Investigating associations and mediating effects between climate and mental health and violence in informal settlements in Kenya

项目总结/摘要 气候变化及相关的天气事件和环境变化预计将产生深远的影响 心理健康和心理健康。中低收入非正规住区居民 这些国家（LMIC）特别容易受到气候变化的影响，因为这些定居点 通常位于生态敏感地区，包括山谷、洪泛区、湿地、工业区和废弃地 垃圾场-更容易受到洪水，山体滑坡，干旱等极端天气事件（EWE）的影响， 热浪居民在适应或减少气候变化影响方面也面临严重障碍，包括 贫困、政治和社会边缘化、被排斥在正规服务和法律的土地保有权之外。虽然 数据有限，估计还表明，抑郁症，自杀企图，酗酒，心理社会 非正规住区居民的压力和人际暴力可能高于其他住区的居民 人口在LMIC。预计气候变化将加剧这些心理健康和暴力挑战 在未来几年。然而，缺乏探索关联和潜力的实证研究 在气候与心理健康和非正规住区中与暴力有关的结果之间发挥调解作用。 因此，这项探索性/发展性研究补助金（R21）的目的是调查 气候与心理健康和暴力相关结果之间的关联和潜在调解人 社区.这一目标将通过以下目标实现：1）家庭一级的调查将 每月从基贝拉和马萨雷的800名妇女的概率样本中收集18个月 内罗毕的定居点。调查将包括心理健康、幸福感、物质使用和 人际暴力2)将提供Mathare和Kibera附近的每日温度和降水数据 由肯尼亚气象部门提供，用于确定这些地区EWE的患病率和频率。 定居点这些数据将与当地居民报告的EWE（包括洪水，山体滑坡）进行比较 和热浪，以帮助制定EWE的工作定义和气象阈值， 符合居民体验的定居点。3)气象数据将与与会者的 目标1中的月度调查和EWE后约72小时的非正式调查的答复 定居点将使用时间序列分析来分析合并的数据集，以测试关联性和潜在的 气候与心理健康，幸福感，物质使用和非正式人际暴力之间的调解人 定居点这项研究的长期目标是提供有关重要气候阈值的有用信息 与非正规住区的心理健康和人际暴力有关的问题，并揭示关键的调解因素， 这些现象之间的联系。这项研究的结果可以用来确定关键的 为干预和适应气候变化提供了依据，并为模式和方法的探索提供了基础 气候和精神健康以及世界各地其他非正规住区的暴力。

PROJECT SUMMARY/ABSTRACT Climate change and related weather events and environmental changes are expected to have a profound impact on psychological well-being and mental health. Residents of informal settlements in lower- and middle-income countries (LMICs) are especially vulnerable to the effects of changes in climate because these settlements are often located in ecologically sensitive areas, including valleys, floodplains, wetlands, industrial sites, and waste dumps—sites that are more susceptible to extreme weather events (EWEs) like floods, landslides, droughts, and heatwaves. Residents also face serious barriers to adaptation or reducing the effects of climate change, including poverty, political and social marginalization, and exclusion from formal services and legal land tenure. Though there is limited data, estimates also suggest that depressive disorder, suicide attempts, alcohol use, psychosocial stress, and interpersonal violence are likely higher among residents of informal settlements than in other populations in LMICs. Climate change is expected to exacerbate these mental health and violence challenges in the coming years. There is, however, a lack of empirical research exploring associations and potential mediating effects between climate and mental health- and violence-related outcomes in informal settlements. The objective of this Exploratory/Developmental Research Grant Award (R21), therefore, is to investigate associations and potential mediators between climate and mental health- and violence-related outcomes in these communities. This objective will be achieved through the following aims: 1) Household-level surveys will be collected monthly for 18 months from a probability sample of 800 women in Kibera and Mathare informal settlements in Nairobi. Surveys will include measures of mental health, well-being, substance use, and interpersonal violence. 2) Daily temperature and precipitation data from near Mathare and Kibera will be provided by the Kenya Meteorological Department and used to determine prevalence and frequency of EWEs in these settlements. This data will be compared with residents’ reports of localized EWEs including floods, landslides and heatwaves to help develop working definitions and meteorological thresholds of EWEs in informal settlements that align with residents’ experiences. 3) Meteorological data will be combined with participants’ responses from the monthly surveys in Aim 1 and surveys taken approximately 72 hours after EWEs in informal settlements. The combined dataset will be analyzed using time-series analysis to test associations and potential mediators between climate and mental health, well-being, substance use, and interpersonal violence in informal settlements. The long-term goal of this study is to provide helpful information about important climate thresholds related to mental health and interpersonal violence in informal settlements and to uncover key mediating factors underlying connections between these phenomena. Findings from the study could be used to identify critical points for intervention and climate change adaptation and provide a foundation for models and methods exploring climate and mental health and violence in other informal settlements around the world.