Date of Conferral





Health Services


Magdeline Aagard


The Affordable Care Act expanded insurance coverage to the general population; however, expanding insurance coverage to immigrants might not be sufficient to improve utilization of annual physical preventive exams. This study evaluated adult Michigan immigrants' individual demographics, perceptions, and behaviors, as well as the collective cultural and system characteristics that might act as barriers to the utilization of annual physical preventive exams. Ken Wilber's integral operating system model for medicine conceptual framework was used to create a comprehensive map of factors and bring more clarity and understanding to the barriers to annual physical preventive exam. The quantitative survey was the best approach for this study because of the large numbers of explanatory independent variables identified in the literature review. Snowball sampling was used to increase the credibility of this research by involving different immigrant communities and reaching large numbers of immigrants.

Descriptive results indicate immigrants' barriers revolve around difficulty accessing health care and the cultural competency of the health care provider. Logistic regression analysis found that immigrants who are stressed and worried, self-employed, and middle class are less likely to utilize annual physical preventive exams. This study could be a force for social change by promoting healthy behaviors and encouraging immigrants to use annual physical preventive exam to reduce the occurrence of chronic conditions and increase life satisfaction in the community.