skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Explore Research Products in the PAR
It may take a few hours for recently added research products to appear in PAR search results.


  • NSF Public Access
  • Search Results
  • Forging compromiso after the storm: activism as ethics of care among health care workers in Puerto Rico, Critical Public Health
Title: Forging compromiso after the storm: activism as ethics of care among health care workers in Puerto Rico, Critical Public Health
Puerto Rico was hit by a category 4 hurricane that severely damaged power, water, and communications systems on the 20th of September 2017. Based on 56 qualitative interviews, this article documents how health care workers created a new ethics of care after Hurricane Maria and engaged in novel forms of health activism to both repair past damage and imagine a different future. Many doctors, nurses, and other health care professionals went to work after the storm treating patients, fixing their workplaces, and resolving logistical problems. Health care workers responded emotionally to the event by finding meaning and purpose in their work, forging a sense of solidarity, and valuing their ability to help others. Our respondents used the term compromiso to describe their determination and sense of purpose, and we borrow this term to label the specific ethics of care generated from their experiences after Maria.  more » « less
Award ID(s):
2049568 2049565
PAR ID:
10315269
Author(s) / Creator(s):
;
Date Published:
Journal Name:
Critical public health
Volume:
31
Issue:
2
ISSN:
0958-1596
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. ; ; (, Medical Decision Making)
    BackgroundHealth care interactions may require patients to share with a physician information they believe but is incorrect. While a key piece of physicians’ work is educating their patients, people’s concerns of being seen as uninformed or incompetent by physicians may lead them to think that sharing incorrect health beliefs comes with a penalty. We tested people’s perceptions of patients who share incorrect information and how these perceptions vary by the reasonableness of the belief and its centrality to the patient’s disease. DesignWe recruited 399 United States Prolific.co workers (357 retained after exclusions), 200 Prolific.co workers who reported having diabetes (139 after exclusions), and 244 primary care physicians (207 after exclusions). Participants read vignettes describing patients with type 2 diabetes sharing health beliefs that were central or peripheral to the management of diabetes. Beliefs included true and incorrect statements that were reasonable or unreasonable to believe. Participants rated how a doctor would perceive the patient, the patient’s ability to manage their disease, and the patient’s trust in doctors. ResultsParticipants rated patients who shared more unreasonable beliefs more negatively. There was an extra penalty for incorrect statements central to the patient’s diabetes management (sample 1). These results replicated for participants with type 2 diabetes (sample 2) and physician participants (sample 3). ConclusionsParticipants believed that patients who share incorrect information with their physicians will be penalized for their honesty. Physicians need to be educated on patients’ concerns so they can help patients disclose what may be most important for education. HighlightsUnderstanding how people think they will be perceived in a health care setting can help us understand what they may be wary to share with their physicians. People think that patients who share incorrect beliefs will be viewed negatively. Helping patients share incorrect beliefs can improve care. 
    more » « less
  2. ; ; (, Academic Medicine)
    Problem: Given the United States’ urgency for systemic-level improvements to care, advancing systems-based practice (SBP) competency among future physicians is crucial. However, SBP education is inadequate, lacks a unifying framework and faculty confidence in its teaching, and is taught late in the medical education journey. Approach: The Oklahoma State University Center for Health Systems Innovation (CHSI) created an SBP program relying on Lean Health Care for a framework and targeted medical students before their second year began. Lean curricula were developed (lecture and simulation) and a partnership with a hospital was secured for work-based practice. The CHSI developed a skills assessment tool for preliminary evaluation of the program. In June 2022, 9 undergraduate medical students responded to a Lean Health Care Internship (LHCI) presentation. Outcomes: Student SBP skills increased after training and again after work-based practice. All 9 students reported that their conceptualization of problems in health care changed “extraordinarily,” and they were “extraordinarily” confident in their ability to approach another health care problem by applying the Lean method. The LHCI fostered an awareness of physicians as interdependent systems citizens, a key goal of SBP competency. After the internship concluded, the Lean team recommendations generated a resident-led quality assurance performance improvement initiative for bed throughput. Next Steps: The LHCI was effective in engaging students and building SBP skills among undergraduate medical education students. The levels of student enthusiasm and skill acquisition exceeded the Lean trainers’ expectations. The researchers will continue to measure LHCI’s effect on students’ rotation experiences to better evaluate the long-term benefit of introducing SBP concepts earlier in medical education. The program’s success has spurred enthusiasm for continued collaboration with hospital and residency programs. Program administrators are exploring how to broaden access. 
    more » « less
  3. ; ; (, Journalism Practice)
    Hurricane Maria (2017) was the most devastating hurricane in Puerto Rico in the last 90 years. The entire communication system collapsed, including cellular. Media organizations in Puerto Rico, with the exception of one radio station, were unable to transmit much-needed information during and immediately after Maria made landfall. This study examines changes in journalistic practices, organizational readiness and disaster coverage plans, and infrastructure preparedness almost 18 months after the event. This study extends the limited research examining long-term changes to news media preparedness plans in the context of disasters and expands theoretical understandings of media practices in the context of the hierarchy of influences model. The results suggest that infrastructure damage severely hampered the ability of news organizations to perform their work, but solidarity among media was useful in the immediate aftermath of the disaster. Each media played a differentiated and important role after the disaster based on their resources and organizational structure. The study shows that preparedness plans were inadequate and that changes are slowly been implemented to deal with challenges related to infrastructure, electricity, and technology, but with limited focus on the long-term well-being of media workers. Recommendations to improve responses to future natural disasters are presented. 
    more » « less
  4. ; ; ; ; ; (, JMIR Formative Research)
    Digital health–enabled community-centered care (D-CCC) represents a pioneering vision for the future of community-centered care. D-CCC aims to support and amplify the digital footprint of community health workers through a novel artificial intelligence–enabled closed-loop digital health platform designed for, and with, community health workers. By focusing digitalization at the level of the community health worker, D-CCC enables more timely, supported, and individualized community health worker–delivered interventions. D-CCC has the potential to move community-centered care into an expanded, digitally interconnected, and collaborative community-centered health and social care ecosystem of the future, grounded within a robust and digitally empowered community health workforce. 
    more » « less
  5. ; ; ; ; ; (, Proceedings of the ACM on Human-Computer Interaction)
    Care workers are increasingly using digital technology in their daily lives, for monitoring, financial compensation, training, coordination, and more. State and corporate actors have invested significant resources to enable this digital shift, particularly during the COVID-19 pandemic. However, care work has remained chronically underpaid, and continues to rely on women from minoritized and marginalized backgrounds. Our paper examines how care workers carefully navigate digitization, precarity, and complex social relationships, in an attempt to care for their communities and each other. We analyze the emerging digital ecosystem for frontline health workers in India during the COVID-19 pandemic where these dynamics have been highly visible. Our research draws attention to four interconnected ways in which workers practiced care, by directing their efforts towards survival, resilience, advocacy, and/or resistance. We suggest these also as care orientations that can be adopted by researchers and practitioners, to critically reflect on and direct technology design towards enabling more caring futures, for (and with) workers and communities. 
    more » « less
  • Citation Formats
  • MLA
  • APA
  • Chicago
  • BibTeX
  • Save / Share this Record
  • Send to Email