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Patients face tremendous challenges when attempting to navigate the United States health care system. This difficulty to navigate the system creates a burden that is placed on the patient and caregiver, in turn affecting the health outcomes of the patient, resulting in higher health care costs, less than desirable outcomes,

Patients face tremendous challenges when attempting to navigate the United States health care system. This difficulty to navigate the system creates a burden that is placed on the patient and caregiver, in turn affecting the health outcomes of the patient, resulting in higher health care costs, less than desirable outcomes, and a large strain on the patient and caregiver's daily lives. There are several ways that people have tried to create a comprehensive theoretical framework to understand the system from multiple perspectives. This work will expand existing theoretical frameworks that observes the relationship between the patient, their social networks, and health care services such as the Burden of Treatment Theory. Consisting of a comprehensive, multidisciplinary literature review, research was derived from the disciplines of medicine, informatics, management, and ethics. In this paper, I attempt to identify key contributing factors and then develop and categorize these stressors into a typology. Since there are many contributing factors that affect the burden of work at multiple levels, a nested typology will be used which will link micro- and macro-leveled pressures to a single system while also showcasing how each level interacts and is influenced by the others. For the categorization of the contributing factors, they will be sorted into individual actors, organizational level, and macro-level factors. The implications of this work suggest that a combination of historical shifts, structural design, and secondary effects of policy contribute to patients' burden of work.
ContributorsTomlinson, Rachel Laiku (Author) / Pine, Katie (Thesis director) / Trinh, Mai (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2017-05
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This paper describes Social Determinants of Health and the implementation of a screener. Social Determinants are structural drivers in an individual's life that affect their status of health. A screener's potential effectiveness at a student-run interdisciplinary clinic was also explored in the paper through the analysis of Student Health Outreach

This paper describes Social Determinants of Health and the implementation of a screener. Social Determinants are structural drivers in an individual's life that affect their status of health. A screener's potential effectiveness at a student-run interdisciplinary clinic was also explored in the paper through the analysis of Student Health Outreach for Wellness (SHOW). SHOW's framework allows for a unique implementation of the screener because of the vulnerable population it serves, and the flexibility of the organization's structure. Its interdisciplinary nature allows for the SDOH screener to be integrated into its process more easily, especially with the presence of disciplines such as social work. A Social Determinants of Health questionnaire can be an important instrument to increase effectiveness in patient care by acknowledging each patient's situation more comprehensively, and moving forward with the most appropriate care plan. Among a vulnerable population such as those experiencing homelessness, an SDOH screener can identify key areas of focus that patients need addressed in order to improve their health status. A literature review was conducted to observe previous screener structures and questions. A model screener and best practices are provided as a guide for other clinics to use and adapt in their own settings. The domains of the sample screener questionnaire are tailored to serve populations with housing insecurity. The hope is to move forward with this screener after further modification of the questions, resources associated to each, and its prospective connection to the EHR system. The screener is planned to be executed at the SHOW clinic in Fall of 2018. In conclusion, a social determinants of health screener should be implemented in interdisciplinary clinics in a similar manner to SHOW's approach, to shift the focus of healthcare toward patient-centered care.
ContributorsThomas, Christy Maria (Author) / Reddy, Swapna (Thesis director) / Essary, Alison (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
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Description
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
This paper sought to answer the question of how to improve the American healthcare system. The Affordable Care Act aimed to do this by increasing access to insurance. What this has done, however, is exacerbate the already rising rate of physician shortages. As a way to fix this problem, it

This paper sought to answer the question of how to improve the American healthcare system. The Affordable Care Act aimed to do this by increasing access to insurance. What this has done, however, is exacerbate the already rising rate of physician shortages. As a way to fix this problem, it is suggested that state legislatures and the federal government adopt the rising trend of expanding scope of practice to the extent of the care providers' certification. This is a movement has garnered support throughout the country and 20 states already allow for nearly autonomous practice by advanced practice nurses (APNs). This paper looked at systematic review, peer-reviewed papers, state/federal legislation and labor statistics to demonstrate how this move could increase access to healthcare providers as well as decrease cost by nearly 25%. This paper also evaluated how to formalization of nursing education has had positive impacts on the French healthcare system. Additionally, it evaluated a more specific look at Arizona and used data provided by the Arizona Board of Nursing and The Arizona Medical Board to make a compelling argument as to why this is a viable option for solving the disparity between rural and urban healthcare. The conclusion of the paper was to push policy makers to make the statutory constraints of the profession closer to the certification the people receive in their education as opposed to relying on case law. Additionally, it would be helpful to use technological innovations, like project echo, to help these professionals practice in rural areas. This will ultimately lead to a healthcare system that better serves the needs of all populations, as well as decreasing the overall cost of care.
ContributorsKingsbury, Andrew (Author) / Brian, Jennifer (Thesis director) / McGregor, Joan (Committee member) / Reddy, Swapna (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
“Let Food be Thy Medicine” focuses on alternative treatment for patients suffering from obesity, diabetes mellitus type 2, hypertension, and coronary artery disease. Nutrition is an important aspect of overall health and can contribute to prevention and management of these conditions, especially when combined with medication and physical activity. Obesity

