Community-based Participatory Research: A Tool to Advance Cookstove Interventions

基于社区的参与性研究：推进炉灶干预的工具

• 批准号: 8425860
• 负责人: Maggie Lynn Clark
• 金额: $ 11.43万
• 依托单位: COLORADO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-02-01 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8425860
• 关键词: Accounting; Address; Adoption; Air Pollution; Behavioral; Biomass; Blood Pressure; Burn injury; Carbon Monoxide; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Communities; Community Surveys; Complex; Developing Countries; Development; Disease Attributes; Enrollment; Environment; Epidemiology; Evaluation; Exhalation; Family; Fostering; Goals; Government; Health; Health Status; Honduran; Honduras; Household; Human; Impact evaluation; Individual; Indoor Air Pollution; Inflammation; Intervention; Intervention Studies; Intervention Trial; Interview; K-Series Research Career Programs; Knowledge; Latin America; Lead; Measurement; Measures; Mentors; Methodology; Methods; Monitor; Nicaragua; Nitric Oxide; Obesity; Participant; Particulate Matter; Pathway interactions; Phase; Plague; Policy Maker; Population; Postdoctoral Fellow; Prevention Research; Prevention approach; Process; Questionnaires; Randomized; Reactive Oxygen Species; Research; Research Design; Research Training; Risk Factors; Role; Shapes; Smoke; Social Change; Social Environment; Solid; Solutions; Target Populations; Techniques; Technology; Time; Training; Trees; Universities; Vent; Water; Woman; Work; arm; base; behavior change; burden of illness; career; community based participatory research; cooking; design; experience; follow-up; improved; innovation; insight; meetings; novel; novel strategies; pollutant; post intervention; premature; programs; public health relevance; response; rural area; skills; social; tool; two-arm study

DESCRIPTION (provided by applicant): The goal of this Career Development Award is to initiate an independent research program in air pollution epidemiology, exploring the dynamic relationship between environmental and social/behavioral risk factors on cardiovascular disease. The additional training the candidate will receive in social and behavior change methodologies will be essential for furthering the field of cook stove research and will uniquely provide the skills necessary to develop an independent research career focused on the development of these novel approaches to intervention research. Nearly 3 billion people rely on biomass combustion to meet basic domestic energy needs. Many households use traditional cook stoves to meet these energy needs, which can result in extremely high indoor air pollution concentrations. Indoor air pollution from biomass combustion accounts for an estimated 1.6 million premature deaths per year, representing about 3% of the global disease burden. Improved stove designs have the potential to substantially reduce indoor air pollution exposures. However, there are few randomized intervention trials, and previous stove intervention studies have been plagued by low improved stove adoption and sustained use, severely limiting interpretations of these studies. This research proposes to conduct community surveys and in-depth interviews among Honduran cook stove users to gain insight into the complex pathways surrounding barriers to and predictors of sustained improved cook stove adoption (Aim 1, K99-phase, among the target population for the proposed intervention in Aims 2-3). This information will be used to conduct and enhance a randomized improved cook stove intervention among 300 Honduran families, incorporating qualitative and quantitative measures of cook stove use and measuring pre- to post-intervention changes in pollutant exposures and subclinical indicators of cardiovascular health (Aims 2-3, R00-phase). The primary goals are twofold: to incorporate Community-Based Participatory Research (CBPR) approaches throughout all aspects of the research and to maximize sustained stove use (thereby maximizing the health impact of the intervention) to achieve valid exposure-response estimates. Both objectives utilize innovative strategies to fill knowledge gaps. The candidate will have the extensive support of a mentoring and research team with expertise in air pollution epidemiology, exposure assessment techniques, and community based approaches to conduct research. The research team will build upon previous studies in Latin America that have focused on identifying and validating appropriate field techniques for exposure and health assessments in rural areas of developing countries. The candidate's post-doctoral research conducting a multiyear stove intervention in Nicaragua and doctoral research experience conducting a cross-sectional cook stove study in Honduras is directly relevant to the proposed project. Over the past 8 years, the candidate and mentoring team have worked closely and successfully with the community partners (Trees, Water & People [TWP], Fort Collins, CO; AHDESA, Tegucigalpa, Honduras). Additionally, a new relationship with the Honduran academic partner (Zamorano University, Tegucigalpua, Honduras), who has an ongoing and productive relationship with TWP and AHDESA, has been cultivated. These partners will form the proposed Community and Academic Advisory Board to further develop the methods and conduct of the research plan. In summary, the proposed training and research plan is a logical follow-up to the research teams' previous cook stove studies conducted in Latin America. It will provide insight regarding barriers/predictors of sustained cook stove adoption, an issue impeding research in this field; assess the relationship between stove use and indicators of cardiovascular health, a substantial and quickly growing disease burden in developing countries; result in a more comprehensive and valid assessment of the impact of a cook stove intervention; and provide the candidate with the tools necessary to develop a vibrant independent research career, impacting the field of air pollution epidemiology by conducting research integrating the dynamic relationship between the physical and the social environment.

