Abstract
In this study, I uncovered the dynamics involved in the exchange (or lack) of social support among a group of Puerto Ricans who experienced a natural disaster. I coded and analyzed 12 semistructured qualitative interviews. My analysis of the interviews revealed that a reported high degree of need was not associated with any type of help seeking from the respondents' social support networks. Relevant issues that arose in explaining the lack of social support exchanges were level of comfort in help seeking and cultural issues. My findings point to the importance of culture in shaping patterns of help-seeking behavior in the aftermath of a disaster. Two of the most salient cultural explanations as to why disaster victims were reluctant to ask for help from family and friends were the issues of confianza (trust) and pena (embarrassment). I discuss the results with reference to how they might help in planning and establishing programs to maximize help seeking among Latinos/as in an emergency situation.
Keywords: culture / cultural competence, health seeking, Latino/Hispanic people, social support
On the surface it seems like a truism that Hispanics benefit from a vast array of social networks, particularly social support ties. However, the belief that Hispanics have larger and more readily accessible access to social support networks has been investigated in the research literature without revealing any conclusive patterns. Although scholars analyzing ethnic/racial comparisons in social support and help seeking have found evidence that Latinos might be at an advantage (Ford, Adams, & Dailey, 2006; Mindel, 1980), there is increasing evidence that suggests this might not always be the case (Boscarino et al., 2004; Stanton-Salazar, Chavez, & Tai, 2001). Thus, it is important to reconsider social support and help seeking among Latinos/as, particularly during a traumatic event such as a natural disaster.
Scholars who have investigated social support among Latinos/as in disaster situations have found a negative relation between social support and adverse health outcomes (Galea et al., 2004; Solomon, Bravo, Rubio-Stipec, & Canino, 1993). However, in the immediate traumatic context, some scholars comparing Latinos/as to other racial/ethnic groups have found that Latinos/as seek help more often (Ford et al., 2006), whereas others concluded otherwise (Boscarino et al., 2004). For instance, during Hurricane Andrew, Latinos/as experienced a sharp decline in their levels of received support during and shortly after the hurricane made landfall (Kaniasty & Norris, 2000). These results indicate inconsistency in the assumed cultural script that Latinos/as have and use social support networks more than other groups. In addition, less is known about the processes that hinder Latinos/as from utilizing their social support networks, particularly in situations of need such as a traumatic event. The purpose of my study was to uncover some of the dynamics in the exchange (or lack) of social support among a group of Puerto Ricans who experienced a natural disaster (mainly hurricanes) in Central Florida. I utilized semistructured qualitative interviews to analyze these dynamics.
Literature Review
For the purpose of this article, I reviewed those studies that analyzed social support/help-seeking mechanisms of Latinos/as in disaster situations. Social support is defined as “those social interactions that provide individuals with actual assistance or embed them into a web of social relationships perceived to be loving, caring, and readily available in times of need” (Kaniasty & Norris, 2001, p. 201; see also Hobfoll, 1989). Furthermore, I conceptualize help seeking as those efforts in utilizing that web of social relationships described above. Finally, disasters are defined as events that simultaneously affect large groups of individuals in their own habitats and familiar surroundings (see Kaniasty & Norris, 2001, and McFarlane & Norris, 2006, for discussion). They are natural and human-induced catastrophes, including acts of terror.
In the past, researchers documented an inverse association between social support and a variety of outcomes that include mental health, physical health, education, and substance abuse (see Turner & Turner, 1999, for a review). The relationship between social support and well-being among Latinos/as has been also well established (Mulvaney-Day, Alegría, & Sribney, 2007; Rivera, 2007; Vega & Rumbaut, 1991). The literature seems to suggest that this relation might be attributed to certain Latino cultural traits such as familismo (familism) and simpatía (sympathy), in which high social support is an expectation. These cultural scripts encompass a collectivistic view of the world in which the interests of the family group are more important than any individual interests. Furthermore, these cultural expectations mandate politeness and respect, avoidance of conflict, cooperation, and mutual helping (Marín & Marín, 1991; Triandis, 1994; Triandis, Marín, Lisansky, & Betancourt, 1984). Indeed, researchers have found that those with high adherence to familismo were less likely to seek help in comparison to those with low adherence to familismo norms (Zack Ishikawa, Cardemil, & Falmagne, 2010). Results from other studies analyzing social support and trauma in disaster situations, which also included Latino survivors, suggest that low social support seems to be related to higher posttraumatic stress disorder (PTSD) symptoms (Fontana & Rosenheck, 2005; Galea et al., 2004). Yet, some research results suggest that Latinos received lower levels of support than other ethnic groups (Dunkel-Schetter, Sagrestano, Feldman, & Killingsworth, 1996; Golding & Baezconde-Garbanati, 1990; Norbeck & Anderson, 1989; Vega, Kolody, & Miranda, 1985). Thus, there is no definitive evidence to suggest that in all circumstances Latinos have and utilize social support networks more than other ethnic/racial groups.
