Disasters, solar energy, and chronic disease management in aging Puerto Ricans

波多黎各老年人的灾害、太阳能和慢性病管理

• 批准号: 10367126
• 负责人: MARK B PADILLA
• 金额: $ 63.14万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-01 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10367126
• 关键词: Address; Adopted; Aging; Altruism; American; Area; Caribbean region; Case Study; Categories; Cessation of life; Characteristics; Chronic; Chronic Disease; Climate; Communities; Diabetes Mellitus; Disasters; Disease; Disease Management; Earthquakes; Electricity; Emotional; End stage renal failure; Energy-Generating Resources; Ethnography; Event; Face; Food; Fostering; Funding; Geography; Government Agencies; Happiness; Health; Healthcare Systems; Hispanic Populations; Homes for the Aged; Hurricane; Immersion; Individual; Interruption; Intervention; Interview; Island; Kidney Diseases; Knowledge; Local Government; Location; Modeling; Morbidity - disease rate; Movement; Natural Disasters; Not Hispanic or Latino; Outcome; Patients; Persons; Policies; Policy Developments; Policy Maker; Population; Positioning Attribute; Process; Pueblo Race; Puerto Rican; Puerto Rico; Recording of previous events; Recovery; Research; Respiratory Disease; Restaurants; Role; Rural; Sampling; Self Efficacy; Series; Solar Energy; Structure; Surveys; Technology; Therapeutic; Training; United States; United States National Institutes of Health; Ursidae Family; Vulnerable Populations; Work; aging population; base; commune; community engagement; community organizations; comorbidity; disadvantaged population; disaster resilience; experience; extreme weather; health disparity; health inequalities; improved; member; mortality; multilevel analysis; negative affect; population health; resilience; response; weather-related disaster; Address; Adopted; Aging; Altruism; American; Area; Caribbean region; Case Study; Categories; Cessation of life; Characteristics; Chronic; Chronic Disease; Climate; Communities; Diabetes Mellitus; Disasters; Disease; Disease Management; Earthquakes; Electricity; Emotional; End stage renal failure; Energy-Generating Resources; Ethnography; Event; Face; Food; Fostering; Funding; Geography; Government Agencies; Happiness; Health; Healthcare Systems; Hispanic Populations; Homes for the Aged; Hurricane; Immersion; Individual; Interruption; Intervention; Interview; Island; Kidney Diseases; Knowledge; Local Government; Location; Modeling; Morbidity - disease rate; Movement; Natural Disasters; Not Hispanic or Latino; Outcome; Patients; Persons; Policies; Policy Developments; Policy Maker; Population; Positioning Attribute; Process; Pueblo Race; Puerto Rican; Puerto Rico; Recording of previous events; Recovery; Research; Respiratory Disease; Restaurants; Role; Rural; Sampling; Self Efficacy; Series; Solar Energy; Structure; Surveys; Technology; Therapeutic; Training; United States; United States National Institutes of Health; Ursidae Family; Vulnerable Populations; Work; aging population; base; commune; community engagement; community organizations; comorbidity; disadvantaged population; disaster resilience; experience; extreme weather; health disparity; health inequalities; improved; member; mortality; multilevel analysis; negative affect; population health; resilience; response; weather-related disaster

