. This study sought to evaluate Registry enrollees'   perceptions of the relationship between physical and mental   health outcomes and 9/11, as well as utilization of and barriers   to 9/11-related health care services. METHODS: Six focus groups   were conducted in January 2010 with diverse subgroups of   enrollees, who were likely eligible for 9/11-related treatment   services. The 48 participants were of differing race/ethnicities,   ages, and boroughs of residence. Qualitative analysis of focus   group transcripts was conducted using open coding and the   identification of recurring themes. RESULTS: Participants   described a variety of physical and mental symptoms and   conditions, yet their knowledge and utilization of 9/11 health   care services were low. Participants highlighted numerous   barriers to accessing 9/11 services, including programmatic   barriers (lack of program visibility and accessibility), personal   barriers such as stigmatization and unfamiliarity with   9/11-related health problems and services, and a lack of   referrals from their primary care providers. Moreover, many   participants were reluctant to connect their symptoms to the   events of 9/11 due to lack of knowledge, the amount of time that   had elapsed since 9/11, and the attribution of current health   symptoms to the aging process. CONCLUSIONS: Knowledge of the   barriers to 9/11-related health care has led to improvements in   the Registry's ability to refer eligible enrollees to appropriate   treatment programs. These findings highlight areas for   consideration in the implementation of the new federal WTC Health   Program, now funded under the James Zadroga 9/11 Health and   Compensation Act (PL 111-347), which includes provisions for   outreach and education.

      Address (URL): http://www.ncbi.nlm.nih.gov/pubmed/22935548