Publication Date

Spring 2017

Advisor(s) - Committee Chair

Randall C. Capps (Director), Grace Lartey, and David Ciochetty

Degree Program

Educational Leadership Doctoral Program

Degree Type

Doctor of Education


The world as a global village has become a ubiquitous trope in the popular discourse, and Bowling Green, Kentucky, with its substantial immigrant population, may be considered an exemplar of this idealized community. It has become an ideal location for research regarding the challenges faced by immigrants. Due to the diverse cultural identities of the refugee/immigrant population, it is particularly well suited for studies into complex culturally dependent healthcare utilization patterns.

The central research question for the study was as follows: What are the healthcare-seeking behavioral patterns (as influenced by culture) among refugees at their nearest healthcare facilities? This mixed study addressed four research questions, which were analyzed by survey and interview results. A survey was administered to refugees who fit the study criteria and have lived in south central Kentucky for six years; 110 responded. Descriptive statistics and psychometric work (factor analysis, Cronbach’s alpha, and inter-scale correlations) were conducted. ANOVA, t-tests, and simultaneous correlations were used to determine significant relationships inherent within each research question.

Research Question 1 used ANOVA due to the ethnic groups and languages that were categorized into groups. With Research Questions 2 and 4, t-tests were conducted with added correlation, while Research Question 3 used a combination of ANOVA and ttests. The analysis explores the relationships between Predisposing Factors, Enabling Factors, Need-Related Factors, and Cultural Competency of Services and utilization of healthcare services.

A purposeful sample of four refugees individually completed interviews that were approximately 50 minutes in length. They shared experiences and insights from their own cultural points of view. The implications of the overall results from the study are discussed.


Bilingual, Multilingual, and Multicultural Education | Public Health | Social Psychology