Abstract:
OBJECTIVE:Asylum seekers have poor access to health care. Qualitative data portraying their experience is lacking. METHODS:We conducted focus groups and comprehensive interviews with 35 asylum seekers and 15 expert providers/advocacy organization representatives. Purposive sampling was used to recruit subgroups. Interviews were recorded, coded, and analyzed. RESULTS: PARTICIPANTS:85% male, mostly from African countries. Major barriers: a) Internal, including mental illness, fatalism, mistrust, and perceived discrimination; b) Structural, including affordability, limited services, inadequate interpretation, resettlement challenges such as shelter, food, and employment insecurity; health care for urgent care only; and poor cultural competency; c) Barriers in social assimilation, including difficulty navigating a complex system and inadequate community support. CONCLUSION:Significant inter-related barriers exist at the individual, provider, and system levels. Strategies to improve access include targeting social programs and mental health services, expanding Medicaid eligibility/enrollment, promoting community-based organizations, enforcing the use of trained medical interpreters, and improving cultural competency.
journal_name
J Health Care Poor Underservedjournal_title
Journal of health care for the poor and underservedauthors
Asgary R,Segar Ndoi
10.1353/hpu.2011.0047subject
Has Abstractpub_date
2011-05-01 00:00:00pages
506-22issue
2eissn
1049-2089issn
1548-6869pii
S1548686911200111journal_volume
22pub_type
杂志文章abstract::Compared with youth of other races/ethnicities, Native American youth (ages 15-19 years) are more likely to have participated in sexual intercourse, thus placing them at greater risk for sexually transmitted diseases (STDs) and unintended pregnancies. This study's purpose was to investigate relationships among protect...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2006.0133
更新日期:2006-11-01 00:00:00
abstract::The HIV/AIDS epidemic in Africa is frequently referred to as a crisis while the principal U.S. program to address it is labeled emergency relief. These terms trigger specific policy responses and corresponding evaluation activities. In this article, three stages in the response to HIV/AIDS are distinguished: awareness...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.0.0230
更新日期:2009-01-01 00:00:00
abstract::The goal of the Promise Clinic (a project of an academic medical center and a local social services group) is to increase access to primary care for an underserved population while addressing deficiencies in medical education. Students manage common primary care problems, creating access for this mostly uninsured popu...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.0.0046
更新日期:2008-08-01 00:00:00
abstract::We determined the impact of 69 African refugee children's arrival age and weight on subsequent weight gain by following BMI of refugee children. During 6-24 months after arrival in the U.S., 57% of underweight children became normal weight, whereas only 2% of normal weight children moved to the next higher weight cate...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.0.0118
更新日期:2009-02-01 00:00:00
abstract:PURPOSE:To describe the ethnicity/race and gender distribution of the international medical graduates (IMGs) qualified to enter graduate medical education (GME) and those who are actually in GME. METHODS:The Educational Commission for Foreign Medical Graduates (ECFMG) database and the American Medical Association's Ma...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.0.0015
更新日期:2008-05-01 00:00:00
abstract::This report describes an innovative approach to implementing the Office-Based Opioid Treatment (OBOT) model in underserved, community-based settings. Although numerous resources are available to physicians interested in offering medication-assisted treatment (MAT), there is little guidance on how to integrate and oper...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2020.0080
更新日期:2020-01-01 00:00:00
abstract::Latinos are the largest immigrant group in the United States, representing 17.6% of the total U.S. population, and are therefore critical to include in research. However, Latino immigrants-and particularly those who are undocumented residents-may be increasingly wary of participating in research amidst hostile anti-im...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2018.0048
更新日期:2018-01-01 00:00:00
abstract::In this study, we examined the treatment and outcomes of pancreatic adenocarcinoma in New Mexico Native Americans (NA). METHODS:A retrospective review of patients treated for pancreatic adenocarcinoma at a university cancer center from 2002-2016 comparing demographic characteristics, disease presentation, treatment, ...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2019.0045
更新日期:2019-01-01 00:00:00
abstract::This study explores ways in which welfare reforms have affected utilization of four health services (physician visits, hospital care, prescription medication, and dentist visits) and the impact of health insurance on these services. A secondary data analysis of a nationally representative sample of 1,259 non-elderly a...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2005.0048
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:The Dominican Republic (DR) has provided free antiretrovirals (ARVs) since 2004. Little is known about adherence to ARV regimens in the DR. METHODS:We audio-recorded 53 HIV care visits at a hospital-based clinic in the DR, conducted post-visit interviews with each patient, and observed clinic policies and p...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2014.0190
更新日期:2014-11-01 00:00:00
abstract::A significant proportion of patients treated for schizophrenia respond poorly to medication. Few studies have systematically examined the impact of clinical characteristics of patients to antipsychotic response in our environment. The study aimed to identify clinical variables associated with response in patients with...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2017.0070
更新日期:2017-01-01 00:00:00
abstract::Nationally, a higher proportion of the medically underserved than of the general population suffer from hypertension. Poorer adherence to recommended therapies (including medication regimens, salt intake reduction, and regular visits with provider) has been linked to poorer blood pressure control. To identify whether ...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.0.0259
更新日期:2010-02-01 00:00:00
abstract::The burden of non-communicable disease (NCD) is increasing in the U.S. Associated Pacific Islands (USAPI). We describe the implementation and evaluation of a NCD Collaborative pilot, using local trainers, as an evidence-based strategy to systematically strengthen NCD health care quality and outcomes, focusing on diabe...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2016.0187
更新日期:2016-01-01 00:00:00
abstract::We surveyed first-year medical students about preparedness for work at student-run clinics, and for addressing patients' access to care, and social issues. Most students did not know how to get uninsured patients ongoing care or medications outside of the student-run clinic. A large majority of students desired an ori...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.0.0225
更新日期:2009-11-01 00:00:00
abstract::There is little research on cancer symptom management among Indigenous populations. This paper reports on the predictors of cancer pain management among American Indian cancer patients/survivors and their caregivers/family. The intervention was a symptom management toolkit delivered via traditional talking circles vs....
