{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:28:09Z","timestamp":1787027289039,"version":"build-2736575974"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stress urinary incontinence is common among older women and can substantially affect quality of life, yet medical help-seeking remains low. While socioeconomic disparities have been associated with variations in health behavior, the underlying psychosocial pathways through which these disparities manifest are not well understood. This study aimed to identify psychosocial factors that influence intention to seek care for urinary incontinence and to assess whether they explain the association between socioeconomic status and help-seeking intention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional survey was conducted among women aged \u2265 50 years with questionnaire-identified stress urinary incontinence recruited from 10 community health centers in Shanghai (\n                      <jats:italic>N<\/jats:italic>\n                      = 585). Measures were developed under the IMB model. Socioeconomic status was derived using latent class analysis. The primary outcome was intention to seek medical care within six months, assessed on a five-point scale. Ordered logistic regression models were used to examine associations and to evaluate attenuation of the socioeconomic effect after inclusion of model constructs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Only 38.1% of participants reported high help-seeking intention (\u22654 on a 1\u20135 scale). Subjective norms (cOR = 2.81, 95% CI 2.25\u20133.51) and stigma (cOR = 1.80, 95% CI 1.35\u20132.40) were the strongest correlates of higher intention, followed by patient\u2013provider communication (cOR = 1.27, 95% CI 1.04\u20131.54). Knowledge was negatively associated with intention (cOR = 0.81, 95% CI 0.67\u20130.97). After sequentially adding information, motivational, and behavioral factors from the IMB framework, the association between socioeconomic status and help-seeking intention was attenuated by approximately 80% and was no longer statistically meaningful.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Social and psychological factors, particularly subjective norms, play a central role in shaping intention to seek care for stress urinary incontinence among older women. These factors substantially explain differences originally attributed to socioeconomic position. Interventions that shift community norms, reduce stigma, and strengthen communication in primary care may improve engagement with treatment and reduce unmet needs in aging populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1794464","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:03:36Z","timestamp":1777442616000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Socioeconomic differences in help-seeking intention for stress urinary incontinence: evidence from an information\u2013motivation\u2013behavioral skills model framework"],"prefix":"10.3389","volume":"14","author":[{"given":"Xin","family":"Ge","sequence":"first","affiliation":[{"name":"Institute of Clinical Research, Tongren Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zizhen","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Liu","sequence":"additional","affiliation":[{"name":"Institute of Clinical Research, Tongren Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunyu","family":"Tao","sequence":"additional","affiliation":[{"name":"Institute of Clinical Research, Tongren Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birong","family":"Wu","sequence":"additional","affiliation":[{"name":"Institute of Clinical Research, Tongren Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Cai","sequence":"additional","affiliation":[{"name":"Institute of Clinical Research, Tongren Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"B1","unstructured":"Ageing\n          \n          2025"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1592","DOI":"10.1001\/jama.2017.12137","article-title":"Urinary incontinence in women: a review","volume":"318","author":"Lukacz","year":"2017","journal-title":"JAMA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1186\/s12877-021-02135-8","article-title":"Prevalence and factors related to urinary incontinence in older adults women worldwide: a comprehensive systematic review and meta-analysis of observational studies","volume":"21","author":"Batmani","year":"2021","journal-title":"BMC Geriatr."},{"key":"B4","doi-asserted-by":"publisher","first-page":"320","DOI":"10.7326\/P18-0011","article-title":"Screening for urinary incontinence in women: a recommendation from the women's preventive services initiative","volume":"169","author":"O'Reilly","year":"2018","journal-title":"Ann Intern Med"},{"key":"B5","unstructured":"National Data. National Bureau of Statistics of China."},{"key":"B6","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s41256-024-00357-y","article-title":"Projections of functional dependence among the late middle-aged and older population from 2018\u20132048 in China: a dynamic microsimulation","volume":"9","author":"Jiang","year":"2024","journal-title":"Glob Health Res Policy."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2565","DOI":"10.1007\/s00192-023-05544-y","article-title":"Help-seeking behavior for non-severe stress urinary incontinence among elderly women in communities, Beijing, China","volume":"34","author":"Zhang","year":"2023","journal-title":"Int Urogynecol J."},{"key":"B8","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1097\/WON.0000000000001162","article-title":"Effect of kegel exercise-focused intervention on urinary incontinence in elderly women","volume":"52","author":"Hakbilen","year":"2025","journal-title":"J Wound Ostomy Continence Nurs."},{"key":"B9","doi-asserted-by":"publisher","first-page":"114513","DOI":"10.1016\/j.ejogrb.2025.114513","article-title":"Medical care-seeking attitude and behaviour for urinary incontinence and associated factors among Chinese adult women","volume":"312","author":"Pang","year":"2025","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"afaf207","DOI":"10.1093\/ageing\/afaf207","article-title":"\u2018Resigned agency' in older adults: a meta-ethnography of the lived experience of urinary incontinence","volume":"54","author":"Loke","year":"2025","journal-title":"Age Ageing"},{"key":"B11","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/s12913-020-06047-y","article-title":"Explaining factors affecting help-seeking behaviors in women with urinary incontinence: a qualitative study","volume":"21","author":"Rashidi Fakari","year":"2021","journal-title":"BMC Health Serv Res."},{"key":"B12","doi-asserted-by":"publisher","first-page":"24535","DOI":"10.1038\/s41598-025-09798-y","article-title":"Knowledge, attitudes, and practices of pregnant and postpartum women regarding stress urinary incontinence","volume":"15","author":"Dong","year":"2025","journal-title":"Sci Rep."