{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T10:41:49Z","timestamp":1780569709182,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Nursing"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n The complex relationship between poverty, health\u2010seeking behavior, and access to health services is critical to understanding health inequalities. This study aimed to deepen our understanding of this field by examining the relationships between poverty, health\u2010seeking behavior, and access to health services with a mixed\u2010methods approach.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Between December 2023 and March 2024, a mixed\u2010methods design (QUAN\u2010QUAL) was employed using a convergent (sequential) approach. The quantitative phase adopted a cross\u2010sectional research approach, while the qualitative part embraced a phenomenological approach. The quantitative stage involved 384 participants, and the qualitative stage involved 11 individuals. Quantitative data were collected using the Health Seeking Behavior Scale and the Healthcare Demand Procrastination Scale. In contrast, qualitative data were gathered through in\u2010depth individual interviews using a semi\u2010structured interview guide.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n As household income levels increase, health\u2010seeking behavior (\n r<\/jats:italic>\n \u00a0=\u00a00.141,\n p<\/jats:italic>\n \u00a0<\u00a00.001) and healthcare demand procrastination (\n r<\/jats:italic>\n \u00a0=\u00a00.143,\n p<\/jats:italic>\n \u00a0<\u00a00.001;\n \u03b2<\/jats:italic>\n \u00a0=\u00a00.132,\n p<\/jats:italic>\n \u00a0=\u00a00.003) significantly increase. Health\u2010seeking behavior rises among individuals who perceive their general health status as good (F\u00a0=\u00a07.111,\n p<\/jats:italic>\n \u00a0<\u00a00.001;\n \u03b2<\/jats:italic>\n \u00a0=\u00a00.143,\n p<\/jats:italic>\n \u00a0=\u00a00.004). In contrast, low income levels (\n t<\/jats:italic>\n \u00a0=\u00a03.797,\n p<\/jats:italic>\n \u00a0<\u00a00.001;\n \u03b2<\/jats:italic>\n \u00a0=\u00a0\u20130.147,\n p<\/jats:italic>\n \u00a0=\u00a00.004) and low education levels (F\u00a0=\u00a04.791,\n p<\/jats:italic>\n \u00a0<\u00a00.001;\n \u03b2<\/jats:italic>\n \u00a0=\u00a0\u20130.145,\n p<\/jats:italic>\n \u00a0=\u00a00.004) are significantly associated with decreases in health\u2010seeking behavior. Procrastination of healthcare demand is more common among workers (\n \u03b2<\/jats:italic>\n \u00a0=\u00a00.176,\n p<\/jats:italic>\n \u00a0<\u00a00.001). On the other hand, higher income levels and the distribution of health expenditures appear to reduce this tendency (\n \u03b2<\/jats:italic>\n \u00a0=\u00a0\u20130.121,\n p<\/jats:italic>\n \u00a0=\u00a00.015;\n \u03b2<\/jats:italic>\n \u00a0=\u00a0\u20130.116,\n p<\/jats:italic>\n \u00a0=\u00a00.021). The synthesis of interviews revealed two main themes: utilization of health services, and access to health services and inequalities. Within the theme of \u201cchallenges in accessing health services,\u201d the qualitative thematic analysis highlighted key difficulties such as transportation problems, long waiting times, and insufficient personnel.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Findings indicate that socioeconomic factors such as income level and education were determinants of health\u2010seeking behavior and that healthcare demands procrastination behavior. Among the challenges encountered in accessing health services, transportation issues, long waiting times, and inadequate staff were prominent.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/phn.70028","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T08:41:37Z","timestamp":1760604097000},"page":"76-90","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Comprehensive Examination of Poverty, Health\u2010Seeking Behavior, and Access to Health Services With a Mixed\u2010Methods Approach"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4770-385X","authenticated-orcid":false,"given":"Eyl\u00fcl G\u00fclnur","family":"Erdogan","sequence":"first","affiliation":[{"name":"Faculty of Health Science Department of Public Health Nursing Bilecik Seyh Edebali University Bilecik T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3471-1383","authenticated-orcid":false,"given":"P\u0131nar","family":"Duru","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Department of Public Health Nursing Eskisehir Osmangazi University Eskisehir T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/10875549.2024.2379795"},{"key":"e_1_2_10_3_1","unstructured":"Andersen R.1968. \u201cA Behavioural Model of Families' Use of Health Services. 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Z.","year":"2016","journal-title":"Journal of Public Health"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010024\u201019798\u20108"},{"issue":"2","key":"e_1_2_10_18_1","first-page":"267","article-title":"Determ\u0131nat\u0131on of the Factors Affect\u0131ng the Cho\u0131ce of Fac\u0131l\u0131ty of Pat\u0131ents: Correspondence Analys\u0131s and Nested Log\u0131t Model","volume":"15","author":"Ozkoc H.","year":"2013","journal-title":"Dokuz Eylul University Journal of Institute of Social Sciences"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.52835\/19maysbd.1011941"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.30621\/jbachs.1068530"},{"key":"e_1_2_10_21_1","first-page":"185","article-title":"Use of Social Media as a Health Seeking Behaviour: Looking Into Covid\u201019 Related Social Media Posts on Facebook During the Measures of Isolation, Lockdown and Social Distance","volume":"60","author":"Sahin E.","year":"2021","journal-title":"Connectist: Istanbul University Journal of Communication Sciences"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.5336\/medsci.2008-9283"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/daab195"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099\u20101751(199601)11:1<53::AID\u2010HPM413>3.0.CO;2\u2010A"},{"key":"e_1_2_10_25_1","doi-asserted-by":"crossref","unstructured":"The World Bank.2022. \u201cPoverty: Overview.\u201d Fromhttps:\/\/www.worldbank.org\/en\/topic\/poverty\/overview#1.","DOI":"10.1596\/978-1-4648-1893-6_ov"},{"key":"e_1_2_10_26_1","unstructured":"Turkish Statistical Institute (TURKSTAT).2023a. \u201cIncome Distribution Statistics 2022.\u201d Fromhttps:\/\/data.tuik.gov.tr\/Bulten\/Index?p=Gelir\u2010Dagilimi\u2010Istatistikleri\u20102022\u201049745#:~:text=T%C3%BCrkiye'de%20y%C4%B1ll%C4%B1k%20ortalama%20hanehalk%C4%B1 98%20bin%20416%20TL%20oldu.&text=T%C3%BCrkiye'de%20y%C4%B1ll%C4%B1k%20ortalama%20e%C5%9Fde%C4%9Fer bin%20642%20TL'ye%20y%C3%BCkseldi."},{"key":"e_1_2_10_27_1","unstructured":"Turkish Statistical Institute (TURKSTAT).2023b. \u201cAddress Based Population Registration System Results 2022.\u201d Fromhttps:\/\/data.tuik.gov.tr\/Bulten\/Index?p=49685."},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2025.118079"},{"key":"e_1_2_10_29_1","unstructured":"United Nations Development Programme (UNDP).2021. \u201cUnited Nations Development Programme Annual Report 2021.\u201d Fromhttps:\/\/annualreport.undp.org\/2021\/assets\/UNDP\u2010Annual\u2010Report\u20102021\u2010en.pdf."},{"key":"e_1_2_10_30_1","unstructured":"United Nations T\u00fcrkiye (UN T\u00fcrkiye).2023. \u201cSustainable Development Goal 1 End Poverty.\u201d Fromhttps:\/\/turkiye.un.org\/tr\/sdgs\/1."},{"key":"e_1_2_10_31_1","unstructured":"Witting L.2023. \u201cLimited Access: Poverty and Barriers to Accessible Health Care.\u201d National Health Council. 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