Campus Location

Abilene Campus (Residential)

Date of Award


Document Type



Social Work

Degree Name

Master of Science

Committee Chair or Primary Advisor

Dr. Kay Jang

Second Committee Member or Secondary Advisor

Dr. Tom Winter

Third Committee Member or Committee Reader

Debra Burchett


ABSTRACT On March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (ACA) to increase value of care, improve clinical outcomes, decrease health care costs, and increase affordability in health care access. The purpose of the study attempts to examine the moderating effects of patient enablement impacting barriers, low socio economic status, and unmet basic needs, toward health care access in uninsured populations post ACA. Only certain aspects of patient enablement in self-management of an individual’s health care goals have been conducted with uninsured populations with barriers toward health care access. The research design was a quantitative, exploratory, cross-sectional study. The study participants were from a convenient sample of patients at the Presbyterian Medical Care Mission. Data was collected through a survey completed by 122 participants from March 20 through March 28, 2018. The Patient Enablement Instrument was used to gather survey data. The primary outcome measure was the effect of patient enablement, moderating variable, on the correlation between low socio-economics status and unmet basic nets, independent variables, on health care access, dependent variable. The primary outcome of the study was gathered by using a binomial logistic regression analysis to determine the association between the dependent, independent, and moderating variables. The results show that patient’s enablement buffers only the relationship between unemployed and primary care access (b = -1.596, Wald = 4.438, p = .035, OR = .203). None of the other predictors included in this model were statistically significant. The sample characteristics receiving primary care services at Presbyterian Medical Care Mission were predominantly white (50.0%), single (39.2%), female (62.0%), average age of 49 years old (11.210%), and a high school graduate (40.0%). This study concludes that a likely explanation of the findings reflects the population being studied. Future research is needed to further the study of patient enablement impact on health care access. It was determined that further studies, preferably longitudinal studies, are required to better determine the association of the variables to assist with future implications in practice to assist with assessment of access to-care barriers and high out-of-pocket costs for already low-income, underserved populations.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.



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