Access to primary care for socio-economically disadvantaged older people in rural areas: exploring realist theory using structural equation modelling in a linked dataset

Table 4 Standardised direct and indirect regression coefficients from context to outcome for the structural equation model

Context	Mechanism	Outcome	Direct effect^a		Indirect effect ^b		Model fit indices^c
Context	Mechanism	Outcome	β	95% CI	β	95% CI	RMSEA	CFI	TLI
Clear information	Health literacy	Obtain an appointment	0.084	−0.056 to 0.224	0.000	−0.006 to 0.006	0.047	0.923	0.908
Higher education including degree or equivalent			Baseline	NA	Baseline	NA
GCE A level or equivalent			−0.028	− 0.115 to 0.060	0.007	− 0.008 to 0.021
GCE O level or equivalent			−0.026	− 0.145 to 0.093	0.005	− 0.007 to 0.016
CSE or equivalent			0.006	−0.072 to 0.085	0.004	−0.006 to 0.013
No qualification			0.009	−0.126 to 0.144	0.011	−0.011 to 0.032
Self esteem	Assertiveness		−0.095	− 0.213 to 0.024	0.035	− 0.045 to 0.116
Clear information	Assertiveness		0.084	−0.056 to 0.224	−0.002	− 0.014 to 0.009
Technology	Convenience		0.080	−0.041 to 0.201	0.029	−0.021 to 0.079
Health care experience			−0.078	− 0.240 to 0.084	0.088	0.018 to 0.158
Ease of getting through to surgery			0.514	0.407 to 0.620	0.140	0.067 to 0.214
Transport			0.011	−0.209 to 0.232	0.018	−0.038 to 0.075
Clear information			0.084	−0.056 to 0.224	0.037	−0.020 to 0.094

β standardised regression coefficients, CI confidence intervals, RMSEA Root Mean Square Error of Approximation, CFI Comparative Fit Index, TLI Tucker-Lewis Index, GCE General Certificate of Education, CSE Certificate of Secondary Education, NA not applicable, GCE General Certificate of Education, CSE Certificate of Secondary Education
^a direct effect refers to the relationship directly between “Context” and “Outcome”
^b indirect effect refers to the relationship from “Context” to “Outcome” through the mediator of “Mechanism”
^c degrees of freedom = 212
The results in bold are statistically significant

ISSN: 1471-2288