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2016.0079
更新日期:2016-01-01 00:00:00
abstract::Grassroots level health care workers provided insights into rural women's health concerns at a program development workshop held at Sundarban Islands in West Bengal, India. This report describes these narratives and identifies strategies for potential intervention plans. The narratives suggest layers of disenfranchise...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2013.0069
更新日期:2013-05-01 00:00:00
abstract::Many observers explain the prevalence of inadequate prenatal care in the United States by citing demographic or psychosocial factors. But few have evaluated the barriers faced by women with different health insurance status and socioeconomic backgrounds. In this study of 149 women at six hospitals in Minneapolis, insu...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2010.0472
更新日期:1991-10-01 00:00:00
abstract::Farmworkers experience a lack of control over the conditions of their work environment. In trying to reduce the effects of exposure to pesticides, most health care providers give instructions to farmworkers about how to protect themselves. Outreach programs that target farmworkers focus on health education and recomme...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2010.0744
更新日期:2001-05-01 00:00:00
abstract::Publicly funded family planning clinics serve millions of low-income women each year, providing a range of critical preventive services and enabling women to avoid unintended pregnancies. It is important to quantify the impact and cost-effectiveness of such services, in addition to these health benefits. Using a metho...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.0.0060
更新日期:2008-08-01 00:00:00
abstract::Specific features of ambulatory care, such as accessibility, may influence hospital use for patients with HIV infection. To identify clinic features associated with a lower risk of hospitalization, 6,280 New York state Medicaid enrollees diagnosed with AIDS in 1987-1992 and managed by one of 157 surveyed clinics were ...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2010.0633
更新日期:1999-08-01 00:00:00
abstract::Large and increasing numbers of Americans lack health insurance. While children have recently fared better than adults, millions still lack coverage, and thus experience difficulty obtaining acute and preventive care during a critical period of growth and development. This situation has both short and long-term social...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.0.0114
更新日期:2009-02-01 00:00:00
abstract:INTRODUCTION:Prior research has shown that tobacco companies target point-of-sale (POS) marketing to low-income communities. This research assessed the association between demographic characteristics and venue type with purchasing tobacco products in response to marketing. METHODS:Using Population Assessment of Tobacc...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2020.0021
更新日期:2020-01-01 00:00:00
abstract::Previous studies show that many physicians do not accept new patients with Medicaid coverage, but no study has examined Medicaid enrollees' actual experience of provider refusal of their coverage and its implications. Using the 2012 National Health Interview Survey, we estimate provider refusal of health insurance cov...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2016.0096
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Direct-acting antivirals (DAA) have revolutionized the treatment of chronic hepatitis C virus (HCV) infection. OBJECTIVE:To evaluate the clinical effectiveness of DAA in a safety-net population. METHODS:Retrospective cohort study including patients who received at least one dose of DAA for chronic HCV infe...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2020.0090
更新日期:2020-01-01 00:00:00
abstract::Uninsured individuals face great challenges in accessing both primary and specialty care. The Access Partnership (TAP) is a novel collaboration between primary and specialty care providers at an urban academic medical center to provide care coordination and facilitate access to specialty services for uninsured patient...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2012.0085
更新日期:2012-08-01 00:00:00
abstract::This study examined factors associated with the use of the Health Care for the Homeless Program and other health care services by homeless adults. A total of 941 homeless adults were identified in 52 soup kitchens in U.S. communities. Descriptive statistics and logistic regression models were applied. Among homeless a...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Health care costs are often a hindrance to seeking health care. Community-based health care insurance schemes (CBHIS) is a suitable alternative to conventional health insurance schemes which are often beyond the budget of majority of rural residents in Africa. Following establishment of a model CBHIS in the ...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2014.0023
更新日期:2014-02-01 00:00:00
abstract::This pilot study evaluated the Ho'ouna Pono curriculum, which is a culturally grounded, school-based, drug prevention curriculum tailored to rural Native Hawaiian youth. The curriculum focuses on culturally relevant drug resistance skills training and is aligned with the State of Hawai'i academic standards. Six Hawai'...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2016.0061
更新日期:2016-01-01 00:00:00
abstract::We aim to evaluate the association between family income and mock multiple mini interview (MMI) performance for prospective medical school applicants. Each applicant participated in a three-station mock MMI and were scored on four items, each on a sevenpoint scale. Of the 48 prospective applicants participating, 29 (6...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2020.0011
更新日期:2020-01-01 00:00:00
abstract::The U.S. Affiliated Pacific Region (USAPR) is an underserved region with high rates of obesity-related, non-communicable diseases and a low proportion of trained obesity prevention professionals, especially indigenous professionals. The Children's Healthy Living Training Program was developed to enhance the USAPR's ca...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2015.0054
更新日期:2015-05-01 00:00:00