Community-Engaged Research and Action to Reduce Respiratory Disease in Appalachia

社区参与减少阿巴拉契亚呼吸道疾病的研究和行动

• 批准号: 9054119
• 负责人: STEVEN R BROWNING
• 金额: $ 51.73万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-15 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9054119
• 关键词: Accounting; Action Research; Address; Adult; Adult asthma; Affect; Age; Air; Air Pollutants; Appalachian Region; Area; Asthma; Back; Behavioral; Chronic Obstructive Airway Disease; Coal Mining; Collaborations; Communities; Community Participation; Data; Development; Diagnosis; Diet; Environmental Exposure; Environmental Pollution; Environmental Risk Factor; Epidemiologic Studies; Epidemiology; Evaluation; Exposure to; Gender; Goals; Health; Health education; Healthcare; Home environment; Individual; Intervention; Kentucky; Knowledge; Lead; Lung diseases; Measurement; Measures; Modification; Nature; Neighborhoods; Occupations; Outcome; Outcome Assessment; Physical activity; Population; Process; Public Health; Quality of life; Randomized; Reporting; Research; Research Design; Research Personnel; Risk; Risk Factors; Role; Rural; Self Efficacy; Self Management; Smoking; Source; Symptoms; Testing; Voice; arm; base; community organizations; community partnership; design; efficacy testing; environmental justice; experience; health disparity; improved; innovation; low socioeconomic status; meetings; member; programs; pulmonary function; residence; respiratory; respiratory health; response; satisfaction; social

DESCRIPTION (provided by applicant): Rural Appalachian residents experience the nation's highest rates of serious respiratory illnesses, with Appalachian Kentuckians twice as likely to be diagnosed with adult asthma and chronic obstructive pulmonary disease as their national counterparts. In response to community concern and to address the critical need to reduce respiratory health disparities in Appalachia, we draw on our decade-long community-academic partnership to undertake three aims and activities: (1) to investigate the extent, nature, and source of respiratory health inequities, we will implement a community-engaged assessment of environmental and individual-level exposures; (2) to enhance community knowledge about respiratory illness and refine a culturally appropriate environmental public health action strategy (EPHAS), we will disseminate results from the epidemiologic assessment and gather input to refine the EPHAS; and (3) to test the efficacy of the EPHAS, we will implement and evaluate a three arm RCT involving self-management and home modification. Outcomes include appropriate health care use; improvement in quality of life, pulmonary function, respiratory illness knowledge and self-efficacy; extent of community participation; and programmatic satisfaction. The proposed application is responsive to "Research to Action: Assessing and Addressing Community Exposures to Environmental Contaminants" (PA-12-153), encouraging "community-engagement projects designed to investigate the potential health risks of environmental exposures of concern to a community and to implement an environmental public health action plan based on research findings." The proposed community-academic effort represents the first of its kind to undertake a comprehensive environmental, behavioral, and social determinants assessment, leading to a community-endorsed environmental public health action strategy to rectify Appalachian respiratory health inequities.

描述（由申请人提供）：阿巴拉契亚农村居民经历了美国最高的严重呼吸系统疾病率，阿巴拉契亚肯塔基州被诊断出患有成人哮喘和慢性阻塞性肺部疾病的可能性是其国家的两倍。为了应对社区关注并满足减少阿巴拉契亚呼吸道健康差异的关键需求，我们借鉴了十年的社区 - 学术伙伴关系，以实现三个目标和活动：（1）研究呼吸健康不平等的程度，性质和来源，我们将实施社区社区与环境和个人级别的接触评估； （2）增强社区对呼吸道疾病的知识并完善具有文化适当的环境公共卫生行动策略 （e Plast），我们将从流行病学评估中传播结果，并收集投入以完善ePHAST； （3）为了测试EPHAS的功效，我们将实施和评估涉及自我管理和家庭修改的三个ARM RCT。结果包括适当的医疗保健；改善生活质量，肺功能，呼吸道疾病知识和自我效能感；社区参与的程度；和程序化满意度。拟议的应用对“行动研究：评估和解决社区对环境污染物的接触”（PA-12-153）的反应，鼓励“旨在调查社区关注的环境暴露的潜在健康风险，并基于研究发现，旨在调查社区关注的环境风险的潜在健康风险。”拟议中的社区学术努力代表了进行全面的环境，行为和社会决定因素评估的第一个，从而导致了社区认可的环境公共卫生行动策略，以纠正阿巴拉契亚呼吸健康不平等。