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 stressrelated 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 prestress 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 June 2018. Direct observations were based off 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 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.

Highlights

  • Stress is present in various areas of life and has been notably difficult to define and study

  • Fifty-five stress management classes were offered with a total of 83 participants

  • This study is valuable in helping fill the gap in qualitative research regarding stress management among uninsured, free clinic patients and provides important practical implications

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Summary

Introduction

Stress is present in various areas of life and has been notably difficult to define and study. There is no agreement within academia on how to define, classify, or measure stress exposure [1]. In 2017, 75% of Americans reported experiencing at least one symptom of stress in the last month [2]. These symptoms of stress included feeling nervous or anxious, irritabilety or anger, and fatigue. In order to cope and manage stress, Americans resort to both unhealthy and healthy ways (e.g. smoking, listening to music, exercise, meditation, and yoga) [2]. Among the well-documented disparities in health, stress has been listed as one of the top 10 determinants of health [5]

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