Post Maria Puerto Rican Families Relocated to Florida: A Multisite Study of Alcohol Misuse and Mental Health Problems

项目摘要/摘要 飓风玛丽亚过后，数以万计的波多黎各人在美国本土寻求庇护， 大多数人搬到了佛罗里达州南部和中部。飓风过后一年多，第一线新闻 我们的初步研究表明，许多后玛丽亚时代的幸存者计划留在美国本土 可预见的未来。然而，目前，我们对流离失所的波多黎各人的了解仍然非常有限。数据 我们的初步研究和正在进行的工作表明，在这群人面临的无数问题中， 酒精滥用和精神健康问题是特别严重的挑战。尤其令人担忧的是， 风暴造成的压力和创伤将导致更大的酒精滥用和心理健康问题 波多黎各成年人及其子女，特别是在与移民有关的文化压力下 源于计划外的、突然的和长期的从具有独特文化的岛屿领土上的流离失所 和语言。拟议的研究以三个目标为导向，旨在建立一个方案 时尚。第一个目标涉及风暴过后移民新出现的公共卫生需求； 也就是说，提供后玛丽亚·波多黎各的特征、经验和需求的流行病学肖像 搬到佛罗里达的里肯家庭。第二个目标侧重于与以下方面相关的更广泛的理论问题 灾后移徙和适应；即审查[a]创伤、 文化压力、家庭功能和酗酒以及精神健康问题，并进行区别对待 在佛罗里达州南部和中部测试文化压力理论，为每个地区的干预发展提供信息。 基于我们之前的研究和文化压力理论，我们的中心假设是，家庭搬迁到南方 佛罗里达(一个拉丁裔文化影响盛行的双语地区)与移民相关的情况将会减少 文化压力，因此享受更多的家庭功能，更少的酗酒和心理健康 与佛罗里达州中部(波多黎各和其他地区最近出现相对上升的地区)相比的问题 拉丁裔移民)。第三个目标侧重于确保--通过与利益攸关方和 参与者--研究结果被有效地转化为现实世界的实践。这样做的科学前提是 这项研究将为支持流离失所的波多黎各人的努力提供信息，并推动灾害相关移民的理论研究 和健康。我们将追求以下具体目标：[1]描述特征、体验和需求 佛罗里达州后玛丽亚·波多黎各家庭；[2]检查未来的关系以检验文化压力理论 跨越不同的重新安置背景；以及[3]与利益攸关方和参与者接触，制定指导方针， 最佳做法和干预建议，以便在未来的研究中传播和测试。这个 这项研究的贡献是重大的，因为它为循证医学的发展奠定了基础 针对高危群体需求的干预措施，并承诺回答对 文化压力理论的发展和关于移民适应和关键成果的更广泛的理论。

Project Summary/Abstract In the aftermath of Hurricane Maria, tens of thousands of Puerto Ricans sought refuge on the US mainland, with the majority relocating to South and Central Florida. More than one year after the hurricane, frontline journalism and our preliminary research make clear that many post-Maria survivors plan to stay on the US mainland for the foreseeable future. And yet, at present, our understanding of displaced Puerto Ricans remains very limited. Data from our pilot studies and our ongoing work suggests that, among the myriad issues faced by this population, alcohol misuse and mental health problems are particularly serious challenges. Of concern, in particular, is that stress and trauma caused by the storm will lead to greater alcohol misuse and mental health problems among Puerto Rican adults and their children, especially when coupled with the migration-related cultural stress stemming from an unplanned, abrupt, and long-term displacement from the island territory with its distinct culture and language. The proposed study is oriented around three objectives designed to build in a programmatic fashion. The first objective relates to the emerging public health needs of migrants in the aftermath of the storm; namely, to provide an epidemiologic portrait of the characteristics, experiences, and needs of post-Maria Puerto Rican families who relocated to Florida. The second objective focuses on broader theoretical issues related to post-disaster migration and adaptation; namely, to examine the prospective association between [a] trauma, cultural stress, family functioning and [b] alcohol misuse and mental health problems, and to conduct a differential test of cultural stress theory in South and Central Florida to inform intervention development in each region. Based on our prior research and cultural stress theory, our central hypothesis is that families relocating to South Florida (a bilingual region where Latino cultural influences are celebrated) will experience less migration-related cultural stress and, consequently, enjoy greater family functioning and fewer alcohol misuse and mental health problems compared to those in Central Florida (an area with a relatively recent uptick in Puerto Rican and other Latino migration). The third objective focuses on ensuring—via engagement with stakeholders and participants—that study findings are effectively translated to real world practice. The scientific premise for this study is to inform efforts to support displaced Puerto Ricans and advance theorizing on disaster-related migration and health. We will pursue the following specific aims: [1] Describe the characteristics, experiences, and needs post-Maria Puerto Rican families in Florida; [2] Examine prospective relationships to test cultural stress theory across distinct resettlement contexts; and [3] Engage with stakeholders and participants to develop guidelines, best practices, and intervention recommendations for dissemination and testing in future research. The contribution of this study is significant because it lays groundwork for the development of evidence-based interventions for the needs of an at-risk group, and promises to answer context-specific questions central to the advancement of cultural stress theory and broader theorizing around migrant adaptation and key outcomes.