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Interpretive policy analysis: Marshallese COFA migrants and the Affordable Care Act

Overview of attention for article published in International Journal for Equity in Health, June 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (89th percentile)
  • Good Attention Score compared to outputs of the same age and source (73rd percentile)

Mentioned by

news
1 news outlet
blogs
1 blog
facebook
1 Facebook page

Citations

dimensions_citation
29 Dimensions

Readers on

mendeley
55 Mendeley
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Title
Interpretive policy analysis: Marshallese COFA migrants and the Affordable Care Act
Published in
International Journal for Equity in Health, June 2016
DOI 10.1186/s12939-016-0381-1
Pubmed ID
Authors

Pearl Anna McElfish, Rachel S. Purvis, Gregory G. Maskarinec, Williamina Ioanna Bing, Christopher J. Jacob, Mandy Ritok-Lakien, Jellesen Rubon-Chutaro, Sharlynn Lang, Sammie Mamis, Sheldon Riklon

Abstract

Since the enactment of the Affordable Care Act (ACA), the rate of uninsured in the United States has declined significantly. However, not all legal residents have benefited equally. As part of a community-based participatory research (CBPR) partnership with the Marshallese community, an interpretative policy analysis research project was conducted to document Marshallese Compact of Free Association (COFA) migrants' understanding and experiences regarding the ACA and related health policies. This article is structured to allow the voice of Marshallese COFA migrants to explain their understanding and interpretation of the ACA and related polices on their health in their own words. Qualitative data was collected from 48 participants in five focus groups conducted at the local community center and three individual interviews for those unable to attend the focus groups. Marshallese community co-investigators participated throughout the research and writing process to ensure that cultural context and nuances in meaning were accurately captured and presented. Community co-investigators assisted with the development of the semi-structured interview guide, facilitated focus groups, and participated in qualitative data analysis. Content analysis revealed six consistent themes across all focus groups and individual interviews that include: understanding, experiences, effect on health, relational/historical lenses, economic contribution, and pleas. Working with Marshallese community co-investigators, we selected quotations that most represented the participants' collective experiences. The Marshallese view the ACA and their lack of coverage as part of the broader relationship between the Republic of the Marshall Islands (RMI) and the United States. The Marshallese state that they have honored the COFA relationship, and they believe the United States is failing to meet its obligations of care and support outlined in the COFA. While the ACA and Medicaid Expansion have reduced the national uninsured rate, Marshallese COFA migrants have not benefited equally from this policy. The lack of healthcare coverage for the Marshallese COFA migrants exacerbates the health disparities this underserved population faces. This article is an important contribution to researchers because it presents the Marshallese's interpretation of the policy, which will help inform policy makers that are working to improve Marshallese COFA migrant health.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 55 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 2%
Unknown 54 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 9 16%
Researcher 9 16%
Librarian 7 13%
Student > Ph. D. Student 6 11%
Student > Doctoral Student 4 7%
Other 5 9%
Unknown 15 27%
Readers by discipline Count As %
Social Sciences 13 24%
Nursing and Health Professions 8 15%
Medicine and Dentistry 8 15%
Psychology 3 5%
Agricultural and Biological Sciences 2 4%
Other 2 4%
Unknown 19 35%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 17. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 July 2016.
All research outputs
#1,872,969
of 22,880,230 outputs
Outputs from International Journal for Equity in Health
#292
of 1,912 outputs
Outputs of similar age
#36,352
of 349,343 outputs
Outputs of similar age from International Journal for Equity in Health
#12
of 46 outputs
Altmetric has tracked 22,880,230 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,912 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.2. This one has done well, scoring higher than 84% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 349,343 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 46 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 73% of its contemporaries.