Welcome to my survey!

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* 1. Dear Participant,

This study is being conducted by Kholoud Sheba who is a graduate student at the Communication department at Arkansas State University, USA. Dr. Mary Jackson Pitts is my faculty mentor. The survey is designed to understand what are the perceptions and barriers of refugees’ population in accessing health care services in the United States. Your response to the survey questions is confidential and available to the researchers. No identifiable data will be collected. Moreover, the survey will not include personal information unless you provide an email address that includes you in a drawing for two $25 gift cards. All personal information will be destroyed upon collection of data. You must be at least 18 years old to be eligible to complete the survey. The findings of this study will be used to better understand how refugees perceive barriers in their experience visiting with public hospitals and clinics in The United States. The questionnaire will take no more than 15 minutes to complete. Please answer every question as accurately as possible.

If you have any questions about this study, you can contact the people below:

Kholoud.mahrouss@smail.astate.edu

mpitts@astate.edu 870-972-3361

If you have any questions or concerns regarding your rights as a research subject, please contact the director of research compliance at +1(870) 972-2694 or by email at jlestes@astate.edu.

Participation is voluntary, refusal to participate will involve no penalty or loss of benefits to which the subject is otherwise entitled, and the subject may discontinue participation at any time without penalty or loss of benefits to which the subject is otherwise entitled.

By selecting "I agree" you state that you agree and sign the consent form. This is necessary to enter the survey. If you disagree, please leave the page.



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* 2. Please consider the following statements and indicate your level of agreement with each statement by circling the answer that best represents your agreement.

  Strongly Agree Agree Disagree Strongly Disagree
Being a refugee/imigrant impacted my general health.
Being a refugee/immigrant influenced the way I think of my health.
I need someone to explain my prescription to me.
I trust my healthcare provider.
I have felt uncomfortable with my healthcare provider.
I have disagreed with my healthcare provider about a specific health issues.
I think my healthcare provider listens to me carefully.
I often go to a healthcare provider.
My healthcare providers explain things in a way I can understand.
My healthcare providers spend enough time with me.
The healthcare I receive is good.
My lack of English language skills has negatively impacted my health.
I understand my health insurance policy.
I know which hospitals that accept my health insurance.
American medical practices influenced your health behavior.
I feel comfortable visiting a health care provider for reproductive health services.
I feel that physicians respect my culture.
I prefer to know about my health status through text message.
It is difficult sometimes to get to the health center.
I believe I would receive better healthcare if I was of a different country of origin.
I usually need an interpreter when I am visiting health services.
I need a community health workers speaking my language.
I prefer the physician, not the social worker, to explain me my health condition.
I use online health information sources.

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* 3. Please consider the following questions and circle that answer that best represents your position on the question.

  Excellent Very good Fair Poor
How do you describe your experience visiting with public health units and hospitals since you came to the united states?
How do you feel about your overall health?
How do you rate American health care providers?

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* 4. What kind of health insurance do you have? Please mark one.

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* 5. I would like mostly to receive information about my health through, Please mark only one.

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* 6. How does your health now compare to when you first arrived in the U.S? / Did you notice any change in your health after arriving in the U.S.?

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* 7. What types of health services do you receive on a regular basis? Please mark all that apply.

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* 8. What is the main reason you visit a health care provider?  Please mark one.

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* 9. What are the circumstances that make you uncomfortable with your health care provider? Please check all that apply.

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* 10. What are some of the issues that might prevent you from seeking health care? Please mark all that apply.

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* 11. What sources do you use for your health related information? Please mark all that apply.

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* 12. How do you usually get to the health center? Please mark only one.

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* 13. Do you normally understand your prescription?

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* 14. Do you usually need someone to explain to you the medicine prescribed?

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* 15. Do you visit spiritual healers to treat illness?

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* 16. Do you use herbal preparation to treat illness?

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* 17. Did you start school since you arrive in the United States?

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* 18. Have you ever missed an appointment or been unable to obtain needed health care because of problems with your transportation?

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* 19. Do you know anyone who migrated to the U.S. as a refugee/immigrant who needed to see a doctor for a health problem but did not go?

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* 20. If No, Skip to the next question.
If yes, what was the reason(s) you could not get to the clinic? Check all that apply.

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* 21. Do you own a car?

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* 22. Do you have friends or family members who are unable to get to a health clinic because of problems with transportation?

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* 23. What is your race?

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* 24. What is your age?

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* 25. What is your gender?

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* 26. In what country were you born?

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* 27. To what ethnic group do you belong?

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* 28. How long have you been in the United States?

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* 29. Who arrived in the United States with you from your  household?

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* 30. Do you identify yourself with a religion? If yes, what religion?

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* 31. What is your marital status?

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* 32. What is your employment status in the United States?

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* 33. How do you describe your English Language?

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* 34. What is the highest level of education you completed before you come to the United States?

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* 35. Thank you for participating in our survey.
In order to participate in the gift card drawing, you must leave your email address. If you do not have an email address please leave your cell phone number and mailing address.

Thank you for your time!

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