“Let Food be Thy Medicine” focuses on alternative treatment for patients suffering from obesity, diabetes mellitus type 2, hypertension, and coronary artery disease. Nutrition is an important aspect of overall health and can contribute to prevention and management of these conditions, especially when combined with medication and physical activity. Obesity is a condition that people worldwide struggle with. Adequate nutrition can play a major role in contributing to the prevention of and management of obesity not only through calorie and macronutrient intake but also by affecting hormonal and energy balances in the body. Recommended physical activity levels are included along with dietary
utritional intake recommendations on the educational pamphlet to give patients a starting guideline and better understanding how to help this condition. Type 2 diabetes, high blood pressure, and coronary artery disease are also common conditions treated by healthcare professionals. There are currently several medications on the market to help manage these conditions that range in price and have many side effects. Nutrition and exercise are two factors that can further contribute to the management of type 2 diabetes, high blood pressure, and coronary artery disease, but they can also help prevent and delay their onset. Nutrition and physical activity education along with examples of certain foods that can aid in reaching nutritional goals are outlined in the educational pamphlet to give patients a visual of what is in the academic paper.
Created2019-05
Description
Introduction: Health disparities for the Native American population in the United States have been well documented for years. Native Americans face many barriers to healthcare access, including low socioeconomic status, historical trauma, and lack of access to healthcare facilities. Barriers to healthcare and challenges associated with achieving optimal health among

Introduction: Health disparities for the Native American population in the United States have been well documented for years. Native Americans face many barriers to healthcare access, including low socioeconomic status, historical trauma, and lack of access to healthcare facilities. Barriers to healthcare and challenges associated with achieving optimal health among Native Americans contribute to health disparities within these populations. If these barriers are to be overcome, they must be understood and addressed. Purpose: The purpose of this review was to identify barriers to healthcare access for Native American populations as well as strategies to address barriers. Method: A preliminary scan of several online databases was conducted. Key terms used in the search included American Indians, Native American, healthcare, healthcare access, health disparities, barriers, and intervention. Articles were selected based on relevance, and data from each chosen article were extracted and categorized. Results: The initial search resulted in 272 articles of potential interest. Based on the abstract review, 32 were deemed relevant, and full text reviews were completed. Based on the full text review, an additional 10 articles were excluded, resulting in a final review of 22 articles. The articles addressed barriers related to various health conditions: cancer treatment, drug or alcohol use, maternal and child health, historical trauma, diabetes and chronic illnesses, and oral health. Conclusion: Native Americans face several barriers to healthcare access that are associated with social, physical, and mental health disparities. Successful efforts to address these barriers include patient-centered, culturally-competent interventions. Others include interventions which focus on community involvement.
ContributorsMohamed, Hebah (Co-author) / Mohamed, Hitham (Co-author) / Coplan, Bettie (Thesis director) / Reddy, Swapna (Committee member) / School for the Science of Health Care Delivery (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
Description

Healthcare is delivered in many ways across the world. Most countries use one of the four healthcare models, but the United States uses parts of the four models. This leads to issues for patients as they may not know what their insurance plans cover. Providers also have issues with health

Healthcare is delivered in many ways across the world. Most countries use one of the four healthcare models, but the United States uses parts of the four models. This leads to issues for patients as they may not know what their insurance plans cover. Providers also have issues with health insurance in getting coverage for their patients. With both patients and providers having issues with insurances, insurance companies have not taken an action to help alleviate some of the issues that everyone faces. Providers are also faced with issues of burnout as they have a lot to do, and not enough time or energy to complete everything. This effects the quality of healthcare that is delivered to their patients as well as when a person can see a provider as there are not enough doctors and nurses to cover the case load all of the time. All in all, providers, insurance companies, and patients need to work together to help fix some of the issues with healthcare to be able to move towards a better healthcare model for all.

Contributorsde Mello, Julianna (Author) / Kingsbury, Jeffrey (Thesis director) / Grozier, Darren (Committee member) / Barrett, The Honors College (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
ContributorsMichels, Bailey (Author) / O'Flaherty, Katherine (Thesis director) / Rasmussen, Elizabeth (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2023-05
ContributorsMichels, Bailey (Author) / O'Flaherty, Katherine (Thesis director) / Rasmussen, Elizabeth (Committee member) / Barrett, The Honors College (Contributor) / College of Health Solutions (Contributor)
Created2023-05