Thesis (M.A. (Health Social Science))--Mahidol University, 2007. / LICL has E-Thesis 0024 ; please contact computer services.

Thesis (Ph. D.)--Rand Graduate School, 2002. / Includes bibliographical references (p. 64-70).

Thesis (LL.M)--York University, 2003. / Includes bibliographical references. Also available on the Internet.

Thesis (Ph. D.)--Rand Graduate School, 2002. / Includes bibliographical references (p. 64-70). Also available online.

Thesis (Ph. D.)--Rand Graduate School, 2002. / Includes bibliographical references (p. 64-70).

Thesis (Ph. D.)--Ohio State University, 2007. / Title from first page of PDF file. Includes bibliographical references (p. 218-226).

Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2016. / Zimbabwe has a fairly developed health-care delivery system that is served by public and private hospitals at district, provincial and national level. The public health-care system is the largest provider of health-care services and caters for the majority of the population but this is done in a resource-restricted context, typical of a developing context. In this context, this research sought to establish the potential of mHealth Technologies in Zimbabwe’s maternal health sector using Parirenyatwa and Harare hospitals as case studies. The reviewed body of knowledge, which was largely a comparative assessment of mHealth technology adoption in developing countries, indicated that the full adoption of the prevailing eHealth strategy in Zimbabwe remains hamstrung by the slow pace of policy implementation. This is a qualitative study and data was collected with unstructured interviews. Purposive and snowball sampling were used to recruit the participants. The gathered data was analyzed through content and thematic analysis. Four broad themes emerged from the primary data collected during the interviews and these include: trends in information dissemination in Zimbabwe’s Public Health System; information needs for expectant women and midwives; the prevalence of ICT use in Zimbabwe’s Public Health System, and mobile technology use in the maternal health sector in Zimbabwe. The research was able to establish that while there is a high proliferation of smartphone use among most expectant women, this has not translated into their use for health information-related purposes.

This dissertation explored mistrust through focus group discussions (study 1), responses to standardized laboratory vignettes (study 2), and survey questionnaires (study 3). In the first study, I found that African American community members (N=60) experienced perceived discrimination, medical mistrust, and poor communication in numerous and interrelated ways. For example, medical mistrust occurred when clinicians did not convey respect to patients, leaving patients to wonder whether their clinician's treatment was discriminatory or not. Based on these findings, I wanted to see whether these experiences of perceived discrimination and mistrust were related to other dimensions of Black experience, such as racial identity. I conducted a secondary analysis of data from a laboratory study (Somnath Saha, PI) in which 104 primary care patients viewed video-recorded, standardized vignettes depicting a cardiologist recommending heart bypass surgery to a patient diagnosed with angina and 3-vessel coronary artery disease. In this study, those who viewed a video of European American cardiologist-actors had lower physician mistrust and lower hypothetical likelihood of having bypass surgery compared to those who viewed the video of African American cardiologist-actors. However, racial centrality did not moderate the relationship between ethnicity of the cardiologist-actor and patients' decision making. The third study explored other dimensions of racial identity (e.g., unfavorable public regard for African Americans) and mistrust (e.g., medical mistrust), while also exploring their association with perceived healthcare discrimination among African American community members (N=210). In this study, perceived discrimination was positively associated with racial centrality, but not associated with unfavorable public regard. Perceived discrimination was also positively associated with medical mistrust and physician mistrust. Although racial centrality and unfavorable public regard were not significant moderators between perceived discrimination and the two dimensions of mistrust, they were positively associated with medical mistrust. Together, these studies provide a better understanding of African Americans' healthcare attitudes and experiences, particularly mistrust toward medical institutions and clinicians. For example, the association between racial centrality and perceived discrimination may suggest that past experience of discrimination in healthcare may influence a person to seek others who experience similar stressors, giving way to identifying more with her or his racial group. Racial centrality may influence a person's trust towards healthcare, prior to entering the doctor's office. However, once the person enters the doctor's office, racial centrality may play a less significant role the patient's trust towards her or his provider. These findings generated new questions to explore for future studies. For example, future studies should explore the relationship between racial centrality and African Americans' healthcare behavioral responses. In addition, the current studies only focused only on attitudes and perspectives; future studies should investigate how the construct medical mistrust may influence health-related outcomes such as adherence in race-discordant patient-provider relationships.

This study uses secondary survey data collected from a sample population of clients from JPS Health Network in Tarrant County, Texas from July-August, 2000. Respondents for this study represents a group of working-age Hispanic immigrant adults, N=379. Andersen's "Behavioral Model for Vulnerable Populations" is used to as the theoretical framework. Bivariate crosstabulation revealed significant relationships for dependent variables: problems getting needed healthcare, doctor visits, emergency room visits, overnight in the hospital, and obtaining prescription medication. Findings confirm that lack of coverage, competing needs, and difficulties in the health care system are significant in access health care. Subsequent implications and policy recommendations suggests the inevitability of short and long term health consequences unless changes are made to policies and programs.

Patient perceptions of health care quality are critical to a health care service provider's long-term success because of the significant influence perceptions have on customer satisfaction and consequently organization financial performance. Patient satisfaction affects not only the outcome of the health care process such as patient compliance with physician advice and treatment, but also patient retention and favorable word-of-mouth. Accordingly, it is a critical strategy for health care organizations to provide quality service and address patient satisfaction. The urgent care (UC) industry is an integral part of the health care system in the United States that has been experiencing a rapid growth. UC provides a wide range of medical services for a large group of patients and now serves an increasing population. UC is becoming popular because of the convenient locations, extended hours, walk-in policy, short waiting times, and accessibility. A closer examination of the current health care research, however, indicates that there is a paucity of research on urgent care providers. Confronted with the emergence of the urgent care industry and the increasing demand for urgent care, it is necessary to understand how patients perceive urgent care providers and what influences patient satisfaction and retention. This dissertation addresses four areas relevant to the above mentioned issues: (1) development of an instrument to measure perceived service quality in the urgent care industry; (2) identification of the determinants of patient satisfaction and behavioral intentions; (3) empirical examination of the relationships among perceived service quality, patient satisfaction and behavioral intentions; and (4) comparison of the perceived service quality across several primary urgent care providers, such as urgent care centers, hospital emergency departments, and primary care physicians' offices. To validate this new instrument and examine the hypothesized relationships proposed in this study, an electronic web based survey was designed and administered to college students. Both exploratory and confirmatory factor analysis were employed to assess the reliability and validity of the developed instrument. The contextualized relationships were evaluated using structural equation modeling. The results of this research could potentially contribute to urgent care management and quality improvement.