Stress Management Classes for Uninsured Free Clinic Patients in the United States

Abstract

Objective: Stress has become a growing public health concern in the United States (US). Uninsured, low-income or minority patients utilizing a free clinic are exposed to stress disproportionately across various areas of life. Health promotion programs regarding stress management have the potential to benefit vulnerable, low-income populations by reducing stress-related health issues. The purpose of this study was to describe and evaluate the "Stress-Management" education class taught at a free clinic that provides healthcare to uninsured patients.Methods: Data for this study were collected by a pre-stress management class survey, field notes during the stress management class, and post-class survey at a free clinic for low-income, uninsured patients. The surveys and class took place in May and June 2018. Direct observations were based on the Theory of Planned Behavior (TPB).Results: Fifty-five stress management classes were offered with a total of 83 participants. Among the class participants, 71 filled out the survey. Free clinic patients experience cumulative negative situations. One strategy that is helpful for patients to cope with stress is to organize participant responsibilities. Main stressors among the participants included finances, family, emotions, work, health, social relationships, and a sense of not belonging. Conclusion:Providing resources regarding stressors would be a feasible solution for patients at free clinics. Future projects should work to develop stress management class which responds to the results of this study.

English Classes for Foreign-born Uninsured Free Clinic Patients in the United States: A Qualitative Study

“…The clinic serves a diverse population, with patients originally from more than 50 countries. More than half of the patients speak Spanish and many of them have limited English proficiency [15]. The clinic relies on volunteer interpreters or patients' families and friends who are bilingual to help with patient care.…”

Perceived Stress, Cortisol Responses, and the Effect of Social Networks among Uninsured Free Clinic Patients

“…3 Socioeconomic status has been linked to health outcomes and substantial disparities across lifespans, which could be related to adverse stress levels. 4,5 A significant number of studies have identified that a lower socioeconomic status, including low levels of income and education, is associated with greater distress, resulting in high rates of morbidity and mental disorders among this population compared with those enjoying higher socioeconomic positions. 5,6 People with lower income levels are exposed to immense stress in various aspects of their lives, including threats to their quality of life and to safety.…”