Pathways Between Provider-Related Healthcare Anxiety, Bilingual Provider Preferences, and Cross-Border Healthcare Access: A Structural Equation Modeling Analysis in United States–Mexico Border Communities

Purpose This study aimed to explore the role of bilingual provider preferences in mediating healthcare anxiety and cross-border healthcare access. Design A multi-channel sampling was employed to recruit participants from Brownsville, Texas from March to September 2024. Setting The research team distributed bilingual (English/Spanish) survey links through partners and community events and promoted the survey via city broadcasts and social media. Sample The final analytic sample comprised 144 adult residents of Brownsville. Measures The survey items included measures of healthcare anxiety related to providers, preference for bilingual providers, and access to cross-border healthcare, with socio demographics included as covariates. Analysis Structural equation modeling examined the relationships between provider-related healthcare anxiety, bilingual provider preferences, and cross-border healthcare access, using path analysis to assess direct and indirect effects. Results The analysis revealed a significant positive relationship between provider-related healthcare anxiety and bilingual provider preferences (β = 0.20, P = 0.018). Additionally, bilingual provider preferences were strongly associated with cross-border healthcare access (β = 0.47, P < 0.001). A mediation effect was observed, where bilingual provider preferences mediated the relationship between healthcare anxiety and cross-border healthcare access (β = 0.10, P = 0.04). Conclusion Bilingual provider preferences significantly mediate the relationship between provider-related healthcare anxiety and cross-border healthcare access in U.S.-Mexico border communities. These findings emphasize the importance of language concordance in reducing healthcare anxiety and enhancing access to care.