Chat with us, powered by LiveChat USE THE CHAPTER 1 INTRODUCTION TEMPLATE. You will write your chapter 1/introduction which is 2-4 pages in length, and also include a title page, and a list of 10 reference articles. | Wridemy

USE THE CHAPTER 1 INTRODUCTION TEMPLATE. You will write your chapter 1/introduction which is 2-4 pages in length, and also include a title page, and a list of 10 reference articles.


USE THE CHAPTER 1 INTRODUCTION TEMPLATE. You will write your chapter 1/introduction which is 2-4 pages in length, and also include a title page, and a list of 10 reference articles. Include your research question in a separate Word doc. 

CAPSTONE PROJECT TOPIC: Comparative Analysis of Access to Healthcare in Rural Communities within the United States.

USE THE CHAPTER 1 INTRODUCTION TEMPLATE. You will write your chapter 1/introduction which is 2-4 pages in length, and also include a title page, and a list of 10 reference articles . Include your research question in a separate word doc.

What do you believe your research question would be?


Or in other words, what do you want to learn that would help improve rural health in the US?






Introduction to the Problem

The introduction section begins with a brief discussion of the area of interest and then presents the following sub-sections:

Background of the Problem

Description of the background of the problem (brief historical perspective and explanation of why the problem remains unsolved at this time).

Statement of the Problem

The problem is presented in statement form, e.g., “The problem is …”

Purpose of the Study

This section explains why the study is being conducted. It may be (but not be limited to) one of the following: (1) to effect a change; (2) to solve a real business problem for an existing business; (3) to predict future situations; (4) to compare and contrast (strategies, technologies); (5) to develop a specific marketing program; (6) to determine the feasibility of a marketing option; (7) to conduct a marketing audit and diagnosis of the client organization; or (8) to conduct a marketing analysis of a given project, product, new market or other change in the existing marketing program.

Hypotheses or Research Questions

Hypotheses are only used in quantitative (statistical) research studies. A hypothesis statement predicts a relationship between two variables. Writing a hypothesis should always precede any actual experiments and is an important part of the scientific method. Remember … a good hypothesis statement makes clear the relationship between the variables and is always testable. Research Questions, on the other hand, are used for either quantitative or qualitative studies. The Statement of the Problem should lend itself to translation into a research question that asks precisely what this study must answer in order to (1) solve the research problem, and (2) achieve its purpose. The research question is a conceptual question, indicating the exact scope of the study.

Significance of the Study

This section provides information concerning the importance of the study. A study may be significant because it adds to the body of knowledge of business in general or is critical to the business under study.


The purpose of this section is to present some of the factors the researcher is asking the reader to accept as conditions of the study. Some examples are (1) the sample is representative of the population, (2) the appropriate variables have been selected for examination, and (3) the measurement tools are valid and reliable. Also, identify your hypothesis statement here.


These are those factors or conditions that may affect the data and are out of the researcher's control. For instance, validity and reliable issues from any surveys completed.


The purpose of this section is to summarize Chapter 1 and introduce the remaining chapters, including applicable subsections within each chapter.


References should be double-spaced, with a double-space between entries. Use the ruler to create a hanging indent.


Attach your appendix item here. If no appendices are needed, then omit this page. If more than one appendix is needed, continue to the following page, place APPENDIX B (in all caps) centered at the top of the page, the title of the appendix (in all caps), then attach the applicable item (e.g., table, figure, graph, illustration, etc.). Continue the same process as necessary for all subsequent appendices.



Introduction to the Problem

Untreated mental health issues are a worldwide public health concern (Chelala, 2013,

June 14). Approximately 450 million individuals suffer from some type of mental condition,

placing it as one of the leading contributors to ill-health and disability globally (World Health

Organization [WHO], 2001, October 4). According to the WHO (2001, October 4), although

there are existing treatments available, about two-thirds of people with a mental disorder do not

seek assistance from traditional services due to barriers such as stigma, discrimination and

disregard for health, which may result from a lack of understanding of mental health.

