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

项目摘要/摘要 这个职业发展奖的目标是发起一个关于空气污染的独立研究计划 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论方面的额外培训 将是进一步发展炉灶研究领域的关键，并将为她提供独特的技能 有必要发展一项专注于开发这些新方法的独立研究事业 干预性研究。近30亿人依靠生物质燃烧满足基本生活能源需求 需要。许多家庭使用传统的炉灶来满足这些能源需求，这可能导致极大的 室内空气污染浓度较高。生物质燃烧造成的室内空气污染占 据估计，每年有160万人过早死亡，约占全球疾病负担的3%。 改进的炉子设计有可能大幅减少室内空气污染暴露。然而， 很少有随机干预试验，以前的炉子干预研究一直受到LOW的困扰 改善了炉灶的采用和持续使用，严重限制了对这些研究的解释。这项研究 建议在洪都拉斯灶具使用者中进行社区调查和深入访谈，以获得 洞察炉灶持续改进的障碍和预测因素周围的复杂路径 通过(目标1，K99阶段，目标2-3中拟议干预的目标人群)。这 将利用这些信息在300人中进行和加强随机改进的炉灶干预 洪都拉斯家庭，融合了炉灶使用的定性和定量措施，并测量了 干预后污染物暴露和心血管健康亚临床指标的变化(目标2-3， R00-阶段)。主要目标有两个：纳入基于社区的参与性研究(CBPR) 方法贯穿研究的所有方面，并最大限度地持续使用炉子(从而最大化 干预对健康的影响)，以实现有效的暴露-反应估计。这两个目标都利用 填补知识空白的创新战略。候选人将得到广泛的指导和支持 拥有空气污染流行病学、暴露评估技术和社区专业知识的研究团队- 以研究为基础的方法。研究小组将在拉丁美洲之前的研究基础上再接再厉 重点是确定和验证暴露和健康方面的适当现场技术 发展中国家农村地区的评估。进行博士后研究的候选人 尼加拉瓜多年的炉灶干预和进行横断面研究的博士经验 洪都拉斯的炉灶研究与拟议的项目直接相关。在过去的8年里，这位候选人 和指导团队与社区合作伙伴(Trees、Water和 人民[TWP]，科林斯堡，科罗拉多；AHDESA，特古西加尔巴，洪都拉斯)。此外，与 洪都拉斯学术伙伴(Zamorano大学，洪都拉斯特古西加尔普阿)，他有一个正在进行的 与TWP和AHDESA建立了生产关系。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……里面 综上所述，拟议的培训和研究计划是对先前研究小组的合理后续行动 在拉丁美洲进行的炉灶研究。它将提供有关持续的障碍/预测因素的洞察 炉灶采用，一个阻碍这一领域研究的问题；评估炉灶使用和 心血管健康指标，这是发展中国家日益严重的疾病负担； 对炉灶干预的影响进行更全面和有效的评估；并提供 应聘者拥有发展充满活力的独立研究事业所需的工具，影响到 通过开展空气污染流行病学研究整合物理之间的动态关系 以及社会环境。

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.