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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: Sexual violence within the collegiate environment is a pressing issue within American society. One way to address sexual violence is through the adaptation and implementation of a sexual assault policy by colleges and universities. The purpose of this study is to review sexual misconduct and assault policies of ten public universities as well as federal policies in the US. This study contributes to increasing the knowledge of sexual assault policies on American campuses that would be helpful in the development of more effective prevention policies, increasing sexual assault reporting, and decreasing sexual assaults. Methods: The data included relevant legislation, and the university sexual assault and/or misconduct policies from ten selected public universities within the United States in Fall 2014. Results: The policies of the ten universities vary. Three of the universities do not have university policies that explicitly address sexual misconduct as assault. Sexual harassment policies tend to focus on the threat of violence, as opposed to perpetrated sexual violence itself. Conclusions: Further efforts in policy revisions need to be made so that more universities will not only implement sexual assault policies, but also implement more comprehensive policies.

Japan launched the Long-term Care Insurance program in 2000, and ratified the United Nations' Convention on the Rights of Persons with Disabilities in 2014. Japan has been taking significant steps to support their elderly population and individuals with disabilities. However, information is lacking on the understanding and opinions of either of these groups among Japanese college students, many of whom will have significant impact on the development of relevant programs in the future. The purpose of this study is to explore perceptions of the elderly, individuals with a physical disability, and individuals with a mental disability. Three focus groups were held with a total of 20 college students throughout June and July 2015 in Japan. Lack of formal and human resources are issues for the elderly and people with physical disabilities. It is important to increase awareness of struggles related to physical and mental disabilities. Images of physical and mental disabilities in society and media need to be improved. Future studies need to expand in the following areas: 1) to examine the issues of lack of formal and human resources and its impact on the elderly, families and society; 2) to develop programs to increase awareness of the issues of disabilities and evaluate the effectiveness of the programs; and 3) to examine the impact of media on perceptions of people with a disability.

The purpose of this study was to explore the motivation of highly physically active older adults based on the socio-ecological model, both before and during the COVID-19 pandemic. Participants were aged 65 or older, engaged in at least 150 minutes of self-identified moderate to vigorous physical activity (PA) per week, and did not report any significant chronic conditions or cognitive impairment that would limit a participant's engagement in PA. Data were collected from January to March 2020 using in-person, one-on-one interviews (N = 19). The follow-up data were collected by e-mail in January 2021. Participants were asked via e-mail questions regarding changes in PA since the beginning of the COVID-19 pandemic. Individual traits are the primary motivational factors for PA. Highly physically active older adults had access to and utilized resources for PA and had social circles with other physically active older adults. While the COVID-19 pandemic had affected PA, overall participants tried to maintain their PA. [ABSTRACT FROM AUTHOR]

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]

Uninsured primary care patients tend to experience barriers to autonomy in clinical decision-making due to limited choices of healthcare facilities and low health literacy. This study examined whether certain factors, including the component of patient-centeredness, are associated with patient autonomy among these populations and contribute to reducing disparities in healthcare. This was a cross-sectional study using a convenience sample of free clinic patients aged 18 years and older who spoke English and/or Spanish. Multiple regression analyses were performed to understand factors associated with Ideal Patient's Autonomy. Data were collected from September to December 2019. Findings conclude that Spanish-speaking patients at the free clinic have a stronger belief in a paternalist model of the provider–patient relationship (P <.01). Better communication between patients and providers results in higher levels of autonomy (P <.01). Higher levels of educational attainment and better communication partnership were associated with higher levels of a free clinic patient's understanding of treatment risks (P <.01). This research study found that components of patient-centeredness are important considerations for improving patient autonomy among free clinic patients. [ABSTRACT FROM AUTHOR]