A model for health care utilization was applied to a sample of low income women. Demographic Predisposing, Psychosocial Predisposing, Illness Level, and Enabling indicators were examined separately for African American (n = 266), Anglo American (n = 200), and Mexican American (n = 210) women. Structural Equation Modeling revealed that for African American and Anglo American women, Illness Level, the only significant path to Utilization, had a mediating effect on Psychosocial Predisposing indicators. The model for Mexican Americans was the most complex with Enabling indicators affecting Illness Level and Utilization. Psychosocial Predisposing indicators were mediated by Illness Level and Enabling indicators which both directly affected Utilization. Implications of the results for future research are addressed.

Workplace stress has been found to be a causal agent of psychological distress consequences in employees. Chronic stressors have been well researched, in particular, role conflict, role ambiguity, and work overload have been extensively studied. A meta-analysis was conducted in order to aggregate past research to gain a better understanding of the impact these stressors have on the psychological distress consequences of depression, tension/anxiety, somatic complaints, and generalized feelings of stress. Only role ambiguity was found to be a significant contributor to psychological distress, in particular to feelings of depression and stress. In general, however, effect sizes for all three stressors were moderate to large. While chronic stressors have been well researched, acute stressors have been widely overlooked. Since research in this area is limited, the Daily Work Hassles Survey was developed and validated in order to analyze the role daily hassles play in the workplace. The survey yielded two factors, Interpersonal Hassles and Task Hassles. The former of which was found to be significantly related to the distress consequences of depression, tension/anxiety, somatic complaints, and general feelings of stress. The ultimate goal of this project was to compare chronic and acute stressors. Results from the daily hassles study were …

Mutations in BRCA1 and BRCA2, the first two breast cancer susceptibility genes identified, carry as much as an 85% lifetime risk of developing breast, ovarian or other cancers. Genetic testing for mutations in these two genes has recently become commercially available. There have been varying amounts of psychological distress noted among women with a family history of breast cancer. Distress has been observed to impact psychological functioning, activities of daily living, and the practice of breast cancer surveillance behaviors. Within the genetic screening process, psychological distress has been shown to impact the decision to undergo genetic screening, the comprehension and retention of risk assessment information, as well as affecting the subject following the receipt of the genetic test results. Little work has been done to examine predictors of distress within at risk subjects. This study examines psychological distress among 52 community women presenting for BRCA1 and BRCA2 genetic mutation testing. Predictors of distress included family cancer history, education, age, Ashkenazi ethnicity, and Internality and Powerful Others Health Locus of Control. Vulnerable sub-groups of patients include younger women, women with higher levels of education and women of Ashkenazi ethnicity.