Structured Abstract Objective Fewer than half of women with urinary incontinence (UI) seek care for their condition. Our objective was to qualitatively assess themes surrounding treatment seeking behaviors. Methods We conducted 12 focus groups in women, and using purposive sampling we stratified by racial or ethnic group (White, Black, Latina) and by UI frequency. All sessions were transcribed and coded for common themes. Comparative thematic analysis was used to describe similarities and differences among groups. Results In total, 113 (39 White, 41 Black, and 33 Latina) community dwelling women participated in focus groups. There were no differences in treatment seeking themes between groups with different UI frequency. However, certain themes emerged when comparing racial/ethnic groups. Women from all groups shared experiences of embarrassment and isolation due to UI, which were impediments to care seeking. White and Black women described discussions with close friends or family that led to normalization of symptoms, and prevented care seeking. Latina women maintained more secrecy about UI and reported the longest delays in seeking care. Women articulated a higher likelihood of seeking care if they had knowledge of treatment options, but White women were more likely to seek UI-related knowledge compared to Black or Latina women. Physician communication barriers were identified in all groups. Conclusions Despite similar experiences, there are different perceptions about care seeking among White, Black, and Latina women. Culturally relevant educational resources that focus on a range of treatment options may improve knowledge and thus improve care seeking behaviors in women with UI.

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Introduction We compared barriers to urinary incontinence (UI) healthcare seeking between white, black, and Latina women. Methods This is a cross-sectional study using a convenience sample of white, black, and Latina women. Women completed the Barriers to Incontinence Care Seeking Questionnaire (BICS-Q), the Incontinence Quality of Life Instrument (I-QOL), the Questionnaire for Urinary Incontinence Diagnosis (QUID), and the Incontinence Severity Index (ISI). The primary objective was to assess barriers to UI care seeking among groups, as measured by the BICS-Q. Secondary objectives were to assess factors associated with barriers to incontinence care and to compare specific barriers using BICS-Q subscale scores. Regression analyses were used to further assess for differences among groups while adjusting for potential confounding variables. Results We included a total of 93 subjects, including 30 white, 33 black, and 30 Latina women. Mean I-QOL, QUID, and ISI scores were not significantly different among our three groups. Barriers, based on BICS-Q scores, were lowest in white women and higher in blacks and Latinas (2.9 vs. 7.3 vs. 10.9 respectively, p<0.001). When adjusting for potential confounders such as age, income, education, presence of UI, ISI score, and I-QOL score, Latinas continued to demonstrate higher barriers compared to white or black women (β= 7.4, 95% CI: 2.2–12.7; p=0.006). There were no significant differences between black women compared to other groups in the adjusted analyses. Conclusions Latinas experience more barriers to UI healthcare seeking compared to white and black women.

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