This thesis address the disparities seen in access to quality healthcare between rural and urban Namibian mothers. This thesis design also delves into the effectiveness of recent initiatives, such as mobile clinics, and their ability to diminish these barriers and overall impact childhood mortality rates. The methods of this research included a literature review that identified and analyzed the socioeconomic barriers these mothers face, interviews with health care professionals in Namibia, and an application of the H.M. Becker Health Belief Model. This design determined that barriers to care included, income, education, transportation, and employment attainability. Through the analysis of the Health Belief Model, it was determined that the benefits of receiving care outweigh the barriers to quality care and mobile clinics do accurately identify and diminish these barriers.

Studies over the past years have collected data on the opinions of women in the workforce related to family planning and societal norms (Buddhapriya, 2009). However, these studies do not address the opinions of college students, the majority of whom have not yet entered the workforce yet, may have strong opinions about whether or not career ambitions and the desire for children are mutually exclusive. In addition, these studies mainly focus on the hardships of women already in the workforce, rather than to understand how to broaden the workforce to accommodate women before entering motherhood. Therefore, to encourage mothers in the workforce to strive for high professional achievement, it is important to first encourage those making life-changing decisions based on degree choice in college. In doing this, 111 Arizona State University (ASU) students of all years, gender, and college choice were surveyed to better understand the difference between men's and women’s opinions on family planning in relation to career. The results of the survey concluded that more women have not let family planning affect their choice of major and career aspirations. Although previous studies have shown that a job affects motherhood in the professional aspect, this does not seem to be a reason to alter career choices.

Minority mental health patients face many health inequities and inequalities that may stem from implicit bias and a lack of cultural awareness from their healthcare providers. I analyzed the current literature evaluating implicit bias among healthcare providers and culturally specific life traumas that Latinos and African Americans face that can impact their mental health. Additionally, I researched a current mental health assessments tool, the Child and Adolescent Trauma Survey (CATS), and evaluated it for the use on Latino and African American patients. Face-to-face interviews with two healthcare providers were also used to analyze the CATS for its’ applicability to Latino and African American patients. Results showed that these assessments were not sufficient in capturing culturally specific life traumas of minority patients. Based on the literature review and analysis of the interviews with healthcare providers, a novel assessment tool, the Culturally Traumatic Events Questionnaire (CTEQ), was created to address the gaps that currently make up other mental health assessment tools used on minority patients.

Early and effective end-of-life care are associated with increased quality of life for those patients who may be nearing the end-of-life (EOL). However, evidence suggests that most non-palliative healthcare providers lack the skills and confidence to initiate EOL conversations. Consequently, about 70% of Americans would prefer to die at home with their families, yet only 25% die according to their wishes (State of California Department of Justice, n.d). In alignment with the Peaceful End of Life Theory, the purpose of this evidence-based project is to increase primary healthcare providers’ level of skills and confidence in end-of-life discussions.

This project utilized a pre and post study design. A total of 11 participants were recruited using convenience sampling from three primary care clinics in Phoenix, Arizona. Due to the small sample size and assumption of a non-normal distribution of the data, Wilcoxon Signed Ranks test and Pearson correlation coefficient were used for statistical analysis. There were clinical and statistical significant improvements in the EOL knowledge of the participants after the implementation of the two-and-a-half-hour Serious Illness Care Program (Z = -2.950, p = .003) with a large effect size (r = -0.62).

The project evaluation also demonstrated that most participants deemed that the intervention was effective. A brief and systematic education session, such as the SICP can be utilized to improve non-palliative healthcare providers’ skills in having more and effective end-of-life conversations.