scholarly journals Identifying Barriers to Healthcare Access for New Immigrants: A Qualitative Study in Regina, Saskatchewan, Canada

Author(s):  
Mamata Pandey ◽  
Rejina Kamrul ◽  
Clara Rocha Michaels ◽  
Michelle McCarron
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nathan G. Rockey ◽  
Taylor M. Weiskittel ◽  
Katharine E. Linder ◽  
Jennifer L. Ridgeway ◽  
Mark L. Wieland

Abstract Background The purpose of this study was to evaluate the extent to which a longitudinal student-run clinic (SRC) is meeting its stated learning objectives, including providing critical community services and developing physicians who more fully appreciate the social factors affecting their patients’ health. Methods This was a mixed methods program evaluation of an SRC at Mayo Clinic Alix School of Medicine (MCASOM). A survey was conducted of medical students who had participated in the clinic and seven interviews and three focus groups were conducted with SRC patients, students, faculty, staff, and board members. Transcripts were coded for systematic themes and sub-themes. Major themes were reported. Survey and interview data were integrated by comparing findings and discussing areas of convergence or divergence in order to more fully understand program success and potential areas for improvement. Results Greater than 85% of student survey respondents (N = 90) agreed or strongly agreed that the SRC met each of its objectives: to provide a vital community service, to explore social determinants of health (SDH), to understand barriers to healthcare access and to practice patience-centered examination. Qualitative data revealed that the SRC contextualized authentic patient care experiences early in students’ medical school careers, but the depth of learning was variable between students. Furthermore, exposure to SDH through the program did not necessarily translate to student understanding of the impact of these social factors on patient’s health nor did it clearly influence students’ future practice goals. Conclusions The MCASOM SRC experience met core learning objectives, but opportunities to improve long-term impact on students were identified. Participation in the SRC enabled students to engage in patient care early in training that is representative of future practices. SRCs are an avenue by which students can gain exposure to real-world applications of SDH and barriers to healthcare access, but additional focus on faculty development and intentional reflection may be needed to translate this exposure to actionable student understanding of social factors that impact patient care.


Author(s):  
Nagesh Shukla ◽  
Biswajeet Pradhan ◽  
Abhirup Dikshit ◽  
Subrata Chakraborty ◽  
Abdullah M. Alamri

Understanding barriers to healthcare access is a multifaceted challenge, which is often highly diverse depending on location and the prevalent surroundings. The barriers can range from transport accessibility to socio-economic conditions, ethnicity and various patient characteristics. Australia has one of the best healthcare systems in the world; however, there are several concerns surrounding its accessibility, primarily due to the vast geographical area it encompasses. This review study is an attempt to understand the various modeling approaches used by researchers to analyze diverse barriers related to specific disease types and the various areal distributions in the country. In terms of barriers, the most affected people are those living in rural and remote parts, and the situation is even worse for indigenous people. These models have mostly focused on the use of statistical models and spatial modeling. The review reveals that most of the focus has been on cancer-related studies and understanding accessibility among the rural and urban population. Future work should focus on further categorizing the population based on indigeneity, migration status and the use of advanced computational models. This article should not be considered an exhaustive review of every aspect as each section deserves a separate review of its own. However, it highlights all the key points, covered under several facets which can be used by researchers and policymakers to understand the current limitations and the steps that need to be taken to improve health accessibility.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6544-6544
Author(s):  
Alexandra Bukowski ◽  
Enrique Soto Perez De Celis ◽  
Wendy A Ramos-López ◽  
Patricia Rojo-Castillo ◽  
Jesus Armando Sanchez- Gonzalez ◽  
...  

