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Reducing Environmental Risk to Rural Low Income Families

减少农村低收入家庭的环境风险

基本信息

批准号：
7477223
负责人：
Patricia G Butterfield
金额：
$ 33.58万
依托单位：
WASHINGTON STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-09-21 至 2010-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7477223
关键词：
Acute Address Adopted Adult Applied Research Area Arsenic Asthma Attitude Behavioral Belief Biological Markers Carbon Monoxide Caring Characteristics Chemicals Child Child health care Chronic Disease Clinic Collaborations Communities Computer software Condition Cotinine Country County Decision Making Demographic Factors Diet Discipline of Nursing Disease Dose Drug Metabolic Detoxication Economic Factors Educational Materials Effectiveness Effectiveness of Interventions Ensure Environmental Health Environmental Risk Factor Environmental Tobacco Smoke Exposure to Family Family Characteristics Farming environment Food Funding Goals Government regulations Health Healthcare Systems Height Home environment Home visitation House Call Household Household and Family Housing Industry Intervention Ionizing radiation Knowledge Lead Life Link Literature Low income Measures Mercury Metric Mining Nervous system structure Numbers Nurses Occupations Parents Perception Pesticides Population Poverty Predisposition Prevention strategy Process Property Rights Public Health Public Health Nurses Public Health Nursing Radon Recommendation Recruitment Activity Relative (related person)Reporting Research Research Personnel Risk Risk Reduction Rural Rural Health Science Scientist Self Efficacy Services Site Smell Perception Smoke Social Security Staging Standards of Weights and Measures Stress Subgroup System Test Result Testing Time Title Training Uncertainty United States Public Health Service Universities Upper arm Water Weight Wood material Work air contaminant anthropogenesis design dosage experience farm worker health care service utilization inner city novel nursing intervention preference programs rapid growth research study sound success water quality

项目摘要

DESCRIPTION (provided by applicant): More than 17 million children participate in public health programs funded by Title. V of the Social Security Act. Providing household environmental risk information to these families is a common sense way of integrating risk reduction into existing programs. However, the success of such efforts will be predicated on testing interventions that can be delivered in home and clinic settings. The proposed study will address 2 gaps in nursing science by yielding evidence addressing: 1) measures of rural children's environmental health (EH) risks, and 2) the effectiveness of a tailored environmental risk reduction (ERR) intervention delivered by public health nurses. Subjects include rural low-income children and adults; there is compelling evidence that exposures to children in the rural West differ from those in other parts of the country. Research aims include: 1) describe EH risks and perceptions of risk that impact the health of rural low-income children, 2) test the effectiveness of an ERR intervention on: a) ERR knowledge, b) ERR self-efficacy, c) stage of action, and d) biomarker (i.e., cotinine, lead) and household contaminant levels (i.e., radon, carbon monoxide, water contaminants), 3) test whether the effect of the ERR intervention persists over time, and 4) explore associations among key measures of risk, risk perception, family characteristics, and ERR. The proposed research uses a 2-arm parallel group RCT design. Subjects will receive an ERR intervention containing 10 standard and 5 tailored educational modules delivered during 4 home visits. Tailored educational materials will be derived from household test results. Consistency in the tailoring process will be assured by the use of decision-making software. Controls will receive usual and customary care; health service utilization metrics in both groups will be collected so that variability in usual care can be analyzed. Families will be recruited from 2 county health departments. A training and sustainability plan is in place to ensure that the intervention is provided in a uniform manner across subjects, site, and over time. Environmental health scientists have predominately adopted an agent versus a family perspective in applied research. An understanding of agents is necessary, but not sufficient in developing interventions aimed at empowering low-income families to make sound ERR decisions. The proposed research takes a nursing perspective by incorporating a broad view of contextual variables that influence children's environmental health. Such a view is consistent with national recommendations that translational EH research be framed and delivered in a manner that is meaningful to families, marginalized populations, and high-risk subgroups.

描述（由申请人提供）：超过1700万儿童参与了Title资助的公共卫生项目。《社会保障法》第5条。向这些家庭提供家庭环境风险信息是将降低风险纳入现有方案的一种常识性方法。然而，这种努力的成功将取决于能够在家庭和诊所环境中提供的检测干预措施。拟议的研究将通过提供证据来解决护理科学中的两个空白：1)农村儿童环境健康（EH）风险的测量，以及2)公共卫生护士提供的量身定制的环境风险降低（ERR）干预的有效性。研究对象包括农村低收入儿童和成人；有令人信服的证据表明，西部农村地区的儿童与该国其他地区的儿童接触的环境不同。研究目的包括：1)描述影响低收入农村儿童健康的EH风险和风险认知；2)检验ERR干预的有效性：a) ERR知识，b) ERR自我效能，c)行动阶段，d)生物标志物（如可汀宁，铅）和家庭污染物水平（如氡，一氧化碳，水污染物），3)测试ERR干预的效果是否持续一段时间，4)探索风险关键指标，风险感知，家庭特征和ERR之间的关联。本研究采用双臂平行组随机对照试验设计。受试者将在4次家访期间接受包含10个标准模块和5个量身定制的教育模块的ERR干预。量身定制的教育材料将来自家庭测试结果。决策软件的使用将确保裁剪过程的一致性。控制将得到通常和惯常的照顾；将收集两组的卫生服务利用指标，以便分析常规护理的可变性。家庭将从两个县卫生部门招募。培训和可持续性计划到位，以确保在不同科目、地点和时间以统一的方式提供干预。环境卫生科学家在应用研究中主要采用了代理人与家庭的观点。了解因素是必要的，但在制定干预措施以使低收入家庭能够作出合理的误读决定方面是不够的。拟议的研究通过纳入影响儿童环境健康的上下文变量的广泛观点，采取护理的观点。这种观点与国家的建议是一致的，即翻译性EH研究应以对家庭、边缘人群和高风险亚群体有意义的方式进行框架和交付。

项目成果

期刊论文数量（11）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Rural Families' Process of Re-Forming Environmental Health Risk Messages.

农村家庭重新形成环境健康风险信息的过程。

DOI：
10.1111/jnu.12149
发表时间：
2015
期刊：
Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing
影响因子：
0
作者：
Oneal,GailA;Eide,Phyllis;Hamilton,Rebekah;Butterfield,Patricia;Vandermause,Roxanne
通讯作者：
Vandermause,Roxanne

Mapping the future of environmental health and nursing: strategies for integrating national competencies into nursing practice.

规划环境健康和护理的未来：将国家能力融入护理实践的策略。