Community Empowerment for Marginalized Practitioners: Designing for Home Care Workers in New York City

Abstract

Home care workers (HCWs) are practitioners that deliver essential health services to patients in their own homes yet face a multitude of challenges: HCWs are physically distributed, vulnerable to exploitation, and work long hours with minimal opportunity for advancement. They are underappreciated and underrecognized for their expertise and role in care delivery. While peers can encourage professionalization and challenge exploitation, HCWs' isolation makes it difficult to access peers and other support. Computer-mediated communications (CMC) may be one way to reduce this isolation. This dissertation explores how HCWs used CMC tools to contact peers, and we describe the types of informational, emotional, and political support they shared. We draw from this exploration and past praxes in social justice to co-design and evaluate a peer-led online support program to connect HCWs to create peer support and collective empowerment. This program used a narrative and non-directive approach that encouraged participants to tell stories of their work and created a sense of voice. This approach aimed to realize a community-empowerment pedagogy to creating transformative social change by helping HCWs define collective purpose, values, and identity beyond supporting a diverse range of informational and emotional needs. We describe how HCW facilitators encouraged reflection on experiences and focused on the social aspects of home care work. This dissertation suggests how the design of technology interventions can create social change by fostering practitioner communities among HCWs and other distributed and marginalized practitioners in various contexts.