描述（由申请人提供）：该职业发展奖的目标是启动空气污染流行病学领域的独立研究计划，探索心血管疾病的环境与社会/行为风险因素之间的动态关系。候选人将在社会和行为改变方法中获得的额外培训对于促进库克炉研究领域至关重要，并将独特地提供开发独立研究职业所必需的技能，这些研究专注于这些新颖的干预研究方法的发展。将近30亿人依靠生物质燃烧来满足基本的国内能源需求。许多家庭使用传统的库克炉来满足这些能源需求，这可能导致室内空气污染的浓度极高。生物质燃烧的室内空气污染估计估计每年160万例死亡，约占全球疾病负担的3％。改进的炉灶设计有可能大大减少室内空气污染的暴露。但是，几乎没有随机干预试验，并且先前的炉灶干预研究受到低改善的炉灶采用和持续使用的困扰，严重限制了对这些研究的解释。这项研究建议对洪都拉斯厨师炉使用者进行社区调查和深入的访谈，以深入了解围绕着持续改进的库克炉采用的障碍和预测指标的复杂途径（AIM 1，K99-Chase，K99-Chase，目标人群，用于目标2-3的拟议干预措施的目标人群中）。该信息将用于进行和增强300个洪都拉斯家族之间的随机改进的库克炉干预措施，并结合库克炉使用的定性和定量测量，并测量污染物暴露前的干预后变化和心血管疾病的亚临床状况的变化（AIMS 2-3，r00-phase）。主要目标是双重的：在研究的各个方面纳入基于社区的参与性研究（CBPR）方法，并最大程度地利用持续的炉灶使用（从而最大程度地提高干预措施的健康影响），以实现有效的暴露反应估计。这两个目标都利用创新策略来填补知识空白。该候选人将获得具有空气污染流行病学，暴露评估技术和基于社区的研究方法的指导和研究团队的广泛支持。研究团队将基于拉丁美洲以前的研究，这些研究致力于识别和验证发展中国家农村地区暴露和健康评估的适当现场技术。候选人的博士后研究对尼加拉瓜进行了多年炉灶干预，并在洪都拉斯进行横断面厨师炉研究的博士研究经验与拟议项目直接相关。在过去的8年中，候选人和指导团队与社区合作伙伴（Trees，Water＆People [Twp]，Collins，CO； Ahdesa，Tegucigalpa，Honduras）紧密合作。此外，已经建立了与洪都拉斯学术伙伴（Zamorano大学，Tegucigalpua，Honduras）的新关系，与TWP和Ahdesa有着持续且富有成效的关系。这些合作伙伴将组成拟议的社区和学术顾问委员会，以进一步制定研究计划的方法和行为。总而言之，拟议的培训和研究计划是研究团队以前在拉丁美洲进行的库克炉研究的逻辑后续行动。它将提供有关持续的库克炉采用的障碍/预测因素的见解，这是阻碍该领域研究的问题；评估炉灶使用和心血管健康指标之间的关系，这是发展中国家的巨大而迅速增长的疾病负担；导致对库克炉干预的影响进行更全面和有效的评估；并为候选人提供开发充满活力的独立研究职业所需的工具，从而通过进行整合身体与社会环境之间的动态关系来影响空气污染流行病学领域。