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

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 由于自然灾害对波多黎各电网造成的破坏，波多黎各(PR)面临频繁的停电。 波多黎各老龄人口(≥50岁)是自然灾害期间的弱势群体，因为他们更有可能 与其他非西班牙裔白人和其他西班牙裔相比，有多种慢性健康状况 在美国的团体。停电可能会增加这些差距，并增加由于 病态的环境。研究表明，能源独立对健康有积极影响。能量 通过直接获得太阳能的独立已经开始出现在公关中，通过非 营利社区组织Casa Pueblo(CP)。我们建议从多层面的角度探讨 使地方政府机构、社区和个人能够适应能源独立的因素 以及通过这些目标对慢性病管理的影响：目标1--通过我们的 与CP合作，探索社区和老龄化人口所经历的过程(≥50年) 在适应能源独立的同时与慢性病生活在一起(例如，引入技术， 关于其使用、获得通电的公共点的培训)，以便更好地了解社区如何 特征(例如，集体认同、感知到的个人主义)可能会阻碍或促进那些患有 肾脏疾病、呼吸系统疾病和糖尿病。目标2--从多个层面系统地记录 视角(即个人、社区和结构)可感知的采用障碍和促进者 公关中的能源独立战略。目标3-记录个人层面的复原力相关变量 (例如，自我效能感、积极态度、知识、利他主义)、公共(例如，情感联系、团体 可促进有效清洁发展机制的结构(即停电、地理变量)水平 在需要以电力为基础的治疗的老龄人口中(即肾脏疾病、呼吸系统疾病、 糖尿病)。为了实现目标1和目标2，我们将：(A)对CP进行详细的人种学观察/测绘， 涉及30个月的身临其境和持续的机构交流，以及(B)对 通过45次对个人的分层深入采访，实现了基于社区的能源独立，≥50年来 CP太阳能设施的访问范围：1)直接访问(n=15)、间接访问(n=15)和禁止访问 15例。此外，我们将对政策、行政和行政部门的人员进行定性访谈。 或在可持续能源和灾难恢复领域工作的技术级别(n=15)。为了达到目的 3，我们将对Adjutas镇345名老年人进行调查，他们有直接的， 间接的，无法获得独立的能源。我们的研究将有助于政策的制定和 宣传社区参与和能源独立在管理慢性病中的作用 美国和加勒比地区易患老年人口疾病 灾难放大了健康方面的不平等。