Michelle Chang

All Publications

• Room to Listen. Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry Chang, M. 2025

  View details for DOI 10.1007/s40596-025-02236-1

  View details for PubMedID 40921911

• Perceptions of providers and unhoused patients on access to eye care in Santa Clara County: A qualitative study. Optometry and vision science : official publication of the American Academy of Optometry Liu, J. M., Chang, M., Liu, F. M., Patel, B., Chang, D. S. 2025

  Abstract

  Perspectives on eye care barriers differ between low-income patients and vision care providers. Comparing these views provides valuable insight into strategies for addressing disparities in underserved communities, especially in regions with significant income inequality and opportunity gaps.The aim is to identify obstacles that prevent individuals who are unhoused, have low income, or are publicly insured in Santa Clara County from accessing basic refractive eye exams and corrective glasses.Patients aged ≥18 years with low income presenting to a free vision care clinic in Northern California (n = 15) and vision care providers who primarily work with underserved patients in Santa Clara County, California (n = 11) participated in one-on-one phone interviews. Interviews were transcribed and analyzed.Most participants (87% patients and 82% providers) say that basic vision care (refractive eye exam and eyeglasses) in Santa Clara County is unaffordable and that in-person eye exams can be physically inaccessible (67% patients and 91% providers) due to busy work schedules or limited access to transportation. However, patient and provider perspectives on intrinsic barriers to accessing eye care diverge. In total, 73% of providers stated that limited health literacy contributed to lower utilization of routine vision care, while 47% of patients cited limited empathy from providers as responsible for their negative experiences and dissatisfaction with care.In Santa Clara County, patients with low income and their providers both identify similar external barriers to basic vision care: high costs, inadequate insurance coverage, and limited services. However, patients and providers may disagree on intrinsic barriers to accessing care. Suggestions for improving access to vision care include more help from healthcare coordinators, better information about affordable services, improved vision insurance, and mobile healthcare options.

  View details for DOI 10.1097/OPX.0000000000002250

  View details for PubMedID 40261685

• Risk of Subsequent Melanoma in Patients with Primary Cutaneous or Ocular Melanoma in the United States between 2000-2020: A Surveillance, Epidemiology, and End Results (SEER) Analysis Chang, M., Cai, Z. R., Mruthyunjaya, P., Swetter, S. M., John, E. M., Linos, E. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2024

  View details for Web of Science ID 001312227706200

• Ophthalmology Career Choices Among Medical Students, House Officers, and Medical Officers in Northern Ghana Journal of Academic Ophthalmology Tiertoore*, N. W., Chang*, M., Bellua, N. S., Bernard, A., Abem, V. K., Tabin, G., Bonsaana, G. B. 2024; 16 (2): 245-252

  View details for DOI 10.62199/2475-4757.1028

• Perceptions of US-Based Muslim Patients of Their Dermatology Care. JAMA dermatology El-Banna, G., Rezaei, S. J., Chang, M., Merrell, S. B., Bailey, E. E., Kibbi, N. 2023

  Abstract

  Cultural humility training is of growing interest, yet the religious and cultural accommodations of Muslim patients in dermatology have not been studied.To explore the perceptions of Muslim patients of their dermatology care.This qualitative mixed-methods study, consisting of surveys and semistructured interviews, recruited participants from 2 clinical sites within a large academic health care system in California. Participants were adult, English-speaking, Muslim patients who were evaluated at least once by a medical or surgical dermatologist between January 2022 and January 2023.A survey obtained the following data: demographics, religious practices pertinent to dermatology care, and experiences of bias outside and inside the dermatology clinic. Semistructured interviews covered topics related to positive and negative experiences in the dermatology clinic, accommodation of cultural and religious needs in dermatology, and future interventions.A total of 21 patients (mean [SD] age, 36.4 [11.6] years; range, 26-71 years) participated in the study: 5 male individuals (24%) and 16 female individuals (76%), including 10 female individuals who wore hijab. Eleven participants identified as Middle Eastern (52%), 8 as South Asian (38%), 1 as North African (5%), and 1 as Pacific Islander (5%). Survey results showed variations in the impact of Islamic practices on dermatology care. Interviews showed that Muslim participants did not perceive dermatology care as a priority and expressed interest in community events focused on general dermatology education. They also experienced stigmatization of their skin disease and cosmetic care. Prior experiences with Islamophobia and colorism hindered the Muslim patient-dermatologist relationship and disclosure of the need for accommodations. There were instances when participants experienced bias and poor cultural humility from dermatologists. Finally, Muslim participants had unique religious and cultural needs pertinent to their care, including clinician gender concordance, medication timing adjustment while fasting, and halal medication ingredients.This qualitative mixed-methods study explored the experiences of Muslim patients in dermatology in the US. Recommendations supported by this study include incorporating religion into cultural humility training, increasing diversity in the dermatology workforce, implementing policies for clearer medication labeling, supporting dermatology research in subpopulations of Muslim individuals in the US, and partnering with community organizations for dermatology education.

  View details for DOI 10.1001/jamadermatol.2023.4439

  View details for PubMedID 37966806

  View details for PubMedCentralID PMC10652213