Outside of the cultural scripts of familismo and simpatía, other scholars have suggested different theories to explain help seeking/social support of Latinos in disaster situations. One is the rule of relative need, which implies that those in need of more support will be provided more (Hobfoll & Lerman, 1989; Kaniasty & Norris, 1995). Alternatively, it might be the rule of relative advantage (Kaniasty & Norris, 1995), which details that certain segments of the population are likely to receive more support than other segments, regardless of need (Ibañez et al., 2003). Disaster victims have often mentioned that formal sources of support were either late in arriving or insufficient; in some instances victims went so far as to falsify documents and assume identities of other community residents to get more aid (Ibañez et al.). Alternatively, other scholars have utilized the conservation of resources (COR) stress theory (Hobfoll, 1989, 1998), which suggests that people build and retain resources to enhance the self and maximize positive reinforcement. The theory predicts that psychological stress occurs when there is a threat of resource loss, loss of resources, or lack of resource gain following investment of resources (Hobfoll, 1989).
A project guided by the COR examined preparation efforts for a disaster, alongside psychological functioning following Hurricane George in the U.S. Virgin Islands, Puerto Rico, Dominican Republic, and the United States (Sattler et al., 2002). More than half of the participant victims in Puerto Rico and the Dominican Republic reported major property damage in comparison to victims in the U.S. Virgin Islands and the United States (Sattler et al.), which resulted in one quarter of Puerto Ricans and Dominicans experiencing several symptoms associated with antisocial disorders. In all locations where this study took place, more than half of the participants believed that the storm was because of God's will, and were angry at people who were breaking the laws to get aid and supplies. More than half of Puerto Rican, Dominican, and American participants believed that both the community and government officials had been cooperative. Results indicated that low social support was associated with psychological distress.
Additionally, disasters can significantly disrupt social support networks, and these networks might continue to deteriorate if conditions and services are not restored promptly (Kaniasty & Norris, 1995). In a study of the Mexican victims of Hurricane Andrew (Ibañez et al., 2003), informal support was found to be as common as or more common than formal support, especially within Miami informants. Findings suggest that even though more formal support might be available, Mexican Americans might feel more comfortable using informal sources of support. The study authors asserted that sources of support need to be accessible and available, but there is no guarantee they will be received. Latino immigrant populations are thought to underutilize social programs and services for various reasons, including a language barrier or lack of knowledge of the system. For example, in a study analyzing PTSD after the September 11, 2001 terrorist attacks, the authors found that Hispanics of Dominican or Puerto Rican origin were more likely than other Hispanics and non-Hispanics to report symptoms consistent with probable PTSD. Dominicans and Puerto Ricans were more likely than persons of other races/ethnicities to have lower incomes, be younger, have lower support, have had greater exposure to the September 11 attacks, and to have experienced a perievent panic attack on hearing of the September 11 attacks. Furthermore, a higher percentage of Dominicans and Puerto Ricans had major depression, relative to Whites. Greater percentages of Dominicans and Puerto Ricans were classified as psychologically unhealthy, compared to Whites, whereas African Americans and other Hispanics had slightly lower percentages (Adams & Boscarino, 2005). In the end, racial and ethnic minorities did not have a greater likelihood of PTSD when compared to Whites; however, it was found that racial and ethnic minorities were more likely to report negative life events and lower levels of social support than Whites.
Recent studies documenting the Latino experience in the Katrina disaster suggest that Latinos living in the area affected by Katrina did not anticipate the potential strength of the storm and were not prepared for its impact (Messias & Lacy, 2007). Once again, participants referred to their families, friends, and coworkers as their primary sources of information about the hurricane. In addition, uninsured and/or undocumented Latinos/as experienced additional social and economic costs when accessing health care. These findings elucidate the extent of the silent suffering and informal solidarity experienced by Latinos/as, who were often at the margins of the broader, more public disaster (Messias & Lacy).