Background of the Problem

Great concern is seen with the mental health of Asian communities among developed

countries of North America (American Psychological Association [APA], 2016; Farah, Khanlou,

& Tamim, 2014). They are known to represent a vast population that is continuing to increase,

hold a prevalence of mental health issues, and are notably recognized to underutilize mental

health services (Leong, 2011). For example, the United States, known as a melting pot of diverse

cultures, has an Asian represents the fastest-growing race group with an estimated amount of

17.3 million residents (Hoeffl, Rastogi, Kim, & Shahid, 2014). As a result, 13% of the Asian

American and Pacific Islanders (AAPIs) in the United States – totaling 2.2 million people – are

diagnosed with a mental illness in a given year (Mental Health America, 2016). In fact, one-third

of this population size utilizes mental health services (Abe-Kim et al., 2007). Research has

analyzed different Asian cultures and their subgroups, reporting that many that go undiagnosed

and untreated (Bauer, Chen, & Alegria, 2010; Derr, 2016).

Canada is another country experiencing a significant growth in their population of Asians

with a reported 4.5 million people (Asian Pacific Foundation of Canada, 2016). Studies reveal

that 1 in 5 Canadians will experience a mental illness at some point in their lifetime (Canadian

Mental Health Association, 2016). More concern is seen among South Asians, which represent

the largest visible minority group (1.26 million) in that country alone (Farah, Khanlou, &

Tamim, 2014). In Canada, the highest rate of South Asian people with unmet healthcare

treatment needs who have a major depression disorder was reported at 48%, with 33% indicating

that they had experienced barriers to accessing mental health services when compared to five

other ethnic groups, including Japanese, Chinese, Koreans, Aboriginals, and Whites (Gadalla,


Studies analyzing Asian subgroups in their foreign countries have recognized various

barriers affecting their ability to access treatment, such as shame and stigma culture (David,

2010), lack of mental health literacy (Nguyen & Bornheimer, 2014), lack of health insurance

(Lee & Matejekowski, 2012), and immigrant status (Kim & Keefe, 2010). Identifying and

understanding these and other perceived barriers to mental health issues among the Asian

population is imperative in order produce better tailored interventions which, in turn, will allow

them to receive the most appropriate assistance (National Alliance of Mental Illness, 2011).

In order to facilitate solution efforts made by public health professionals and policy

makers, research should continue to address all factors impacting their access to mental health

services (Snowden & Yamada, 2005). Much of recent published research has studied barriers

either as a single factor (e.g., language proficiency, stigma, acculturation difficulties) affecting

one specific Asian group (e.g., Asian refugees, Asian elderly immigrants, Asian American

college students) (Lai & Surood, 2013; Leong, 2011; Shannon, Vinson, Cook, & Lennon, 2016)

or collectively with other ethnic minority groups (Abe-Kim et al., 2007). There have been few

reports which have offered summarized data on barriers to health care treatment (Kim & Keefe,

2010), but no comprehensive review of the issue. Recent relevant systematic reviews are specific

to access to treatment (Greenwood, Habibi, Smith, & Manthrope, 2015), language barriers

(Ohtani, Suzuki, Takeuchi, & Uchida, 2015) and the impact of mental health-related stigma

(Akutsu & Chu, 2006).

Statement of the Problem

Asian populations in developed countries of North America experience barriers to mental

health services. Research aiming to learn more about each of the individual Asian sub groups

will offer critical details to assist with development of personalized mental health interventions,

thereby providing each one with the essential support that result in decreasing the prevalence and

incidence of mental health issues (Leong & Kalibatseva, 2011). In fact, the “one size fits all”

method has been shown to have limited effectiveness over time (Betancourt, Green, Carrillo, &

Park, 2005, para. 18). Research has also identified how tailored approaches to health care, such

as cultural competency are found to improve health outcomes as well as the quality of care

(Health Policy Institute, 2004).

Purpose of the Study

Taking various forms, and experienced at different levels of intensity, mental illness is a

common health issue affecting many individuals not only in North America, but worldwide.

Several studies have examined barriers to mental health services among Asian subgroups

collectively, but there is very little research separating the separating them to gather their

similarities and differences in mental illness among them (Leong & Kalibatseva, 2011).