6544 Background: High cancer mortality rates in developing nations are partially driven by advanced stages at diagnosis and limited access to care. In Mexico, the interval from problem identification to start of treatment can be up to 7 months, mostly due to healthcare system delays. We implemented a patient navigation (PN) program aimed at reducing time to referral to cancer centers for patients (pts) with a suspicion or a diagnosis of cancer seen at a public general hospital in Mexico City. Methods: Pts age > 18 seen at Hospital General Ajusco Medio in Mexico City who required referral to a cancer center were enrolled. Baseline demographic, economic and psychosocial data were collected. A Patient Navigator assisted pts with scheduling; paperwork; obtaining results in a timely manner; transportation; and with other cultural barriers. The goal of the PN program was for at least 70% of enrolled patients to obtain a specialized appointment at a cancer center within the first 3 months from enrollment. Results: 53 pts (median age 54, range 19-80; 51% female) were included between 01/16 and 12/16. 19% (n = 10) had breast/GYN, 19% (n = 10) GU, 19% (n = 10) endocrine, 19% GI (n = 10) and 14% (n = 13) other tumors. All the pts were uninsured, 59% (n = 30) had less than middle school education, 80% (n = 41) were unemployed and 96% (n = 49) had a monthly household income of < $360 USD. 54% (n = 28) reported deprivation in at least one basic living need (education, running water, toilet, electricity or flooring). The most commonly identified barriers to healthcare access were financial (73%, N = 37), lack of transportation (47%, N = 24), fear (37%, N = 19) and poor communication with healthcare workers (35%, N = 18). Mean time to referral was 11 days (range 0–46, SD 11.2) and mean time to cancer specialist appointment 26 days (range 1–94, SD 21.18). 92% of pts successfully obtained appointments at a cancer center in < 3 months. Conclusions: Compared with previously reported data, this PN program shortened time to referral to a cancer center for pts with a suspicion or diagnosis of cancer in Mexico City. PN represents a potential solution to overcome barriers to healthcare access for underserved pts with cancer in developing countries.


2001 ◽  
Vol 9 (6) ◽  
pp. 445-453 ◽  
Author(s):  
Syed M. Ahmed ◽  
Jeanne P. Lemkau ◽  
Nichol Nealeigh ◽  
Barbara Mann

2020 ◽  
Vol 18 (2) ◽  
pp. 1809
Author(s):  
Ali A. Al Jumaili ◽  
Kawther K. Ahmed ◽  
Dave Koch

Objective: To identify barriers to healthcare access, to assess the health literacy levels of the foreign-born Arabic speaking population in Iowa, USA and to measure their prevalence of seeking preventive healthcare services. Methods: A cross-sectional study of native Arabic speaking adults involved a focus group and an anonymous paper-based survey. The focus group and the Andersen Model were used to develop the survey questionnaire. The survey participants were customers at Arabic grocery stores, worshippers at the city mosque and patients at free University Clinic. Chi-square test was used to measure the relationship between the characteristics of survey participants and preventive healthcare services. Thematic analysis was used to analyze the focus group transcript. Results: We received 196 completed surveys. Only half of the participants were considered to have good health literacy. More than one-third of the participants had no health insurance and less than half of them visit clinics regularly for preventive measures. Two participant enabling factors (health insurance and residency years) and one need factor (having chronic disease(s)) were found to significantly influence preventive physician visits. Conclusions: This theory-based study provides a tool that can be used in different Western countries where Arabic minority lives. Both the survey and the focus group agreed that lacking health insurance is the main barrier facing their access to healthcare services. The availability of an interpreter in the hospital is essential to help those with inadequate health literacy, particularly new arriving individuals. More free healthcare settings are needed in the county to take care of the increasing number of uninsured Arabic speaking patients.


2018 ◽  
Author(s):  
Miriam Navarro ◽  
B�rbara Navaza ◽  
Anne Guionnet ◽  
Rogelio L�pez-V�lez

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Sunita Dodani

Background: Cardiovascular diseases, including stroke, remain the leading cause of mortality and morbidity in the US. Hypertension (HTN) is the single most chronic condition among African-American (AA) adults with health disparities in respect to control, awareness, and compliance. HEALS Med-Tech (HMT) is a 12-month HTN management program. This abstract will present findings from the first 3 months of HMT on BP reduction in diagnosed AA adults. Primary outcomes of interest are changes in systolic BP (SBP), diastolic BP (DBP), and weight at 3, 6, and 12 months. Methods: HMT has 3 components: a) HEALS (Healthy Eating And Living Spiritually) a group-based, 12-month behavioral lifestyle intervention (3-months of weekly sessions followed by 9 monthly maintenance sessions) modified from the NIH-funded DASH and PREMIER programs; b) Med-component provides HTN management through medications and social support provided by PCPs; and c) Tech-component provides an interactive telehealth by mobile phone to combat barriers to healthcare access. Results: A total of 62 eligible AA participants were enrolled and randomized to either HEALS Med-Tech or standard care (control). The study is currently in maintenance phase. The least squares mean SBP at baseline was 144.1 mm Hg, and after 12 weeks of intervention, the SBP was 134.0 mm Hg. Similar changes were seen in DBP at 12 weeks from baseline. Conclusion: A multidisciplinary, community-engaged approach utilizing technology, supported by community peers, could improve HTN management in high-risk AAs. This study will contribute to understanding methods to empower AAs to increase self-care management of HTN and improve access to healthcare.


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