This mixed methods research was conducted in the fall of 2014 to understand the perceptions and experiences of health risks and health outcomes due to pesticide exposure among community members (n=13) - concerned community members, agriculture workers and teachers- that live in the Central California agriculture counties of Monterey, Santa Cruz, Tulare, Fresno and Madera. This research explored: 1) The crops growing in participants’ communities, and how exposure to pesticides used in these crops pose potential health risks to participants and their communities 2) How pesticide exposure is impacting Hispanic/Latino communities in Central California, particularly those that are most vulnerable including school children, agriculture workers, and community members 3) The major public health concerns of impacted communities 4) Feelings of empowered to advocate for community health and environment and 5) What impacted communities wish to see on behalf of government and agribusiness to protect public health from pesticide exposure and toxins.

Caregivers often associate fevers with permanent harm and bring children to emergency departments (EDs) unnecessarily. However, families using EDs for nonurgent complaints often have difficulty accessing quality primary care. Mutual misconceptions among caregivers and healthcare providers regarding nonurgent ED use are a barrier to implementing meaningful interventions. The purpose of this project was to identify dominant themes in caregivers’ narratives about bringing children to the ED for nonurgent fevers. Thirty caregivers were recruited in a pediatric ED for participation in qualitative semi-structured interview from August to November 2014. Interview transcripts were coded and analyzed for themes. Caregivers’ decisions to come to the ED revolved around their need for reassurance that children were not in danger. Several major themes emerged: caregivers came to the ED when they felt they had no other options; parents feared that fevers would result in seizures; caregivers frequently drew on family members and the internet for health information; and many families struggled to access their PCPs for sick care due to challenging family logistics. Reducing nonurgent ED utilization requires interventions at the individual and structural level. Individual-level interventions should empower caregivers to manage fevers and other common illnesses at home. However, such interventions may have limited …

Using ethnographic research methods, I collaborated with the organization Earthworks to conduct a community assessment on the health issues related to the air quality in Karnes County, Texas, an oil and gas community. The research consisted of in-depth interviews with residents on their experiences and knowledge on the health issues associated to air quality. This research is going to be used to inform the community and develop strategies to empower community members in improving their environmental conditions.

This thesis presents qualitative research conducted in summer 2017 at the Finger Lakes Free Clinic, which provides free medical and holistic care to people without insurance in upstate New York. The primary goal of this research was to strengthen the relationship between a free clinic and its donors by gathering donor concerns and perceptions regarding federal healthcare policy. Data from 32 interviews with donors, staff, board members, and volunteers, along with 100 hours of participant observation revealed that donors to this clinic were concerned about the potential impact of Congressional healthcare reform yet did not consider federal policy a strong influence on their donations. Rather, donors cited dedication to local giving and personal connections with the clinic as their primary motivations. These motivations suggest the value of viewing the clinic-donor relationship as a relationship of reciprocity. From this framework, the research identifies opportunities for the clinic to reciprocate donor generosity while expanding services in response to a growing need. Insights from the research will guide the clinic's response to federal policy changes and support the clinic's vision of becoming a national model for integrative care.

Autoimmunity is a modern age medical dilemma which is inextricably linked with emotional stress. Based on semi-structured interviews and participant Adverse Childhood Experiences (ACE) survey results, this study confirms that the autoimmune process may be initiated via psychosocial factors like emotional stress and childhood trauma. Ninety-three percent of participants experienced adversity or trauma in childhood, and 50% of participants talked about a period of prolonged stress that preceded the onset of their condition. This study also confirms the intimate and satisfactory relationship developed between patients and complementary and alternative (CAM) practitioners, who invite patients to be co-producers of health and holistically address patients' minds, bodies, and souls. Finally, this study demonstrates the incredible resiliency of people diagnosed with autoimmune conditions and how they find healing and meaning post-diagnosis.

This study explored the lived experience of Gen Z adults in a liminal life-stage crisis where the symbolic meaning of health, identity and brands are in transition. Sixteen ethnographic in-home interviews with college students were conducted and analyzed using Geertz's interpretive and Turner's symbolic anthropology. A hermeneutic textual analysis was used to interpret three types of phenomenological data: text, pictures and collages. An "incubation" step was key in the creative interpretation process where the leap from data to abstract themes was made. Environmental circumstances like money, time, resources and social networks change the quality of health, but the fundamental health explanatory system of a young person is a reflection of their family of origin experiences. Women associate health with mental health-independence and empowerment. Men define health as physical health-food and cooking. Skills such as cooking and shopping as well as the consumption of water, cannabis and other complementary products impact health and identity. Three health worldview themes emerged: health as negotiating identity; creating home; and taking responsibility. Implications for branding and public information campaigns to change the health beliefs and practices of young adults are offered. This thesis closes with a reflection on the "research study," the dominant symbol in …

This study aimed to create a holistic understanding of the physician experience in relation to telemedicine. This study examined a Tele-NICU and a Tele-ER program at a large metropolitan pediatric specialty hospital with a Level IV NICU that provides telemedicine consults to 16 remote sites across Texas. Twenty-four semi-structured interviews were conducted with physicians and nurses at remote hospitals, physicians who provide consultations from the pediatric specialty hospital, and managers of the tele-specialty programs. These interviews were coded using the consolidated framework for implementation science to contextualize program strengths and weaknesses and reviewed to make recommendations for future program development. Remote site participants reported that the programs are useful when they are in need a second opinion and providing reassurance to patient's families. Barriers to program use include issues with the tele-carts, insurance acceptance, and hesitation to request a consult. Study findings demonstrate the need to treat each tele-specialty programs as independent to suit the differing needs of both remote sites and the consulting physicians. This study demonstrates the importance of understanding physician's perspectives, culture, and the role of hospital settings in telemedicine program acceptance and refutes telemedicine as a monolithic solution to limited healthcare access.

The worldwide maternal mortality rate is excessive. Developing countries such as Tanzania experience the highest maternal mortality rates. The continued exploration of issues to create ease of access for women to quality maternal health care is a significant concern. A central strategy for reducing maternal mortality is that every birth be attended by a skilled birth attendant, therefore special attention was placed on motivations and factors that might lead to an increased utilization of health facilities. This qualitative study assessed the perceptions of local population concerning maternal health services and their recommendations for improved quality of care. The study was conducted in the Karatu District of Tanzania and gathered data through 66 in-depth interviews with participants from 20 villages. The following components were identified as essential for perceived quality care: medical professionals that demonstrate a caring attitude and share information about procedures; a supportive and nurturing environment during labor and delivery; meaningful and informative maternal health education for the entire community; promotion of men’s involvement as an essential part of the system of maternal health; knowledgeable, skilled medical staff with supplies and equipment needed for a safe delivery. By providing these elements, the community will gain trust in health facilities …

This rapid ethnographic study explored how a 'mobile health education' app might impact preschool teachers and students, interact with organizational protocols and policies, and align with the preschool culture. The researcher evaluated the app's early Pre-K content and user experience. With a systems thinking approach, this study revealed the lived-experiences and processes in preschools around Austin, Texas. The outcomes of this study guided the client with more human-centered approaches to researching and designing their apps and services.