Author ORCID Identifier

Date of Award

Summer 8-9-2022

Degree Type


Degree Name

Doctor of Philosophy (PhD)


Public Health

First Advisor

Dr. Claire Spears

Second Advisor

Dr. Iris Feinberg

Third Advisor

Dr. Ashli Owen-Smith


Healthcare access is not equally distributed throughout the United States, and the COVID-19 pandemic has even further exacerbated these health disparities. Specific populations that may face more barriers in accessing healthcare services during the COVID-19 pandemic are individuals with lower health literacy and refugee populations. Individuals with limited health literacy are less likely to access preventive health services and are more likely to have worse health outcomes. Additionally, lower health literacy and challenges accessing healthcare may hinder vaccination in the context of the pandemic, especially among refugee populations who the COVID-19 pandemic has disproportionately burdened. Therefore, it is necessary to examine what health services individuals of varying health literacy accessed during the COVID-19 pandemic, their experiences accessing care, and factors related to vaccination uptake. The aims of this dissertation are:

Aim 1: Investigate the association between health literacy and healthcare access in the context of the COVID-19 pandemic and examine if social support may act as a potential protective factor among undergraduate students.

Aim 2: Investigate telehealth experiences and preferences of individuals with varying health literacy among adults in the United States.

Aim 3: Develop a conceptual model of factors related to vaccination practices among refugee populations based on a scoping literature review.

The overarching theme of this dissertation is to understand barriers and facilitators to healthcare access among diverse populations in the context of the COVID-19 pandemic with a specific focus on health literacy. This topic was explored through three studies focused on three populations (i.e., undergraduate students, U.S. adults, and refugees living in the U.S.).


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