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Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also to give students hands-on experience. It is plausible that these

Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also to give students hands-on experience. It is plausible that these two agendas may compete and give patients sub-par quality of care.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
ContributorsWilson, Ethan Sinead (Author) / Jehn, Megan (Thesis director) / Harrell, Susan (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
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Description
As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional practice and education to improve patient outcomes, reduce costs, and

As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional practice and education to improve patient outcomes, reduce costs, and enhance the patient experience of care (Triple Aim). Interprofessional collaboration among diverse disciplines is evident on the Phoenix Biomedical Campus, integrating a wide variety of institutions and multiple health profession programs; and at the Student Health Outreach for Wellness (SHOW) free clinic, -- a successful tri-university, student-led, faculty mentored, and community-based model of interprofessional learning and care -- based in downtown Phoenix. This project conducted a comparative analysis of interprofessional components of 6 different clinical models in order to provide recommendations for best practice implementation. These models were chosen based on availability of research on interprofessionalism with their clinics. As a result, three recommendations were offered to the SHOW clinic for consideration in their efforts to improve both patient and educational outcomes. Each recommendation was intentionally formulated for its capacity to increase: interprofessionalism and collaboration between multiple disciplines pertaining to healthcare, among healthcare professionals to promote positive patient and educational outcomes. These recommendations include implementing an interprofessional education (IPE) course as a core component in an academic program's curriculum, offering faculty and professional development opportunities for faculty and mentors immersed in the interprofessional clinics, and utilization of simulation centers. Further studies will be needed to evaluate the impact these specific interventions, if adopted, on patient and educational outcomes.
ContributorsMousa, Mohammad (Co-author) / Mousa, Bakir (Co-author) / Johnson, Ross (Co-author) / Harrell, Liz (Thesis director) / Saewert, Karen (Committee member) / Harrington Bioengineering Program (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
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Description
Physician-assisted suicide occurs when a physician facilitates a patient's death by prescribing a lethal medication that they understand will be used for the purpose of ending the patient's life. It is a highly contentious subject and, with the recent addition of California to the list of states that allow physician-assisted

Physician-assisted suicide occurs when a physician facilitates a patient's death by prescribing a lethal medication that they understand will be used for the purpose of ending the patient's life. It is a highly contentious subject and, with the recent addition of California to the list of states that allow physician-assisted suicide, is an increasingly relevant subject. Physician-assisted suicide is rarely framed as a healthcare experience, despite being a choice in the process of end-of-life care. The research seeks to bring together the debates about physician-assisted suicide with conversations about health care experiences. The experiences and perspectives of young people are particularly valuable to evaluate now, as their voices will soon be the leaders in the debate over physician-assisted suicide. Within this research, there is an underlying theme of independence of individuals that is present through both the literature review and the body of data collected and analyzed. The study found that there was no significant relationship between the quality of a person's healthcare and their perspectives about physician-assisted suicide.
ContributorsMoeur, Katherine Elizabeth (Author) / Brian, Jennifer (Thesis director) / Graff, Sarah (Committee member) / Stevenson, Christine (Committee member) / School of Life Sciences (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
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Description
This study investigates how the patient-provider relationship between lesbian, gay, and bisexual women and their healthcare providers influences their access to, utilization of, and experiences within healthcare environments. Nineteen participants, ages 18 to 34, were recruited using convenience and snowball sampling. Interviews were conducted inquiring about their health history and

This study investigates how the patient-provider relationship between lesbian, gay, and bisexual women and their healthcare providers influences their access to, utilization of, and experiences within healthcare environments. Nineteen participants, ages 18 to 34, were recruited using convenience and snowball sampling. Interviews were conducted inquiring about their health history and their experiences within the healthcare system in the context of their sexual orientation. The data collected from these interviews was used to create an analysis of the healthcare experiences of those who identify as queer. Although the original intention of the project was to chronicle the experiences of LGB women specifically, there were four non-binary gender respondents who contributed interviews. In an effort to not privilege any orientation over another, the respondents were collectively referred to as queer, given the inclusive and an encompassing nature of the term. The general conclusion of this study is that respondents most often experienced heterosexism rather than outright homophobia when accessing healthcare. If heterosexism was present within the healthcare setting, it made respondents feel uncomfortable with their providers and less likely to inform them of their sexuality even if it was medically relevant to their health outcomes. Gender, race, and,socioeconomic differences also had an effect on the patient-provider relationship. Non-binary respondents acknowledged the need for inclusion of more gender options outside of male or female on the reporting forms often seen in medical offices. By doing so, medical professionals are acknowledging their awareness and knowledge of people outside of the binary gender system, thus improving the experience of these patients. While race and socioeconomic status were less relevant to the context of this study, it was found that these factors have an affect on the patient-provider relationship. There are many suggestions for providers to improve the experiences of queer patients within the healthcare setting. This includes nonverbal indications of acknowledgement and acceptance, such as signs in the office that indicate it to be a queer friendly space. This will help in eliminating the fear and miscommunication that can often happen when a queer patient sees a practitioner for the first time. In addition, better education on medically relevant topics to queer patients, is necessary in order to eliminate disparities in health outcomes. This is particularly evident in trans health, where specialized education is necessary in order to decrease poor health outcomes in trans patients. Future directions of this study necessitate a closer look on how race and socioeconomic status have an effect on a queer patient's relationship with their provider.
Created2016-05
Description
The Flying Samaritans is a group of volunteers who provide health care on a monthly basis at the Laguna de San Ignacio Clinic in Baja California Sur, Mexico. The purpose of this study was to gather demographic information about the patients at the clinic as well as to determine why

