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: 10763097
• 负责人: MARK B PADILLA
• 金额: $ 4.45万
• 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/10763097
• 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; Disparity; Disparity population; Earthquakes; Electricity; Emotional; Enabling Factors; End stage renal failure; Energy-Generating Resources; Ethnography; Event; Face; Fostering; Funding; Geography; Government Agencies; Happiness; Health; Healthcare Systems; Hispanic Populations; Homes for the Aged; Hurricane; Individual; Institution; Interruption; Intervention; Interview; Island; Kidney Diseases; Knowledge; Local Government; Location; Maps; 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; Vulnerable Populations; Work; aging population; commune; community engagement; community organizations; comorbidity; disaster resilience; experience; extreme weather; food marketing; health disparity; health inequalities; improved; member; mortality; multilevel analysis; negative affect; optimism; population health; resilience; response

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.

项目总结