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Forest management workers, H-2B guest workers, Undocumented workers, Legal status, Labor conditions, Latinos, Southeast, Pacific Northwest, Alabama, Oregon,

Purpose: To provide a prototypical patient narrative of the cardiac rehabilitation (CR) experience for providers and prospective patients using narrative analysis. Methods: Qualitative interviews with 17 CR patients from a previous study regarding their experiences, reasons, and motivations related to engagement in CR were analyzed using narrative inquiry. Interviews were previously analyzed and coded for recurring themes, and these themes were implemented in an exploratory narrative inquiry to craft a CR patient “story.” A hypothetical composite character representing the varied experiences of CR patients interviewed was developed, and a patient story was constructed that reflected on an initial cardiac event, time during rehabilitation, difficult experiences, social interactions, and personal values and accomplishments. Results: The CR patient narrative is presented for use in CR recruitment and programming materials, and in provider education. Conclusion: The narrative analysis comprehensively provides patients with an amalgam of patient experiences and can be used by providers to gain an understanding of CR patient experiences. Further research is needed to determine whether use of the resulting narrative analysis within the referral process and/or programming could increase participation and engagement.

Co-management has been promoted as a solution to expanding rural water access. In Central America, community water associations provide water service to 25% of the population, but poor water quality continues to leave many residents at risk of waterborne illness. In Costa Rica, dominant prescriptions for addressing these shortcomings include improvements to the institutional framework and policy reform. In this article, we evaluate the role of institutional arrangements, community involvement, and human capital in ASADA (Administrative Associations for Aqueducts and Sewers, by Spanish acronym) performance. We argue that while national community water management programs can be effective in expanding rural water access, there are limits to the indiscriminate implementation of co-management to address rural= urban water disparity. More specifically, we find that community-level factors impact ASADA performance, and thus need to be considered in policy decisions about whether co-management itself is necessarily the most appropriate approach.

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