The Flying Samaritans is a group of volunteers who provide health care on a monthly basis at the Laguna de San Ignacio Clinic in Baja California Sur, Mexico. The purpose of this study was to gather demographic information about the patients at the clinic as well as to determine why the patients need to use a free clinic, how they use other health care facilities that are available to them, how well they take care of themselves in terms of exercise, nutrition, and care of chronic disease, and how the Flying Samaritans can improve their care for this population. This information was gathered using an extensive patient survey as well as through interviews with both patients and health care providers at this clinic. Based on the data gathered, it was determined that some health problems present in the population could be prevented with education about daily health and dental care. The Flying Samaritans could implement some forms of patient education in order to minimize chronic health problems and to continue to improve the overall health of this population. The data also demonstrated that the patients rely heavily on the Flying Samaritans services, as the town in very isolated and does not offer any other medical or dental facilities. The Flying Samaritans are essential to the well-being of this town and provide services that the patients may not otherwise receive.
ContributorsLiberty-Bibbens, McKenzie Bryn (Author) / Hurlbut, Ben (Thesis director) / Schroeder, Stefanie (Committee member) / Maupin, Jonathan (Committee member) / School of Life Sciences (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
Climate change is a well-known global threat to societal systems; however, its effects on the health of individuals are often less evident. Physicians who aim to properly treat patients holistically must be educated on the various forms of illness and disease projected to be exacerbated by climate change. Without this necessary climate education,

Climate change is a well-known global threat to societal systems; however, its effects on the health of individuals are often less evident. Physicians who aim to properly treat patients holistically must be educated on the various forms of illness and disease projected to be exacerbated by climate change. Without this necessary climate education, physicians run the risk of being unable to fulfill the most sacred charge of the Hippocratic oath: Do No Harm. To ensure that physicians moving forward are prepared to face this new global health threat, the prevalence of climate change in current medical school curricula must be examined. Content analysis of publicly available medical school curricula in the Southwest U.S. was done using ChatGPT to track the frequency of climate health search terms. Medical school curricula analyzed included mandatory degree programs as well as optional dual degree programs or pathways for medical student education. Researchers found that medical schools within the Southwest region of the United States are not sufficiently preparing students to mitigate the regional effects of climate change on the health of patients. Mandatory medical degree curriculum does not sufficiently educate on climate health issues, nor is it present in Utah, New Mexico, or Colorado. Optional degrees and pathways are available to medical students to enroll in and may be sufficient to educate a medical student, but are not enticing enough to sufficiently educate all medical students. Some medical schools have recently conducted revisals of their mandatory curriculum and still show a lack of education available about climate health issues. The lack of educational resources for future providers could lead to detrimental health outcomes for patients, and medical schools in development should take the lead in educating their students about climate health issues.
ContributorsGutierrez, Sean (Author) / Jamieson, Ann (Co-author) / Vanos, Jennifer (Thesis director) / Lobo, Jose (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / Historical, Philosophical & Religious Studies, Sch (Contributor)
Created2023-12
Description

Health service quality is understood to be a crucial determinant in successful patient-physician encounters and patient health. One common feeling that patients have reported experiencing during appointments is shame. We hypothesized that patients who experience appearance-based shame during an appointment are not likely to return to the same physician and

