Multilevel barriers and facilitators to behavioral health treatment among Latino sexual minority men

Latino sexual minority men (Latino/x or Hispanic gay, bisexual, or men who have sex with men; LSMM) are less likely to use behavioral health treatment than non-Latino white adults. However, there are no measures that evaluate barriers or facilitators to behavioral health treatment for LSMM. The purpose of this study was to (1) evaluate the factor structure of a measure of multilevel barriers and facilitators to behavioral health treatment among LSMM and (2) examine the association between identified factors of barriers and facilitators and engagement in behavioral health treatment. We developed the Multilevel Barriers and Facilitators to Behavioral Health Treatment measure. We first examined the hypothesized factor structure of the Multilevel Barriers and Facilitators to Behavioral Health Treatment measure using confirmatory factor analyses (CFA) in a sample of 235 LSMM. Next, we evaluated the correlation between identified barrier and facilitator factors and the association of the factors with engagement in behavioral health treatment. The CFA included seven multilevel barriers and four multilevel facilitators. Language and immigration barriers were significantly associated with less engagement in behavioral health. Positive provider demeanor was associated with higher engagement. The Multilevel Barriers and Facilitators to Behavioral Health Treatment Measure captures structural factors (e.g., insurance issues), interpersonal factors (e.g., negative provider demeanor), and individual factors (e.g., knowledge) that could impact treatment engagement. This multilevel measure of barriers and facilitators can inform behavioral health researchers of which modifiable determinants to focus on to improve engagement in behavioral health treatment for LSMM.