Given the available literature, it is not unreasonable to suggest that Latinos/as generally might lack a strong social support system, or if they have such a system, refuse to use it because it might not be perceived as helpful, efficient, or as visible as the dominant cultural scripts suggest. This might be the result of many factors, primarily culture as a main determinant. Culture is reflected in language, living situations, customary behavior, and so forth. Furthermore, in regard to custom behavior, many Latinos/as tend to overlook other forms of support because of overreliance on the family, or just to avoid seeking help altogether for fear of being a burden.
Data and Methods
Participants
Puerto Ricans make up 8.6% of Latinos/as in the United States (Ramirez & Patricia de la Cruz, 2002), and are one of the largest Latino groups in the Central Florida region (Falcón, 2004). For many, prior experience living in Puerto Rico has put them, or someone they know, at risk for natural disasters, especially hurricanes. Participants in this study included Puerto Rican adults aged 18 years and over who were living in Central Florida and had experienced a natural disaster. Participants were recruited by distributing flyers about the study, in both English and Spanish, to different agencies with a substantial Puerto Rican clientele (i.e., Department of Health, business groups, and so forth). In addition, information about the study was put in a local Central Florida Hispanic newspaper. Potential participants who met the criteria to take part in the study were asked to call me to schedule a face-to-face interview. Recruitment continued until I was satisfied that all the components of the interview script had been discovered and that saturation had been reached (Denzin, 1989; Strauss & Corbin, 1998), yielding a sample of 12 participants.
Procedure
Semistructured, in-depth interviews were conducted over a 6-month period from September 2007 to March 2008. Interviews were conducted by the author, an experienced doctoral level sociologist, who is also a native-born Puerto Rican, and a bilingual research assistant from Costa Rica familiar with the customs and idioms of the Puerto Rican culture. An interview guide was designed to explore themes from the Latino social support literature as they related to the study objectives. Specifically, the interview script included the following themes: hurricane experience, help-seeking comfort, help received, help provided, social bitterness, and general social support. A short demographic survey that included information about the participants' race, age, gender, years in the United States, marital status, language use, acculturation stress, and a measure of PTSD was given to participants before conducting a face-to-face in-depth interview.
Before data collection began, the university institutional review board approved the study. Interviews were conducted (in English and Spanish) at locations convenient to the participants (e.g., participants' homes, work-places, restaurants, and so forth), and lasted between 30 and 45 minutes. After consent to participate in the study was obtained, the interviews were recorded on a small digital recorder. Each of the participants received $20 for their participation. At the conclusion of the project, the interviews were transcribed verbatim by a professional transcribing service, resulting in approximately 130 pages of data.
Analysis
Each interview was digitally recorded and transcribed by a professional transcriber. NVivo 8 (QSR International, 2008), a computer software program, was used to organize and analyze the data. The analyses and coding were derived from a concept-driven perspective known as framework analysis (Gibbs, 2007; Ritchie & Lewis, 2003). In accordance with framework analysis, I built a list of thematic ideas drawn from the literature documenting social support among Latinos in disaster situations. Subsequently, a graduate student not involved in the interview process and I independently read the transcripts and assigned sentences to different thematic domains based on the interview script. At the conclusion of this process, a meeting took place to review the themes until consensus was reached.
Based on the interview script, the concept-driven themes, and my consensus, participant quotes were divided into the following themes: hurricane experience, help-seeking comfort, help received, help provided, social bitterness, and general social support. In addition to these themes, another theme (culture) was discovered during the coding of the data. For this analysis, I concentrate on the following themes: the hurricane experience, the context of need, usage of social support networks (e.g., help seeking and help-seeking comfort), and culture. I identify the research participants as respondents with no identifiable traits outside of gender. Because of space restrictions all narratives are reported in English.
Results
Participants
The sample consisted of 12 Puerto Rican adults: 9 women and 3 men. Interviews were conducted in both Spanish (8) and in English (4). The average age was 42 years (ranging from 31 to 50 years). Most of the respondents were born in Puerto Rico (9); the rest of the participants were born in Chicago (1) and New York City (2). All participants were employed full time. Seven were currently married, 4 were divorced, and 1 was never married. The mean for years of education was 16. Participants' residence in the continental United States ranged from 1 to 5 years (1), 6 to 10 years (1), 11 to 15 years (1), 16 to 20 years (4), and more than 20 years (5). Residence in Florida ranged from 1 to 5 years (2), 6 to 10 years (2), 11 to 15 years (3), 16 to 20 years (2), and more than 20 years (3).