Health service quality is understood to be a crucial determinant in successful patient-physician encounters and patient health. One common feeling that patients have reported experiencing during appointments is shame. We hypothesized that patients who experience appearance-based shame during an appointment are not likely to return to the same physician and that patients who do not experience appearance-based shame are likely to return to the same physician. This was assessed by conducting an anonymous online survey of 13 questions that served to establish a general foundation for understanding the participants' physical characteristics such as race, age, weight, and gender identity as well as their overall patient-physician relationship and experiences of shame, if applicable. 119 participants were recruited from Arizona State University and a case study was performed individually for five participants of interest. The data analyzed from this study suggests that while appearance-based shame does exist in healthcare spaces, it is not a significant determining factor in patients returning to their physicians. In addition, there was no significant evidence to suggest that patients who do not experience appearance-based shame are either likely or more likely to return to their physician. We hypothesize this could be due to confounding variables such as convenience, accessibility, or insurance limitations which patients may prioritize over feeling ashamed during an appointment. However, more research needs to be conducted to confirm these hypotheses.

ContributorsHolmes, Madison (Author) / Santos, Emily (Co-author) / Kathir, Nehhaa (Co-author) / Fontinha de Alcantara, Christiane (Thesis director) / Roberson, Robert (Committee member) / Brian, Jennifer (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2023-05
Description

The term “Iraqi American” defines any person of Iraqi origin who is residing in the United States. From 1960 until 2014, Iraq experienced numerous armed conflicts and international sanctions. As a result, a great surge of Iraqis migrated out of the country to seek refuge elsewhere. The United States alone

The term “Iraqi American” defines any person of Iraqi origin who is residing in the United States. From 1960 until 2014, Iraq experienced numerous armed conflicts and international sanctions. As a result, a great surge of Iraqis migrated out of the country to seek refuge elsewhere. The United States alone currently houses about 400,000+ persons of Iraqi descent, many of whom identify as its citizens. Despite that, Iraqi Americans remain severely understudied. Therefore, this study aims to understand the cultural barriers Iraqi American women face while seeking healthcare in the United States, and how these barriers can impact their behaviors. I collected data via semi-structured interviews with eight Iraqi American women. In this study, I identified five major themes that contributed to women’s healthcare seeking behaviors: societal/familial pressures, staying “pure,” shame associated with performing medical procedures, taboo surrounding discussions of female health conditions, and issues regarding being in the presence of male doctors. Many of these themes involved cultural stigmas and pointed to potential pathways to destigmatize women’s healthcare in the community. This study acts as an initiative to understanding Iraqi Americans better and lays groundwork for further research.

ContributorsRahee, Hajer (Author) / Hruschka, Daniel (Thesis director) / Drake, Alexandria (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / School of Human Evolution & Social Change (Contributor)
Created2023-05
Description

The study investigated unconscious biases in physicians regarding conflicts in developing care plans for patients related to religious restrictions in medicine. Fourteen physicians were interviewed to discuss their experiences with these patients and find patterns and factors that could lead to more negative attitudes from the physicians in the patient’s

The study investigated unconscious biases in physicians regarding conflicts in developing care plans for patients related to religious restrictions in medicine. Fourteen physicians were interviewed to discuss their experiences with these patients and find patterns and factors that could lead to more negative attitudes from the physicians in the patient’s care. It was found that the gender, religious background, and location of residency had various impacts on the attitude of the physician regarding a religious concern; however, there was no outstanding demographic that led to a comparatively negative attitude. Additionally, the type of reasoning a patient used related to a religious concern had an impact on the attitude of the physician, and this was due to the logic and duration of the concern as well as the attitude of the patient. These factors and patient cases were thoroughly analyzed and discussed throughout the paper to shed light on possible factors that could negatively affect the patient’s care.

ContributorsKalmadi, Nisha (Author) / Hurlbut, Ben (Thesis director) / Dietz, Elizabeth (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / College of Health Solutions (Contributor)
Created2023-05
Description

The objective of this thesis is to further understand the obstacles that impoverished families face, which may include: meeting nutritional needs, an earlier introduction to violence, or struggles with family planning. It is crucial to illustrate the effects of poverty on the physical, mental, and emotional health of both children

The objective of this thesis is to further understand the obstacles that impoverished families face, which may include: meeting nutritional needs, an earlier introduction to violence, or struggles with family planning. It is crucial to illustrate the effects of poverty on the physical, mental, and emotional health of both children and caregivers. Additionally, the family dynamics and educational challenges for children will also be explored as supplemental research. This study will draw upon psychological theories with an emphasis on maternal and child health. The goal is to empower families to make informed family planning decisions. This project will be focused on supporting families in low-income areas, particularly in Arizona

ContributorsKizior, Kameron (Author) / Agu, Nennna (Thesis director) / Nelson, Robin (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / College of Health Solutions (Contributor)
Created2023-05