},{"key":"B13","doi-asserted-by":"publisher","first-page":"118234","DOI":"10.1016\/j.socscimed.2025.118234","article-title":"Paradoxical effects of community social cohesion on mental health and help-seeking among older adults: the role of reputation concern and socioeconomic status","volume":"380","author":"Huang","year":"2025","journal-title":"Soc Sci Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"116618","DOI":"10.1016\/j.socscimed.2024.116618","article-title":"The impact of socioeconomic status on health practices via health lifestyles: results of qualitative interviews with Americans from diverse socioeconomic backgrounds","volume":"344","author":"McCoy","year":"2024","journal-title":"Soc Sci Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"127800","DOI":"10.1016\/j.vaccine.2025.127800","article-title":"Subjective norms and perceived behavior control are more critical than attitudes in HPV vaccination: an investigation in China","volume":"65","author":"Shi","year":"2025","journal-title":"Vaccine."},{"key":"B16","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1111\/jocn.12623","article-title":"Predicting help-seeking intention of women with urinary incontinence in Jinan, China: a theory of planned behaviour model","volume":"24","author":"Wu","year":"2015","journal-title":"J Clin Nurs."},{"key":"B17","doi-asserted-by":"publisher","first-page":"119527","DOI":"10.1016\/j.jad.2025.119527","article-title":"Determinants of death wishes and the impact of considering life completed in geriatric-psychiatric outpatients","volume":"387","author":"Verlinde","year":"2025","journal-title":"J Affect Disord."},{"key":"B18","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1186\/s13561-025-00654-3","article-title":"Household health-seeking behaviour and response to informal payment: does economic status matter?","volume":"15","author":"Nwokolo","year":"2025","journal-title":"Health Econ Rev."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1461672251328722","DOI":"10.1177\/01461672251328722","article-title":"Social class, control, and culture: individuals with low socioeconomic status perceive less control in relationally immobile societies","volume":"28","author":"Huang","year":"2025","journal-title":"Pers Soc Psychol Bull"},{"key":"B20","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.copsyc.2017.08.031","article-title":"Social class shapes the form and function of relationships and selves","volume":"18","author":"Carey","year":"2017","journal-title":"Curr Opin Psychol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1186\/s12889-023-15067-2","article-title":"Empirical validation of the information-motivation-behavioral skills model of gestational weight management behavior: a framework for intervention","volume":"23","author":"You","year":"2023","journal-title":"BMC Public Health."},{"key":"B22","doi-asserted-by":"publisher","first-page":"3727","DOI":"10.1007\/s10508-025-03212-4","article-title":"Application of the information-motivation-behavioral skills theory to explore hiv self-testing behavior among men who have sex with men in Southwest China","volume":"54","author":"Zhu","year":"2025","journal-title":"Arch Sex Behav."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1772","DOI":"10.3390\/healthcare11121772","article-title":"Urinary incontinence affects the quality of life and increases psychological distress and low self-esteem","volume":"11","author":"AlQuaiz","year":"2023","journal-title":"Healthcare"},{"key":"B24","doi-asserted-by":"publisher","first-page":"109191","DOI":"10.1016\/j.pec.2025.109191","article-title":"A cross-sectional study to assess patients\u2018 perception of physicians' communication skills: 15 minutes is what it takes","volume":"138","author":"Shaikh","year":"2025","journal-title":"Patient Educ Couns."},{"key":"B25","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1002\/nau.22657","article-title":"symptom and quality of life instruments measure clinically relevant improvements in women with stress urinary incontinence","volume":"34","author":"Nystr\u00f6m","year":"2015","journal-title":"Neurourol Urodyn."},{"key":"B26","doi-asserted-by":"publisher","first-page":"e92203","DOI":"10.7759\/cureus.92203","article-title":"Awareness of pelvic floor disorders among postpartum and menopausal women: a cross-sectional study","volume":"17","author":"Saadia","year":"2025","journal-title":"Cureus."},{"key":"B27","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1186\/s12939-025-02633-w","article-title":"Changes in primary health care service experiences and urban-suburban disparities among Shanghai residents: a two-year comparative study","volume":"24","author":"Sen","year":"2025","journal-title":"Int J Equity Health."},{"key":"B28","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1097\/JU.0000000000000706","article-title":"Women's experience with stress urinary incontinence: insights from social media analytics","volume":"203","author":"Gonzalez","year":"2020","journal-title":"J Urol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1016\/j.maturitas.2014.01.009","article-title":"Disease stigma and intentions to seek care for stress urinary incontinence among community-dwelling women","volume":"77","author":"Wang","year":"2014","journal-title":"Maturitas."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.1186\/s40359-025-03468-4","article-title":"Understanding mental health literacy, stigma, and help-seeking attitudes among university students in the Maldives: a mediation analysis","volume":"13","author":"Hussain","year":"2025","journal-title":"BMC Psychol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"2444008","DOI":"10.1080\/21645515.2024.2444008","article-title":"Socioeconomic disparities in childhood vaccine hesitancy among parents in China: the mediating role of social support and health literacy","volume":"21","author":"Yao","year":"2025","journal-title":"Hum Vaccin Immunother."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1007\/s10552-024-01903-2","article-title":"Cancer health disparities in minority communities: peer support networks can bridge the gap","volume":"35","author":"Abioye","year":"2024","journal-title":"Cancer Causes Control."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1794464\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:03:43Z","timestamp":1777442623000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1794464\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,29]]},"references-count":32,"alternative-id":["10.3389\/fpubh.2026.1794464"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1794464","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,29]]},"article-number":"1794464"}}