Therefore, the aim and scope of this systematic literature review is to provide a comprehensive

synthesis of barriers to mental health services found among Asian groups living in North

America. Furthermore, reveal which factors giving the most hindrance among Asian populations,

and identify barrier trends among the Asian subgroups.

Research Question

This project aims to answer the following research question: What are the major barriers

preventing Asian populations from seeking mental health services?

Significance of the Study

According to data and findings collected from the Substance Abuse and Mental Health

Services Administration (SAMHSA), the Social Security Administration, and the National

Comorbidity Survey – Replication (NCS-R), the National Institute of Mental Health (NIMH)

estimates an excess of $300 billion of total annual expenses are related to serious mental illness

which affects about 6% of the adult population. Furthermore, the approximate total amount spent

on all items associated with mental illness is rooted from the direct expenditures (e.g., treatment,

mental health services), as well as indirect expenditures consisting of losses resulting from

disability related to the mental condition (e.g., lost earnings, disability support) (NIMH, 2016a).

Lost earnings alone for serious mental illness costs the U.S. about $193.2 billion per year (Insel,

2008). The objectives of this systematic literature review are to analyze a collection of numerous

studies published in the past 11 years, identifying barriers hindering Asian populations in the

U.S. and Canada from receiving mental health care services and to highlight the trending barriers

found among individual Asian subgroups.


The systematic literature review was conducted by a single author; therefore, the

assumption is that the validity of the results may be affected as there is a risk of bias during the

assessment of studies. It is further assumed that production of generalize results can be found as

majority of the research studies involved quantitative methodology involving large populations.

Lastly, the review can be replicated as it follows a step-by-step systematic process of collecting,

examining, and synthesizing data from research studies.


The review consisted exclusively of peer-reviewed articles published within an 11-year

timeframe. Credible online resources and books were not included as they posed potential

complications with coding and issues with data analysis. Due to these limitations, the review

may have not examined all pertinent articles. Although, there is certainty that the results may not

have differed significantly if there were more articles included. The majority of the studies were

conducted in the U.S. and a few from Canada. The review itself uncovered commonalities in

barriers to mental health services (e.g., stigma, strong cultural adherence among older

immigrants) between both Asian Americans and Asian Canadians which contributed more

knowledge of the Asian subgroups found in developed countries. Unfortunately, it does not

reflect all barriers found in populations located in other developed nations within North America.

In addition, bias may have occurred during the article selection process (e.g., setting of inclusion

and exclusion criteria) and the reviewing stages (e.g., coding) due to the examination being

conducted by one author.


There is scarce research examining the unique barriers to mental health services among

the individual Asian subgroups. It creates a challenge for public health professionals to develop

effective interventions for these people who have been identified as one of the populations

experiencing a high incidence of mental health issues in North America. The intention of the

systematic literature review is to provide a comprehensive synthesis of distinct barriers found in

each Asian subgroup and identify influences contributing the greatest challenge to seeking help

for their mental illnesses.

Chapter 2 consists of a literature review of past research providing its history and current

state, which will provide support to the given public health issue. Chapter 3 includes the

methodology of the systematic literature review consisting of the description of the participants,

as well as the inclusion and exclusion of studies selected. Chapter 4 discusses the data collection

procedures, analysis, and results. Lastly, the project closes with Chapter 5, which provides

further discussion, conclusions, as well as recommendations for future studies.


Abe-Kim, J., Takeuchi, D., Hong, S., Zane, N., Sue, S., Spence, S. S., . . . Alegria, M. (2007).

Use of mental health-related services among immigrant and US-born Asian Americans:

Results from the National Latino and Asian American Study. American Journal of Public

Health, 91(1), 91-8.

Akutsu, P. D., & Chu, J. P. (2006). Clinical problems that initiate professional help-seeking

behaviors from Asian Americans. Professional Psychology: Research and Practice,

37(4), 407-415.

Asian Pacific Foundation of Canada. (2016). Proportion of total population of major Asian

ethnic groups by selected metropolitan areas. Retrieved from


Bauer, A. M., Chen, C. N., & Alegria, M. (2010). English language proficiency and mental

health service use among Latino and Asian Americans with mental disorders. Medical

Care, 48(12), 1097-1104.

