Due to the COVID-19 pandemic, declared in March of 2020, there have been many lifestyle changes which have likely influenced tobacco smoking behavior. Such lifestyle changes include lockdowns, stay at home orders, reduction in social cues related to smoking, increased stress, and boredom among other things. This study utilized a cross-sectional survey which looked into these behaviors, primarily perceived risk to COVID-19, and determined if there is an association between perceived risk and education level/race. Education level is a proxy for income and material resources, therefore making it more likely that people with lower levels of education have fewer resources and higher perceived risk to negative effects of COVID-19. Additionally, people of color are often marginalized in the medical community along with being the target of heavy advertising by tobacco companies which have likely impacted risk to COVID-19 as well.

In this formative research project, we seek to better understand the general barriers to refugee access to higher education. Using mixed methods research--which included surveys, interviews, and course data--we evaluate the benefits and challenges experienced by refugee students in Israel who are enrolled in Arizona State University's Education for Humanity programs. In the end, this case study resulted in 24 recommend programmatic changes designed to eliminate the barriers that prevent refugee students from accessing and succeeding in higher education.

In this formative research project, we seek to better understand the general barriers to refugee access to higher education. Using mixed methods research--which included surveys, interviews, and course data--we evaluate the benefits and challenges experienced by refugee students in Israel who are enrolled in Arizona State University's Education for Humanity programs. In the end, this case study resulted in 24 recommend programmatic changes designed to eliminate the barriers that prevent refugee students from accessing and succeeding in higher education.

This project is an investigation of the gene by environment (GxE) interactions’ effect on substance use outcomes among refugee communities. Substance use disorders (SUDs) are a major public health concern, affecting individuals and communities worldwide. The etiology of SUDs is complex, involving a combination of genetic, environmental, and social factors. In recent years, there has been growing interest in the role of gene by environment interactions in the development of SUDs, particularly in vulnerable populations such as refugees. Refugee populations are exposed to a range of environmental stressors that may interact with genetic factors to increase their risk of SUDs. However, a number of studies describe a “refugee paradox,” where despite having been exposed to risk factors that can lead to SUDs, they are less likely to develop SUDs. Understanding these gene by environment interactions in refugee communities is crucial for not only understanding this phenomenon, but developing effective prevention and treatment strategies for this population. This thesis aims to investigate the gene by environment interactions underlying substance use in refugee communities and to analyze different methods for gene by environment analyses, ultimately determining which method is best suited for this population.

Refugee women face many challenges to obtaining maternal, reproductive, and sexual health post-resettlement including the language barrier, navigating the healthcare system, finding childcare to attend appointments, and cultural mismatches between their beliefs and practices around the prenatal, childbirth, and postpartum periods and that of the healthcare system in which they resettle into. This cultural barrier poses a challenge to healthcare providers as well as it necessitates that they respect their patients’ cultural beliefs while still providing them with the highest standard of care. Cultural competency training has been used to assist providers in understanding and responding to cultural differences, but gaps still exist when it comes to navigating specific scenarios. The objective of this research was to conduct a literature review of studies pertaining to refugee maternal, reproductive, and sexual healthcare post-resettlement to investigate the following questions: how tensions between biomedically accepted best practices and cultural norms present themselves in these healthcare fields, how healthcare providers take into consideration their patients’ cultural beliefs and norms when providing maternal, reproductive, and sexual healthcare to refugee women, and what can be done to continue to improve the provision of culturally appropriate care to refugee women. Findings from twenty different studies that focused primarily on eight cultural groups identified that Cesarean sections, inductions, and certain family planning methods are significant points of contention regarding cultural norms for refugee women and that they prefer certain foods, birthing positions, and other cultural practices during the delivery. Healthcare providers consider their refugee patients’ cultural beliefs by creating relationships with them built on trust, utilizing community liaisons, and through attempts to accommodate cultural practices when possible. Some potential improvements offered to improve cultural competency were improved cultural competency training that focused on how healthcare providers ask questions and interact with their patients, increased partnership with refugee communities, and an emphasis on patient education surrounding interventions and procedures related to maternal and reproductive health that could cause hesitations. The results of this literature review accentuated the importance of relationships within the field of refugee women’s healthcare, between both refugee patients and their providers and refugee communities and the healthcare systems. Providing refugee women access to more culturally competent healthcare can increase their trust in the healthcare systems of the countries they resettle in and healthcare utilization that can contribute to improved health outcomes for refugee women and their children.