Hurricane Experience
All of the participants related their experiences during the 2004 hurricanes Charley, Frances, and Jeanne, although 3 participants talked about their experiences with hurricanes Hortensia (1996) and Hugo (1989) while living on the island of Puerto Rico. Charley was the first hurricane to make landfall in the United States in August of 2004. Charley was a Category-4 storm when it hit Florida and caused an estimated $14 billion in damages. In early September, hurricane Frances impacted Florida as a Category-2 storm. The damages were estimated to be around $8 billion. Three weeks after Frances, hurricane Jeanne made landfall in Florida (following almost exactly the same entry point as Frances) as a Category-3 storm. It was responsible for $6 billion in damages and the death of 3,000 people in Haiti (National Climatic Data Center, 2004).
The personal hurricane experiences were varied. For half of the respondents, it was a traumatic event with lingering memories. For example, a woman participant described her experience as follows:
So we went inside and got the video camera, and standing outside, with ponchos like getting soaking wet, trying to video tape, and the only way I can describe it is, I don't know if you've ever seen the movie Predator. [pause] Okay, when he's like jumping in the trees and he's invisible and you can't see him, that's exactly how I felt. I got goose bumps, I felt so spooky out, like, “Oh no, let's go inside,” but yeah [pause] that was an experience for me.
Descriptions of other experiences touched on the inconvenience of not having electricity, going to hotels or shelters, and having to deal with hurricane preparedness with no support from family or friends.
Context of Need
I examined the context of need of participants after the hurricane experience. The social support literature suggests that the need for support tends to be high at the aftermath of disastrous events. One of the recurring need aspects was the lack of electricity; half of the sample discussed the difficulties of living without access to power sources: “But the effort of being without electricity, the heat, [pause] one had to shower like three or four times a day, since the heat was intolerable.” The majority of respondents (8) suffered some type of property damage. The damage varied in scope, from a broken fence to a smashed car. The respondents described their experiences of losing shingles on their roofs, and flooded rooms, fallen trees, and downed electricity lines. A respondent stated,
Yeah, I had a car that was up front, in between the two houses. It wasn't in my garage or his garage [referring to a neighbor]. And one of those trees fell down—a sycamore. I will never forget the name of that tree—and it broke my hood.
Help Seeking
As stated previously, it is usually in the context of need after a traumatic situation that social support exchanges occur. One of the main aspects of social support is the dynamics of whether people opt to use their support networks or not. The respondent narratives suggest a not-so-clear pattern of help-seeking dynamics. For instance, when asked directly if they asked for help from neighbors, family, or friends, 5 of the 8 respondents who shared their help-seeking experiences said no. According to one of the woman respondents, “We just tried to do what we can.” Another woman respondent explained, “The help I found, I found it myself [laughter], because I did not ask for help anywhere; that's all I did.” Other respondents commented that they did not ask for any specific help from family because it was not necessary to do so: “But in terms of economic help and the sort, it wasn't necessary.” Two respondents expressed that they did not ask for help because they did not have the need, although they had previously stated that they suffered damage to their property.
Help-Seeking Comfort
Responses about not asking for help varied, with some respondents showing some type of ambivalence in their narratives, in which they stated that they did not ask for help but felt that they could if they wanted to. Of the 11 respondents who shared their level of comfort in help seeking, 4 were comfortable with asking for help, and the rest were either ambivalent about it or clearly uncomfortable in asking for help. One of the recurring themes for those participants who did not ask for help was the issue of imposing on or bothering people. For example, when asked if help was sought from neighbors, a man respondent stated, “I could have, uh, but I didn't want to bother them, [or be] with them.” A woman respondent stated, “I didn't wanna inconvenience anybody, I guess, you know.”
Other themes that were manifested were the issues of confianza and pena. Confianza, which translates as trust, is a level of comfort or easiness in asking questions or engaging in a social situation. Furthermore, as stated by Kana'iaupuni, Donato, Thompson-Colón, and Stainback (2005, p. 1140),
[C]onfianza occurs before any exchange takes place and forms a building block for social cohesion. It is rooted in a mutual desire and disposition to initiate or maintain a relationship of reciprocal exchange, and it is often described as both an honor and an obligation. Kin or not, persons de confianza [of trust] are responsible for helping others in many different ways.
