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The oppression of underserved populations is pervasive throughout the history of the United States (U.S.), especially in health care. Brazilian educator Paulo Freire's controversial ideas about systems of power can be aptly applied to health care. This paper focuses specifically on arguably the most medically underserved group in the U.S. healthcare system, free clinic patients, and analyzes the effects oppression on acculturation and patient provider communication, and the potential of health education classes to reduce oppression and health disparities in this population. One way in which oppression materializes within the realm of medical and health education is through acculturation. Spanish-speaking free clinic patients are less satisfied with overall interpersonal communication at a free clinic than US born and non-US born English-speaking free clinic patients. Oppression can also be seen in patient-provider communication, specifically, around communicating diagnoses. It is vital for providers and educators to consistently and accurately educate their patients, and to ensure that patients fully understand their diagnoses before concluding an office visit. Reduction of national deaths through preventative health measures, such as health education programming, is an achievable goal. However, one concern in health education classes amongst underserved populations is the underlying power dynamic associated with individuals from a privileged background educating less privileged populations. Engaging health education participants through informal discussions rather than lectures is something that can be applied in future health-related educational settings. Further examining issues of acculturation, patient-provider communication, and health education classes would help answer Freire's pedagogical questions and improve health care services for free clinic patients and other underserved populations in the U.S.

Objective: Free clinics provide free or reduced fee healthcare to individuals who lack access to primary care and are socio-economically disadvantaged in the USA. Free clinic patients may have health education needs, but experience barriers to attending health education programmes. In an attempt to reach out to free clinic patients who might not otherwise attend health education classes, this project examined the efficacy of student-led health education classes conducted in the waiting room prior to a patient's appointment with a provider. Design: The classes had two areas of focus: women's health and health information. Health educators and Spanish interpreters were graduate and undergraduate students. Setting: This study was conducted in the waiting room of a free clinic in the Intermountain West region of the USA. Method: The health education classes were held 22 times in total from late August to early December 2014. Results: While the survey-based assessment of the programme did not show a difference in levels of health consciousness, health information seeking and health attitudes, the programme potentially increased interest in attending the health education classes. Conclusion: There were some challenges associated with the implementation of a health education class in the waiting room setting, particularly in regards to environments, evaluation and interpretation services. Future projects are needed to address challenges associated with conducting a health education class in a waiting room setting. In addition, a variety of health topics, evidence-based evaluation and interpreter services are key for future success.

Volunteers provide important social support for homeless people. While motivations of the volunteer population for homeless people have been studied, little is known about volunteers for a hospice targeting the homeless population. The purpose of this study is to describe volunteer experiences and motivation at a hospice for homeless people during the COVID-19 pandemic. This study was conducted at a hospice for homeless individuals in Fall 2021. Data were collected by six virtual focus groups in November and December 2021. There were 21 participants. The recordings of the focus groups were automatically transcribed via ZOOM. The data were analyzed based on themes. This study has highlighted three main findings. First, honoring a loved one and being engaged in the community were two main reasons individuals began volunteering at the hospice center. Second, volunteers faced many challenges during the COVID-19 pandemic, including a slow start, increased use of technology, and constant change in volunteers' responsibilities due to safety reasons. During this time however, volunteers felt much support from the program staff. Third, interactions with staff, other volunteers and residents were the main reasons driving volunteer motivation. This project examined the under-studied subject of volunteers' experiences at a hospice for homeless people and provided insight in this topic. While the COVID-19 pandemic affected volunteering at a hospice for homeless people, support from the program staff and leadership helped sustain volunteer motivation. [ABSTRACT FROM AUTHOR]

The annual number of opioid prescriptions for pain relief has been increasing in the United States. This increase has raised concerns about prescription opioid abuse and overdose. The purpose of this study was to examine opioid risks (risk factors that increase the chance of opioid abuse) among uninsured primary care patients utilizing a free clinic. Data were collected using a self-administered paper survey in the waiting room of the free clinic from May to July 2017 (N = 506). Higher levels of somatic symptoms were associated with higher levels of opioid risks. U.S.-born English speakers had higher levels of opioid risk than non–U.S.-born English speakers and Spanish speakers. Being employed was associated with higher levels of opioid risk while attending college or being postcollegiate was related to lower levels of opioid risk. Research surrounding best practices, prescription trends, and population risk is vital in driving health and social policy. Further research would benefit from examining where people are obtaining opioids. In addition, further research on opioid abuse among Hispanic populations would be beneficial. Finally, future studies should examine how prescribing practices are different among free clinic health professionals in comparison to health care professionals working in-patient or at for-profit clinics. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to examine cardiovascular disease-related health beliefs and how they are influenced by knowledge and a sense of community among uninsured primary care patients. Method This study was a cross-sectional study using a self-administered paper survey (January to April 2016). The study population included medically uninsured US-born English speakers, non-US-born English speakers, and Spanish speakers. Results Medically uninsured adults utilizing a free clinic (N = 374) participated in the survey. Increasing knowledge about major risk factors for developing cardiovascular disease helped enhance levels of perceived severity of cardiovascular disease and benefits of healthy diet and physical activity. Spanish speakers reported higher levels of perceived severity of cardiovascular disease but lower levels of knowledge compared to US-born or non-US-born English speakers. Conclusion Spanish speakers may need different approaches to promote cardiovascular disease prevention due to their higher levels of perceived severity of cardiovascular disease but lower levels of cardiovascular disease-related knowledge compared to English speakers. Developing a healthy "community" in a clinic setting may be effective to promote cardiovascular disease-related health for underserved populations. [ABSTRACT FROM AUTHOR]