Date of Award


Degree Name

Master of Arts



First Advisor

Chwalisz, Kathleen


This study is an investigation of how experiences of discrimination, self-efficacy, and the associated outcome expectations influence health care utilization of young college students. The relationships tested were informed by Andersen’s Behavioral Model of Health Services Use (Andersen, 2008), the most widely used model to understand and predict health care utilization. Andersen proposed that health care utilization is influenced by predisposing (i.e., personal characteristics), enabling (i.e., income, insurance), and need (i.e., perception of illness) factors. However, his model has been criticized for not taking in consideration social factors and oversimplifying the role of ethnicity as a predictor (Bradley et al., 2002). The purpose of this study is to expand the explanatory power of Andersen’s model, by including psychosocial variables (e.g., discrimination, self-efficacy). One hundred and eighty-five students completed a 20 minute online survey, which included measures of experiences of discrimination, outcome expectations, self-efficacy, attitudes, and demographic variables. Results indicated that self-efficacy to communicate with physicians was a significant predictor of health care utilization, although experiences of discrimination were not. The effects of discrimination on health care utilization were further found to be mediated by self-efficacy to communicate with physicians. The present study's finding provided support for the inclusion of psychosocial variables (i.e., self-efficacy) in Andersen's model to increase its explanatory power.




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