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In this paper, we delineate how staff of two complex care management (CCM) programs in urban safety net hospitals in the United States understand trauma. We seek to (1) describe how staff in CCM programs talk about trauma in their patients' lives; (2) discuss how trauma concepts allow staff to understand patients’ symptoms, health-related behaviors, and responses to care as results of structural conditions; and (3) delineate the mismatch between long-term needs of patients with histories of trauma and the short-term interventions that CCM programs provide. Observation and interview data gathered between February 2015 and August 2016 indicate that CCM providers define trauma expansively to include individual experiences of violence such as childhood abuse and neglect or recent assault, traumatization in the course of accessing health care and structural violence. Though CCM staff implement elements of trauma-informed care, the short-term design of CCM programs puts pressure on the staff to titrate their efforts, moving patients towards graduation or discharge. Trauma concepts enable clinicians to name structural violence in clinically legitimate language. As such, trauma-informed care and structural competency approaches can complement each other. [ABSTRACT FROM AUTHOR]

Privacy amid rapid digitalization of medical records is a critical ingredient to the success of electronic-based health service. This paper explores the potential roles of privacy attitudes concerning medical data, based on a large set of a national sample data (n = 2638) from the U.S. Health Information National Trend Survey. We examine the ways in which privacy concern and confidence are (a) mediated through one's interest in sharing information with health professionals and (b) moderated by one's medical condition and the reliance on Internet. Evidence from this study provides insights into the factors shaping health-related engagement in information technologies, helping us argue that privacy is a key predictor. Discussion offers interpretations of how people's perceived need of medical data will mediate privacy concern, contextualizing the affordances of health technologies in future algorithmic applications. • Tenuous behavioral effects of both privacy concern and confidence were found. • Effects of concern and confidence are mediated through interest in sharing data. • Engagement with technologies is also illustration of social contexts in sharing. [ABSTRACT FROM AUTHOR]