Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Mary Jo Clark, PhD, RN, Chairperson; Lois Howland, DPH, MS, RN; Fred J. Galloway, EdD


health insurance coverage, nursing, public awareness, public opinion, San Diego County (California), Tuberculosis


This quantitative descriptive cross-sectional study examined the effect of TB awareness and demographic variables on the level of support for expanding health insurance coverage for all residents, including undocumented immigrants. A modified 13-item tool developed by Morisky et al. (1990) was used to measure TB awareness; a single item created by the researcher assessed personal opinion regarding expansion of health insurance coverage; and a demographic questionnaire was used to collect data from 281 registered voters in San Diego County. The majority of San Diego County voters participating in the study supported at least some expansion of health insurance coverage. ANOVA tests indicated that personal opinion was not associated with awareness of tuberculosis, but was significantly associated with political party affiliation and education level in the initial analysis (p = .000, and .035, respectively). TB awareness was significantly associated with ethnicity (p = .003) and the education level of the participants (p = .004). When the opinion variable was dichotomized and trichotomized, other demographic variables were significantly related. Study findings suggest that efforts to promote public opinion in favor of expanded health insurance coverage need to be differentially targeted to different audiences. Further studies, addressing the underrepresentation of certain groups that occurred in this study, might result in different findings in different parts of the country, especially nonborder areas.

Document Type

Dissertation: Open Access



Included in

Nursing Commons