Reducing Environmental Risk to Rural Low Income Families

减少农村低收入家庭的环境风险

• 批准号: 7125069
• 负责人: Patricia G Butterfield
• 金额: $ 54.98万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-21 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7125069
• 关键词: carbon monoxide; children; clinical research; clinical trials; data collection methodology /evaluation; disease /disorder proneness /risk; environmental contamination; environmental exposure; environmental health; hazardous substances; health care service utilization; health education; health surveys; household; human subject; lead poisoning; longitudinal human study; low socioeconomic status; nursing intervention; occupational hazard; public health; questionnaires; residential mobility; rural area; water quality

DESCRIPTION (provided by applicant): More than 17 million children participate in public health programs funded by Title. V of the Social Security Act. Providing household environmental risk information to these families is a common sense way of integrating risk reduction into existing programs. However, the success of such efforts will be predicated on testing interventions that can be delivered in home and clinic settings. The proposed study will address 2 gaps in nursing science by yielding evidence addressing: 1) measures of rural children's environmental health (EH) risks, and 2) the effectiveness of a tailored environmental risk reduction (ERR) intervention delivered by public health nurses. Subjects include rural low-income children and adults; there is compelling evidence that exposures to children in the rural West differ from those in other parts of the country. Research aims include: 1) describe EH risks and perceptions of risk that impact the health of rural low-income children, 2) test the effectiveness of an ERR intervention on: a) ERR knowledge, b) ERR self-efficacy, c) stage of action, and d) biomarker (i.e., cotinine, lead) and household contaminant levels (i.e., radon, carbon monoxide, water contaminants), 3) test whether the effect of the ERR intervention persists over time, and 4) explore associations among key measures of risk, risk perception, family characteristics, and ERR. The proposed research uses a 2-arm parallel group RCT design. Subjects will receive an ERR intervention containing 10 standard and 5 tailored educational modules delivered during 4 home visits. Tailored educational materials will be derived from household test results. Consistency in the tailoring process will be assured by the use of decision-making software. Controls will receive usual and customary care; health service utilization metrics in both groups will be collected so that variability in usual care can be analyzed. Families will be recruited from 2 county health departments. A training and sustainability plan is in place to ensure that the intervention is provided in a uniform manner across subjects, site, and over time. Environmental health scientists have predominately adopted an agent versus a family perspective in applied research. An understanding of agents is necessary, but not sufficient in developing interventions aimed at empowering low-income families to make sound ERR decisions. The proposed research takes a nursing perspective by incorporating a broad view of contextual variables that influence children's environmental health. Such a view is consistent with national recommendations that translational EH research be framed and delivered in a manner that is meaningful to families, marginalized populations, and high-risk subgroups.

描述（由申请人提供）：超过1700万儿童参加了标题资助的公共卫生计划。 《社会保障法》的v。向这些家庭提供家庭环境风险信息是将降低风险降低与现有计划相结合的常识方式。但是，这种努力的成功将取决于可以在家庭和诊所环境中提供的测试干预措施。拟议的研究将通过提出证据来解决护理科学中的2个差距：1）衡量农村儿童环境健康（EH）风险的措施，以及2）量身定制的环境风险降低（ERR）干预措施的有效性是由公共卫生护士提供的。受试者包括农村低收入儿童和成人；有令人信服的证据表明，向西部的儿童暴露与该国其他地区的儿童不同。研究目的包括：1）描述影响农村低收入儿童健康的风险和对风险的看法，2）测试错误干预的有效性：a）a）错误知识，b）错误自我效能感，c）行动阶段，d）生物标志物（即，cotinine，铅）和家庭敏感水平（即，radon），radon，radon的效果，radon，radon，radon，radon，radon，radon的效应，radon sonigions，radon sonigions，rade），）随着时间的流逝，错误干预持续存在，4）探索风险，风险感知，家庭特征和错误的关键度量之间的关联。拟议的研究使用了2臂并行组RCT设计。受试者将收到一个错误干预措施，其中包含10个标准和5个量身定制的教育模块。量身定制的教育材料将来自家庭测试结果。使用决策软件将确保裁缝过程中的一致性。控件将获得常规和习惯护理；将收集两组中的卫生服务利用率指标，以便可以分析常规护理的变异性。家庭将从两个县卫生部门招募。制定了培训和可持续性计划，以确保在主题，现场和随着时间的时候以统一的方式提供干预措施。环境卫生科学家在应用研究中主要采用了一种代理与家庭观点。对代理是必要的，但在制定旨在赋予低收入家庭做出声音错误决定的干预措施中不足。拟议的研究通过纳入影响儿童环境健康的上下文变量的广泛观点来采用护理的观点。这种观点与国家建议相一致，即对家庭，边缘化人群和高风险亚组有意义的方式进行翻译EH研究。