Betancourt, J. R., Green, A., Carrillo, E., & Park, E. R. (2005) Cultural competence and health

care disparities: key perspective and trends. Health Affairs, 24(2). 499-505.


Canadian Mental Health Association. (2016). Fast facts about mental illness. Retrieved from

Chelala, D. (2013, June 14). Untreated mental health issues: A global reality. Movement for

Global Mental Health. Retrieved from


Farah, I., Khanlou, N., & Tamim, H. (2014). South Asian population in Canada: Migration and

mental health. BMC Psychiatry, 14, 154.

Gadalla, T. (2010). Ethnicity and seeking treatment for depression: A Canadian society. Journal

of Health Social Behavior, 44(3), 233-245.

Health Policy Institute. (2004). Cultural competence in health care: is it important for people

with chronic conditions? Retrieved from


Hoeffel, E., Rastogi, S., Kim, M., & Shahid, H. (2014). The Asian population: 2010. U.S. Census

Bureau. Retrieved from

Insel, T. R. (2008). Assessing the economic costs of serious mental illness. American Journal of

Psychiatry, 165(6), 663-665. Retrieved from


Kim, W., & Keefe, R. (2010). Barriers to healthcare among Asian Americans. Social Work in

Public Health, 25, 286-295.

Lai, D.W., & Surood, S. (2013). Effect of service barriers on health status of aging South Asian

immigrants in Calgary, Canada. Health and Social Work, 38(1), 41-50.

Lee, S., & Matejkowski, J. (2012). Mental health services utilization among non-citizens in the

United States: Findings from the national Latino and Asian American study.

Administration and Policy in Mental Health and Mental Health Services, 39(5), 406-418.

Leong, F. (2011). Cross-cultural barriers to mental health services in the United States. The Dana

Foundation. Retrieved from

Leong, T. L., & Kalibatseva, Z. (2011, March 23). Cross-cultural barriers to mental health

services in the United States. The Dana Foundation. Retrieved from

Mental Health America. (2016). Asian American/Pacific Islander communities and mental

health. Retrieved from


National Alliance on Mental Illness. (2011). Asian American teenage girls have highest rates of

depression. NAMI Releases Report. Retrieved from


Nguyen, D., & Bornheimer, L. (2014). Mental health service use types among Asian Americans

with a psychiatric disorder: Consideration of culture and need. Journal of Behavioral

Health Services and Research, 41(4), 520-528.

Shannon, P., Vinson, G.A., Cook, T. L., & Lennon, E. (2015). Characteristics of successful and

unsuccessful mental health referrals of refugees. Administration and Policy in Mental

Health and Mental Health Services Research, 43(4), 555-568.

Snowden, L., & Yamada, A. (2005). Cultural differences in access to care. Annual Review of

Clinical Psychology, 1, 143-66.

World Health Organization. (2001, October 4) Mental disorders affect one in four people.

Retrieved from


The Capstone Project

Signature Page


Table of Contents


Literature Review











Chapter Structure

Chapters are easier to read if they have a logical

internal sequence, for example


What is the problem?

What is to be done?

Literature Review

What is already known about the problem?


How did your project address the problem?


What did your project find?


What do the results mean?

Each section should lead logically to the next.


This section should

• Summarize what is established

• Discuss the significance of this work and identify the consequences of this work in the context of the capstone project

• Raise issues that follow from this, that remain to be addressed (leading to the conclusion, without actually stating it, that there is a need to extend the research further in a particular area).

• Provide a compelling justification for the work presented.


Identify the Health Issue

Illness, Death, Disability, Disorder

Example: Coronary Heart Disease in the United States

Justify its importance

Leading Cause of death, prevalence, incidence, trends, cost for both genders and most ethnic groups

Example: CHD is leading cause of death in the United States

Specific Aspect of Health Issue you will address

Reduce cholesterol levels, prevent falls in hospital

Example: Reducing cholesterol levels will lead to reduction in CHD deaths

Limit to 2-4 pages



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