Project Summary Puerto Rico (PR) faces frequent power outages due to damage caused by natural disasters to its electric grid. Aging Puerto Ricans (≥50 years) are a vulnerable population during natural disasters as they are more likely to have multiple chronic health conditions when compared to other non-Hispanic whites and other Hispanic groups in the US. Power outages can increase these disparities, and elevate morbidity and mortality due to co- morbid conditions. Research has demonstrated that energy independence has positive health impacts. Energy independence through direct access to solar power has begun to appear in PR through the work of the non- profit community organization Casa Pueblo (CP). We propose to explore, from a multilevel perspective, the factors that enable local government agencies, communities and individuals to adapt to energy independence in their settings, and their implications for chronic disease management via these aims: Aim 1 – Through our partnership with CP, explore the process experienced by communities and the aging population (≥50 years) living with chronic diseases while adapting to energy independence (e.g., introduction of the technology, training on its use, access to energized communal points) in order to better understand how communal characteristics (e.g., collective identity, perceived individualism) can hinder or foster CDM among those with renal disease, respiratory disease, and diabetes. Aim 2 – Systematically document from a multilevel perspective (i.e., individual, community and structural) the perceived barriers and facilitators for adopting energy independence strategies in PR. Aim 3 – Document resilience related variables at the individual level (e.g., self-efficacy, positive attitudes, knowledge, altruism), communal (e.g., emotional connection, group membership), and structural (i.e., power outages, geographical variables) levels that can foster effective CDM among aging populations in need of electricity-based treatments (i.e., renal disease, respiratory diseases, diabetes). To achieve Aim 1 and 2, we will conduct: (a) a detailed ethnographic observation/mapping of CP, involving 30 months of immersive and ongoing institutional exchange and (b) a multilevel analysis of the community-based energy independence through 45 tiered in-depth interviews with individuals ≥50 years with a range of access to CP’s solar installations: 1) direct access (n=15), indirect access (n=15) and no access (n=15). In addition, we will conduct qualitative interviews with individuals engaged at the policy-, administrative- or technical-levels working within the field of sustainable energy and disaster recovery (n=15). To achieve Aim 3, we will administer a survey to a sample of 345 aging persons in the town of Adjuntas who have direct, indirect and no access to independent energy sources. Our research will contribute to policy development and dissemination regarding the role of community engagement and energy independence in managing chronic diseases among aging populations in areas of the United States and the Caribbean that are vulnerable to health inequities magnified by disasters.

项目摘要 波多黎各（PR）由于自然灾害引起的电网而遭受电力停电。 波多黎各人老化（≥50岁）是自然灾害期间脆弱的人口 与其他非西班牙裔白人和其他西班牙裔相比，具有多种慢性健康状况 在美国。停电可以增加这些分布，并提高由于共同的发病率和死亡率 病态条件。研究表明，能源独立性具有积极的健康影响。活力 通过直接获得太阳能的独立性已通过非 - 的工作开始出现在PR中 利润社区组织Casa Pueblo（CP）。我们建议从多层次的角度探索 使地方政府机构，社区和个人能够适应能源独立的因素 在他们的环境中，以及通过这些目标对慢性疾病管理的影响：目标1 - 通过我们 与CP的合作伙伴关系，探索社区和人口老龄化的过程（≥50岁） 在适应能源独立性的同时，患有慢性疾病（例如，引入技术， 培训其使用，获得通电的公共点），以便更好地了解公共方式 特征（例如，集体身份，感知的个人主义）可能会阻碍或促进CDM 肾脏疾病，呼吸道疾病和糖尿病。 AIM 2 - 系统地记录多级 观点（即个人，社区和结构性）采用的障碍和促进者 PR的能源独立策略。 AIM 3 - 单个级别的文档弹性相关变量 （例如，自我有效，积极出勤，知识，利他主义），公共（例如，情感联系，群体 会员资格）和结构性（即停电，地理变量）级别可以促进有效的CDM 在需要基于电力治疗的老龄化人群中（即肾脏疾病，呼吸道疾病， 糖尿病）。为了达到目标1和2，我们将进行：（a）CP的详细民族志观察/映射， 涉及30个月的沉浸式和持续的机构交流，以及（b）对 基于社区的能源独立性通过45个分层的深入访谈≥50岁的个人 访问CP太阳能安装的范围：1）直接访问（n = 15），间接访问（n = 15）和无访问权限 （n = 15）。此外，我们将对参与政策的个人进行定性访谈 - 或在可持续能源与灾难恢复领域工作的技术级别（n = 15）。实现目标 3，我们将向有直接的邻近镇的345个老年人的样本进​​行调查 间接且无法获得独立的能源。我们的研究将有助于政策制定和 关于社区参与和能源独立性在管理慢性方面的作用的传播 美国和加勒比地区衰老人口的疾病很容易受到伤害 健康不平等因灾难而放大。