Community-based Participatory Research: A Tool to Advance Cookstove Interventions

项目概要/摘要 这个职业发展奖的目标是发起一个独立的空气污染研究计划 流行病学，探索环境和社会/行为风险因素之间的动态关系， 心血管疾病她将接受社会和行为改变方法方面的额外培训 将是必不可少的进一步领域的炉灶研究，并将独特地提供她的技能， 有必要发展一个独立的研究生涯，专注于这些新方法的发展 干预研究。近30亿人依靠生物质燃烧来满足基本的国内能源 需求许多家庭使用传统的炉灶来满足这些能源需求，这可能导致极端的能源消耗。 室内空气污染浓度高。生物质燃烧造成的室内空气污染 估计每年有160万人过早死亡，约占全球疾病负担的3%。 改进的炉灶设计有可能大大减少室内空气污染。然而，在这方面， 很少有随机干预试验，以前的炉子干预研究一直受到低水平的困扰。 改进炉灶的采用和持续使用，严重限制了对这些研究的解释。本研究 建议对缅甸炉灶用户进行社区调查和深入访谈， 深入了解围绕持续改进炉灶的障碍和预测因素的复杂途径 采用（目标1，K99阶段，目标2-3中拟议干预措施的目标人群）。这 这些信息将用于在300名患者中进行和加强随机改良炉灶干预。 对使用炉灶的家庭进行定性和定量测量， 污染物暴露和心血管健康亚临床指标的干预后变化（目标2-3， R 00-相）。主要目标有两个：将社区为基础的前瞻性研究（CBPR） 方法贯穿研究的各个方面，并最大限度地持续使用炉灶（从而最大限度地 干预措施的健康影响），以获得有效的风险-响应估计。这两个目标都利用 创新战略，填补知识空白。候选人将得到指导和 拥有空气污染流行病学、暴露评估技术和社区- 基于方法进行研究。该研究小组将以以前在拉丁美洲的研究为基础 重点是确定和验证适当的暴露和健康现场技术 发展中国家农村地区的评估。候选的博士后研究进行了 尼加拉瓜的多年炉灶干预和博士研究经验， 洪都拉斯的炉灶研究与拟议项目直接相关。在过去的八年里，候选人 和指导团队与社区合作伙伴（树木，水和 人[TWP]，柯林斯堡，CO; AHDESA，特古西加尔帕，洪都拉斯）。此外，与 洪都拉斯学术合作伙伴（洪都拉斯特古西加尔普阿萨莫拉诺大学），他正在进行一项 与TWP和AHDESA建立了富有成效的关系。这些合作伙伴将组成拟议的 社区和学术咨询委员会进一步制定研究计划的方法和进行。在 总而言之，拟议的培训和研究计划是研究小组合乎逻辑的后续行动以前的 在拉丁美洲进行的炉灶研究。它将提供有关持续的障碍/预测因素的见解。 炉灶的采用，这是阻碍这一领域研究的一个问题;评估炉灶的使用与 心血管健康指标，这是发展中国家一个巨大且迅速增长的疾病负担; 对炉灶干预措施的影响进行更全面和有效的评估;并提供 候选人与必要的工具，以发展一个充满活力的独立的研究生涯，影响领域的 空气污染流行病学的研究，结合物理的动态关系， 和社会环境。

Project Summary/Abstract The goal of this Career Development Award is to initiate an independent research program in air pollution epidemiology, exploring the dynamic relationship between environmental and social/behavioral risk factors on cardiovascular disease. The additional training she will receive in social and behavior change methodologies will be essential for furthering the field of cookstove research and will uniquely provide her with the skills necessary to develop an independent research career focused on the development of these novel approaches to intervention research. Nearly 3 billion people rely on biomass combustion to meet basic domestic energy needs. Many households use traditional cookstoves to meet these energy needs, which can result in extremely high indoor air pollution concentrations. Indoor air pollution from biomass combustion accounts for an estimated 1.6 million premature deaths per year, representing about 3% of the global disease burden. Improved stove designs have the potential to substantially reduce indoor air pollution exposures. However, there are few randomized intervention trials, and previous stove intervention studies have been plagued by low improved stove adoption and sustained use, severely limiting interpretations of these studies. This research proposes to conduct community surveys and in-depth interviews among Honduran cookstove users to gain insight into the complex pathways surrounding barriers to and predictors of sustained improved cookstove adoption (Aim 1, K99-phase, among the target population for the proposed intervention in Aims 2-3). This information will be used to conduct and enhance a randomized improved cookstove intervention among 300 Honduran families, incorporating qualitative and quantitative measures of cookstove use and measuring pre- to post-intervention changes in pollutant exposures and subclinical indicators of cardiovascular health (Aims 2-3, R00-phase). The primary goals are twofold: to incorporate Community-Based Participatory Research (CBPR) approaches throughout all aspects of the research and to maximize sustained stove use (thereby maximizing the health impact of the intervention) to achieve valid exposure-response estimates. Both objectives utilize innovative strategies to fill knowledge gaps. The Candidate will have the extensive support of a mentoring and research team with expertise in air pollution epidemiology, exposure assessment techniques, and community- based approaches to conduct research. The research team will build upon previous studies in Latin America that have focused on identifying and validating appropriate field techniques for exposure and health assessments in rural areas of developing countries. The Candidates post-doctoral research conducting a multiyear stove intervention in Nicaragua and doctoral research experience conducting a cross-sectional cookstove study in Honduras is directly relevant to the proposed project. Over the past 8 years, the Candidate and mentoring team have worked closely and successfully with the community partners (Trees, Water & People [TWP], Fort Collins, CO; AHDESA, Tegucigalpa, Honduras). Additionally, a new relationship with the Honduran academic partner (Zamorano Univeristy, Tegucigalpua, Honduras), who has an ongoing and productive relationship with TWP and AHDESA, has been cultivated. These partners will form the proposed Community and Academic Advisory Board to further develop the methods and conduct of the research plan. In summary, the proposed training and research plan is a logical follow-up to the research teams previous cookstove studies conducted in Latin America. It will provide insight regarding barriers/predictors of sustained cookstove adoption, an issue impeding research in this field; assess the relationship between stove use and indicators of cardiovascular health, a substantial and quickly growing disease burden in developing countries; result in a more comprehensive and valid assessment of the impact of a cookstove intervention; and provide the Candidate with the tools necessary to develop a vibrant independent research career, impacting the field of air pollution epidemiology by conducting research integrating the dynamic relationship between the physical and the social environment.