Evaluation of the Portable Alternative Sanitation System (PASS) on In-Home Water Use and Quality of Life

便携式替代卫生系统 (PASS) 对家庭用水和生活质量的评估

• 批准号: 10437545
• 负责人: Laura P Eichelberger
• 金额: $ 30.17万
• 依托单位: ALASKA NATIVE TRIBAL HEALTH CONSORTIUM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-05 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10437545
• 关键词: 12 year old; Address; Affect; Alaska; Alaska Native; American Indians; Arctic Regions; COVID-19 pandemic; Categories; Child; Collection; Communities; Data; Defecation; Disease; Elderly; Engineering; Enrollment; Evaluation; Feces; Funding; Goals; Handwashing; Health; Home; Household; Human; Hygiene; Impact evaluation; Incidence; Indigenous; Individual; Infection; Infectious Skin Diseases; Infrastructure; Intervention; Longitudinal Studies; Maintenance; Measures; Methods; Native American Research Center for Health; Native Americans; Outcome; Personal Satisfaction; Persons; Pilot Projects; Plumbing; Prevalence; Privacy; Prospective cohort; Public Health; Quality of life; Reporting; Respiratory Tract Infections; Running; Sample Size; Sanitation; Seasons; Security; Services; Smell Perception; Stress; Symptoms; System; Testing; Time; Tribes; Urine; Waste Management; Water; Woman; Work; World Health Organization; base; climate change; design; disease disparity; disparity reduction; experience; follow-up; foot; gastrointestinal infection; health organization; hookah; improved; infection rate; men; novel; portability; post-COVID-19; response; tribal health; wasting; water treatment

PROJECT SUMMARY (ABSTRACT) Water-washed diseases (infections related to inadequate water access and poor sanitation) are a preventable public health issue that continues to affect the 1.4 million people in the U.S. who still lack access to basic water and sanitation. The COVID-19 pandemic brought to the forefront a reminder that Native American households are 19 times more likely to lack indoor plumbing than White households. Historically, AN communities with a lower proportion of in-home piped water and sanitation services have disproportionately higher rates of respiratory and skin infections compared to plumbed communities, and these infection rates decreased after the installation of in-home water services in some communities. Inadequate funding, engineering challenges, affordability, and now climate change have hindered the installation and maintenance of centralized piped water and sewer systems in remote Alaska. There is therefore an urgent need to evaluate whether novel, targeted water, sanitation, and hygiene (WASH) interventions reduce water-wash disease disparities. To address this need, this study will evaluate the impact of a targeted WASH intervention developed specifically for American Indian/Alaska Native (AI/AN) communities, known as the Portable Alternative Sanitation System (PASS), on water use, waste management, water-wash disease and well-being (defined by both biomedical and locally- defined categories) over time in AN households. We will do this through two Specific Aims: 1) Characterize the lived experiences of household water- and sanitation security (HWSS), health, and well-being in remote AN households across the water and sanitation service spectrum using community-based measures and 2) Evaluate the impact of the PASS on in-home water storage and use, quality of life, water security and reliability, and prevalence of water-washed diseases. Through this mixed methods, longitudinal study, we will provide evidence that demonstrates how a targeted WASH intervention affects water-wash diseases, in-home water use and waste management, and overall well-being in AIAN communities. This will also enable tribes, tribal health organizations, and related stakeholders beyond Alaska to evaluate the PASS system to decide if it is appropriate for their own communities. This study builds on our previous work in the community of Kivalina with a greater sample size, comparison of data from piped and unpiped households, and longitudinal data from the post-COVID era. To our knowledge, this is the first longitudinal evaluation of how an in-home point-of-use water treatment and waterless toilet system affects household water and sanitation security, health, and well-being in an Arctic, Indigenous context.

项目概要（摘要） 水冲疾病（与供水不足和卫生条件差有关的感染）是一种可以预防的疾病 公共卫生问题继续影响美国 140 万人，他们仍然无法获得基本用水 和卫生条件。 COVID-19 大流行提醒人们，美国原住民家庭 缺乏室内管道的可能性是白人家庭的 19 倍。从历史上看，AN 社区具有 家庭自来水和卫生服务所占比例较低，但使用率却过高 与管道社区相比，呼吸道和皮肤感染的感染率在 在一些社区安装家庭供水服务。资金不足、工程挑战、 负担能力，现在气候变化阻碍了集中式自来水的安装和维护 和阿拉斯加偏远地区的下水道系统。因此，迫切需要评估是否新颖、有针对性 水、环境卫生和个人卫生 (WASH) 干预措施可减少水洗疾病的差异。为了解决这个问题 根据需要，本研究将评估专门为美国开发的有针对性的 WASH 干预措施的影响 印第安人/阿拉斯加原住民 (AI/AN) 社区，称为便携式替代卫生系统 (PASS)， 用水、废物管理、水洗疾病和福祉（由生物医学和当地定义） AN 家庭中随时间变化的定义类别）。我们将通过两个具体目标来做到这一点：1）描述 偏远地区的家庭用水和卫生安全 (HWSS)、健康和福祉的生活经历 使用基于社区的措施对整个供水和卫生服务范围内的家庭进行评估；2) 评估 PASS 对家庭储水和使用、生活质量、水安全和可靠性的影响，以及 水冲疾病的流行。通过这种混合方法、纵向研究，我们将提供证据 展示了有针对性的 WASH 干预措施如何影响水洗疾病、家庭用水和 废物管理以及 AIAN 社区的整体福祉。这也将使部落、部落健康 阿拉斯加以外的组织和相关利益相关者评估 PASS 系统以确定其是否合适 为了他们自己的社区。这项研究建立在我们之前在 Kivalina 社区所做的工作的基础上，并更深入地研究了 样本量、管道和非管道家庭数据的比较以及新冠疫情后的纵向数据 时代。据我们所知，这是对家庭使用点水处理方式的首次纵向评估 无水厕所系统影响北极地区的家庭用水和卫生安全、健康和福祉， 本土背景。