Table 4.

Multi-Level Analysis, adjusted odds of receiving preventive counseling servicesa, Central Pennsylvani^a Women’s Health Study (n = 1407)

	aORb	95% CIc	p-value
Level 1. Individual Level Covariates
Predisposing
Higher self-esteem vs. lower	0.82	(0.67,1.01)	0.058
Lower Psychosocial Stress vs.  higher	0.69	(0.57,0.85)	<0.001
Some college vs. high school  education	1.26	(1.02,1.55)	0.028
White, non-Hispanic vs. other	0.89	(0.61,1.32)	0.567
Depression risk vs. none	1.31	(1.01,1.69)	0.045
No intimate partner violence vs.  IPV	0.74	(0.46,1.19)	0.219
Enabling
High social support-tangible vs. low	1.20	(0.97,1.49)	0.095
High social support-emotional vs.  low	1.25	(1.00,1.56)	0.049
Sees any obstetrician-gynecologist  vs. does not	1.51	(1.22,1.88)	<0.001
Usual source of care vs. None	0.95	(0.67,1.34)	0.765
Continuous insurance vs. insurance  coverage gap	0.95	(0.72,1.27)	0.736
Does not forego care due to cost  vs. forgoes care	0.95	(0.71,1.28)	0.755
Poverty Status
In poverty	1.17	(0.92,1.49)	0.416
Missing poverty	1.08	(0.80,1.47)
Not in poverty	Ref.
Need
Lower self-reported health status  vs. Excellent	1.15	(0.89,1.47)	0.283
Any chronic condition vs. none	1.52	(1.22,1.88)	<0.001
Level 2. Contextual Covariates
Healthcare Resources
Primary care physician  density(quartiles)
Q1. Up to 170	Ref.		0.430
Q2. 171-193	1.34	(0.92,1.95)
Q3. 194-218	1.53	(0.81,2.88)
Q4. 219+	1.26	(0.79,2.01)
1 or more Federal/Rural Health  Clinic vs. none	0.95	(0.75,1.20)	0.667
Community Characteristics
% Persons in Poverty (quartiles)
Q1. Up to 8.6%	1.01	(0.70,1.46)	0.996
Q2. 8.7 – 10.4%	0.99	(0.66,1.49)
Q3. 10.5% - 13.4%	1.00	(0.71,1.41)
Q4. 13.5% +	Ref.
% without Health Insurance  (quartiles)
Q1. Up to 8.8%	0.91	(0.59,1.42)	0.620
Q2. 8.9% - 9.9%	1.11	(0.74,1.68)
Q3. 10.0% - 11.0%	1.24	(0.82,1.88)
Q4. 11.1%+	Ref.
Rural Urban Continuum (County)
Metropolitan county	0.81	(0.39,1.68)	0.142
Nonmetro, Urban	0.64	(0.34,1.21)
Nonmetro, Rural	Ref.

Note: Variance of random error term estimated at 0. Overall Likelihood Ratio test , p < 0.001; McFadden Pseudo R² = 0.022.

^adependent variable is ordinal.

^baOR, adjusted odds ratio.

^cCI, confidence interval.