The importance of confianza is illustrated in the following exchange:
Interviewer (I): Were you comfortable asking neighbors for help?
Respondent (R): No, really, I don't know. Because I did not trust them enough, in reality I couldn't tell you. I mean, I asked for it from a particular, a stranger. I did not go to any person I knew to ask for a favor.
(I): And why not?
(R): I don't know [laughter]. Good question. I don't know, really. The way you were raised …. Trust, I don't know. Maybe, because I don't like to bother, I feel uncomfortable asking those types of things or letting people know.
Pena is a Puerto Rican cultural idiom that closely resembles confianza, but it also encompasses feelings of shame, remorse, and embarrassment. To feel pena is to feel embarrassed. Again, the idea derives as a type of respect for others and dignity for oneself. It is instilled in the Puerto Rican culture, passed down to its younger generations across the United States, as well. Pena emerged as a repetitive theme throughout the course of the interviews. This theme is illustrated by a woman respondent who, when asked why she did not seek help, replied,
One feels like a little embarrassed. Because I believe that in my situation, my folks taught me not to ask for help unless you really need it. Because one is respectful of another person's time and the resources of other persons; thus one does not abuse it. I believe my situation warranted that, and for that we took the initiative of doing it. I get a little pena when I ask for help. I tried not to do it unless it is really necessary.
Culture
There were some cultural themes that surfaced in the interviews. One of the cultural factors that arose was the difference between experiencing a hurricane in Puerto Rico vs. the mainland United States. For instance, discussing some of the differences in hurricane preparedness, a man said,
Puerto Ricans that come from the island, they say, “Oh well, you know, we went through a hurricane in Puerto Rico and it wasn't that bad.” Yeah, I lost the power, and we didn't have such a big impact, uh, from a residential perspective, and there's a lot of factors that varies, 'cause you know, because the building code here in Florida is different from the building code in Puerto Rico. You have, uh, una urbanización [residential area, subdivision] in Puerto Rico, concrete, port roof, and others. It ain't gonna suffer a whole lot of damage, but here, a little bit different story. So, the, the complacency, uh, preparedness of what they experienced in Puerto Rico, if they lived in urbanización area, when they come here, they think it's the same. And there's different hazards and different risks involved, when we look at those, you know, uh, here, because the construction, people take for granted the roof is gonna stay on, and may not be the point. So, so, there's a lot of disparity when it comes to preparedness, what is preparedness, and how safe is my home when it comes to, uh, hurricane events.
Another participant shared his insights about his hurricane experience and social support exchanges in Puerto Rico:
I remember that as a child in Puerto Rico, all of us went to our grandparents' house, and all the family was there, and it was almost like a party—not like here, a hurricane here is a bit more. Comparing my childhood experiences in Puerto Rico with the hurricane experience here, there was more fun than what happened here this time.
Some of the cultural differences were linked to a fundamentally different view of communal relationships and ties, affecting the usage of social support ties and help-seeking mechanisms—in particular the issues of how different things tend to work in the mainland United States. One woman elucidated,
After I left Puerto Rico and came here, and went directly to California, I first lived fourteen years in California. There the culture is very different. Then, I don't know if it was when I went to California that, I lost the sense of mutual help or asking for help or what happened. But when I got there, the culture of the Pacific, the South American, Central American, Mexican culture is different from the Atlantic culture, the Caribbean culture.
Another woman explained:
I think that since we moved here maybe we have a greater sense of independence. I don't know how to explain it. [pause] [It] is not that we haven't integrated with the community where we live, since we go to the Lutheran church, the same that a lot of people from where we live go to and all that, but is not the same.
Finally, there were some attributions to the different gradient of Puerto Ricans (in Puerto Rico) as a community and culture that might explain their reluctance to ask for help. For instance a woman respondent said, “I think that a Puerto Rican is a person that likes to get ahead by him-/herself, independent. We like to give more than we like to receive.” Another woman respondent added,
Usually, Puerto Rico is a community that tends to unite in tragic times, and the neighbors too. We gave each other mutual support, we helped. If someone needed water for daily use and someone had something to give or had something to share, they shared. Yes, the support was not only in my family, [it] was in all the community as well.
Discussion
I analyzed 12 qualitative interviews to assess the dynamics of the social support/help-seeking mechanisms of Puerto Ricans after a natural disaster. The narratives revealed a degree of need that did not necessarily lead to any type of help seeking from the respondents' social support networks. Relevant issues that arose in explaining the lack of social support exchanges were level of comfort with help-seeking and cultural issues. I discuss their meanings and implications below.