In January of 2020, the first cases of COVID-19 were recorded in the United States with one of them being an Arizona State University student. Since these initial cases, over 2.4 million more cases have been recorded in Arizona alone. As of March of 2020, Arizona State University Ambulatory Health Services moved to adjust their healthcare delivery methods in response to the COVID-19 pandemic. We aim to identify areas of ASU Ambulatory Health Services as of March of 2020 that need improvement based on an anonymous survey carried out among ASU students, faculty, and staff. The survey was created through Survey Monkey and consisted of 20 questions about the participant’s experience with ASU’s Ambulatory Health Services; while the survey was being created, a literature review was being conducted concerning ASU’s health care delivery in the past and the health care delivery in the greater Maricopa County region. The overall consensus of the 54 participants who took the survey was that approximately 55% of participants had an overall very satisfactory experience through ASU Ambulatory Health Services with a net promoter score of 87% satisfaction and approximately 47% of participants were very likely to recommend ASU Ambulatory Health Services with a net promoter score of about 79%. Most participants reported overall satisfactory experiences but when asked for further commentary they provided more specific criticisms of their experience that could be improved. The specific frustrations that were mentioned were issues with insurance, lack of awareness with available services, instructions on updated regulations and scheduling, and issues with patients’ visits being logged into their medical records. We recommend that ASU Ambulatory Health Services improve in these areas highlighted by the survey answers; as most of these issues are results from communication issues between ASU Ambulatory Health Services and the public, we suggest better means of communication between the public and the health services.

In January of 2020, the first cases of COVID-19 were recorded in the United States with one of them being an Arizona State University student. Since these initial cases, over 2.4 million more cases have been recorded in Arizona alone. As of March of 2020, Arizona State University Ambulatory Health Services moved to adjust their healthcare delivery methods in response to the COVID-19 pandemic. We aim to identify areas of ASU Ambulatory Health Services as of March of 2020 that need improvement based on an anonymous survey carried out among ASU students, faculty, and staff. The survey was created through Survey Monkey and consisted of 20 questions about the participant’s experience with ASU’s Ambulatory Health Services; while the survey was being created, a literature review was being conducted concerning ASU’s health care delivery in the past and the health care delivery in the greater Maricopa County region. The overall consensus of the 54 participants who took the survey was that approximately 55% of participants had an overall very satisfactory experience through ASU Ambulatory Health Services with a net promoter score of 87% satisfaction and approximately 47% of participants were very likely to recommend ASU Ambulatory Health Services with a net promoter score of about 79%. Most participants reported overall satisfactory experiences but when asked for further commentary they provided more specific criticisms of their experience that could be improved. The specific frustrations that were mentioned were issues with insurance, lack of awareness with available services, instructions on updated regulations and scheduling, and issues with patients’ visits being logged into their medical records. We recommend that ASU Ambulatory Health Services improve in these areas highlighted by the survey answers; as most of these issues are results from communication issues between ASU Ambulatory Health Services and the public, we suggest better means of communication between the public and the health services.

In January of 2020, the first cases of COVID-19 were recorded in the United States with one of them being an Arizona State University student. Since these initial cases, over 2.4 million more cases have been recorded in Arizona alone. As of March of 2020, Arizona State University Ambulatory Health Services moved to adjust their healthcare delivery methods in response to the COVID-19 pandemic. We aim to identify areas of ASU Ambulatory Health Services as of March of 2020 that need improvement based on an anonymous survey carried out among ASU students, faculty, and staff. The survey was created through Survey Monkey and consisted of 20 questions about the participant’s experience with ASU’s Ambulatory Health Services; while the survey was being created, a literature review was being conducted concerning ASU’s health care delivery in the past and the health care delivery in the greater Maricopa County region. The overall consensus of the 54 participants who took the survey was that approximately 55% of participants had an overall very satisfactory experience through ASU Ambulatory Health Services with a net promoter score of 87% satisfaction and approximately 47% of participants were very likely to recommend ASU Ambulatory Health Services with a net promoter score of about 79%. Most participants reported overall satisfactory experiences but when asked for further commentary they provided more specific criticisms of their experience that could be improved. The specific frustrations that were mentioned were issues with insurance, lack of awareness with available services, instructions on updated regulations and scheduling, and issues with patients’ visits being logged into their medical records. We recommend that ASU Ambulatory Health Services improve in these areas highlighted by the survey answers; as most of these issues are results from communication issues between ASU Ambulatory Health Services and the public, we suggest better means of communication between the public and the health services.

Elective cosmetic surgery has grown more popular in the last several decades, including procedures specifically targeted at older adults and anti-aging. The aim of this study is to better understand elective cosmetic surgery rationale for older adults. The first part of the study summarizes literature on elective cosmetic surgery for older adults and determines what factors influence the desire for elective cosmetic procedures. From the research databases PubMed, JSTOR, and ScienceDirect, eighteen sources were referenced in the final review. The review found that there are differences in sociocultural views of men and women as they age as well as internal views of aging. The modest number of studies used in the literature review reflect a current gap in current research studying elective cosmetic surgery in older adults. For the second part of the study, data was collected from a 2018 survey designed to better understand aging, body image, and subjective age. The survey was limited to individuals living in the United States aged 40 and above and was deployed through MTurk (Mechanical Turk). A total of 1199 responses were received. Only participants 55 years and above are included for the purpose of this study. Most participants who answered the question for elective cosmetic surgery rationale answered that their primary rationale is to reduce age-related physical markers. For participants identifying as female, nine percent cited self-esteem as their rationale while no male-identifying participants responded similarly. Future research can include questions on internal and external factors older adults feel have the greatest impact on their decision to have elective cosmetic procedures.