who provided insightful feedback and scholarly guidance throughout this process. They committed their time to reviewing my work and posed critical questions that challenged me to reflect more deeply. I am forever grateful to Dr. Ryan Combs, who welcomed me into his research team from the beginning of my doctoral program. His mentorship and guidance honed my skills and led to my passion for qualitative research, which was fundamental in completing this study. I also appreciate the Department of Health Promotion and its Chair, Dr. Monica Wendel, for the financial and logistical support towards my data collection in Goma. My sincere gratitude to Dr. Robert Vutsopire from Goma Health Zone, who authorized my research, provided valuable insights, and facilitated my entry into the v study sites for data collection. I am equally grateful to the Ethics Committee at the Université Libre des Pays des Grands Lacs, who conducted an expedited ethical review of this study, in addition to the University of Louisville Institutional Review Board. I also extend my sincere gratitude to all the key informants who participated in this study. My family and friends have been a special part of this journey. I am forever grateful to my dad, Dr. Kambale Karafuli; my mom, Dr. Muteho Kasongo; and my brother, Taji Vuruka, for all they have sacrificed for me to achieve this significant milestone. My parents have instilled in me the passion for learning and invested in my dreams, supporting me every step of the way. To my loving husband, Steven Nwaokolo "SJ", who has shown me unconditional love, endless support, and extraordinary patience over the years. He has encouraged me to dream big and has always seen the glass half full when I saw it half empty. Finally, I am thankful for my friends and colleagues who have made this doctoral journey fun and unforgettable.
Health insurance and health systems literacy needs are evolving with changes to the U.S. healthcare system. Following the implementation of the Affordable Care Act, many residents in West Louisville, Kentucky, a predominantly African American community, gained health insurance coverage for the first time. A qualitative study was conducted to assess residents' health insurance and health systems needs and to identify ways of assisting residents with navigating the healthcare system and utilizing their health insurance coverage. Twelve focus groups were conducted with a total of eighty-seven residents. Round one explored participants' experiences with health insurance, and round two examined their health information delivery preferences. An inductive thematic analysis was performed. Participants revealed the complexity of the health insurance system, many citing difficulty understanding health insurance concepts and finding suitable healthcare providers. High costs, mistrust in the healthcare system, and perceived public-private disparities were barriers to effective health insurance utilization. Health insurance materials in their current form have limited value in translating health insurance and health systems information to the West Louisville population. Alternative forms of information delivery, such as locally accessible and culturally competent community health workers may be better received and more successfully utilized by the community.
Black children are twice as likely as non-Hispanic white children to have asthma due to an interplay of socioeconomic, historical, and industrial factors. The underlying socio-economic and structural inequities result in poor adherence to recommended asthma management treatments. National guidelines suggest asthma action plans (AAPs) as a tool for patient self-management, yet they remain underutilized. Boot Camp Translation (BCT), rooted in community-based participatory research, provides a method for engaging communities to improve health literacy. This article describes the successful use of BCT to develop a culturally relevant AAP promotion campaign in West Louisville, a predominantly Black community that experiences social and health disparities.
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