Of the several theoretical traditions utilized to study social support and help seeking among Latinos during disaster situations, Hobfoll's (1998) conservation of resources (COR) theory might be particularly appropriate to understand the resulting themes of the study. Briefly, the main tenet of the COR is that people want to obtain, retain, and protect those things that they value; stress results when those valuables are threatened. The COR also states that it is within culture and societies that those valuables gain and retain their meaning. This is particularly important, because the results indicated that the meaning and value attached to whether or not to ask for help were predominantly a result of the cultural context of the participants. In the context of this study, it was Puerto Rican culture.
For example, several narratives touched on the issues of confianza, or trust—the socialized idea that one is not supposed to impose on others unless it is absolutely necessary. In the context of the disaster situation, although there was need, the respondents seemed not to believe that their need was severe enough to tap into their social support networks. It seems, as stated in the first principle of the COR theory, that resource loss is disproportionately more salient than is resource gain (Hobfoll, 1998). There was a hesitation to utilize those valuable social support networks in a relatively stable level of need. This interpretation also gives support to the second principle of COR, which states that people must invest resources to protect against resource loss, recover from losses, and gain resources (Hobfoll, 1998). Thus, whereas in Puerto Rico the resources were relatively readily available, in the United States context the investment and effort to have strong social support seemed more difficult to obtain. Based on the context of need, it seems that respondents weighted their resources and decided not to utilize them, but to wait for a particular, more severe context to cash in their social support and help-seeking resources. Alternately, the United States cultural context changed or impaired the social support resources available to the respondents.
The findings of this study also point to the importance of culture in shaping patterns of help seeking in the aftermath of a disaster. Two of the most salient cultural explanations as to why disaster victims in this study were reluctant to ask for help from family and friends were the issues of confianza and pena. Confianza is a culturally determined rule for providing assistance that is considered of high significance and honor. The use of it implies some type of reciprocal action; thus, Puerto Ricans exercise caution in their exchanges, especially when they might lack the resources necessary to provide reciprocal assistance. It seems that this is a particularly strong cultural mandate, which might be in place as a cultural coping mechanism to be used only under the utmost need. The other cultural idiom is pena. Pena is more than embarrassment or shame; it is an idiom that encompasses a cultural belief in second chances and forgiveness. One expresses pena in a plethora of circumstances, for instance, giving an unfaithful partner a second chance, or feeling pity for others in an unexpected situation (e.g., death of a loved one). Pena is also intertwined with trust, especially in circumstances in which one might feel uneasy or out of place. Both pena and confianza act as safeguards for the mundane use of social support and help resources.
Conclusions
The results of this study are of significance in guiding researchers, health providers, emergency management personnel, and others in planning and establishing programs to maximize the help-seeking mechanisms of Latinos, especially Puerto Ricans, in a disaster situation. Furthermore, the identification of confianza and pena as impairments to seeking help has significant implications for health-seeking behaviors outside of the emergency realm, particularly because researchers have found that Latinos/as are less likely to seek formal sources of treatment for health and mental health problems (Zack Ishikawa et al., 2010). In the future, researchers can explore these themes and incorporate them in disaster health care practice plans. Whereas it might seem as a limitation that my analyses did not explore the ways by which Latinos/as seek help, I argue that that is precisely the point. Even in situations of need, Latinos/as are hesitant to ask for help or utilize their social support networks. It is important to highlight these findings, as it is reasonable to expect that failure to do so will result in Latinos/as continuing to suffer in silence during disaster and other emergency situations.
Acknowledgments
Valuable comments on earlier versions of this article were provided by Larry Palinkas, Krys Kaniasty, Shannon Carter, and Irene Lopez. I thank research assistants Monica Mendez and Cyndia Morales for their invaluable contributions to the study.
Funding The author disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Preparation of this article was supported by an in-house grant from the Office of Research and Commercialization of the University of Central Florida, and from a training grant from the Research Education in Disaster Mental Health Program at Dartmouth University and the National Institute of Mental Health (NIMH grant # 5 R25 MH 068298-02).
Biography
Bio Fernando I. Rivera, PhD, is an associate professor at the University of Central Florida, Department of Sociology, in Orlando, Florida, USA.
Footnotes
Declaration of Conflicting Interests The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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