SCC-CIVIC-PG Track B: Community-Based Research meets Systems Approach: Closing the Loop on Child Lead Poisoning

即使在了解铅暴露途径的社区，向受影响最严重的个人提供资源也存在重大障碍。在获得医疗保健方面的这些差距导致了代际劣势，因为面临铅中毒的家庭不成比例地由居住在低收入社区的少数族裔组成。这项公民研究是基于社区的研究和技术驱动的框架的交汇点。这项研究的目标是了解如何弥合家庭、医疗保健提供者和政策制定者之间的沟通差距。这有可能增加及时获得医疗保健的机会，并通过开发一款应用程序实现快速和积极的干预，将所有相关各方联系在一起，以改善护理协调，以防止儿童铅中毒。最初的目标社区是印第安纳州的圣约瑟夫县。这项研究让所有相关利益攸关方参与铅中毒的诊断、干预和补救/减轻过程。这项工作的更广泛影响包括改善低收入社区儿童的健康状况，减少铅中毒，以及工程和化学本科生的参与和培训。学生将参与编写可利用的教育材料，告知家庭铅暴露的风险，特别是在儿童中，目的是帮助社区成员确定和寻求铅评估/消除资源，以保护其亲人的健康。参与第一阶段和后续第二阶段计划的学生团队，如果获得资助，将获得体验式学习机会，并与社区合作，将社区挑战转化为问题陈述，并帮助实施可能的解决方案。研究成果、开发的技术和信息材料将可推广到美国其他土壤和家庭铅浓度较高的地方。尽管基于社区的参与性研究鼓励多学科案例审查小组评估干预措施的有效性，但目前对个人、社区、提供者和系统因素之间的关系的了解还不够深入。这妨碍了制定降低风险策略、改善临床路径和消除护理障碍所需的关键洞察力。在公民阶段1规划期间，将召集一个由社区成员、保健提供者、研究人员和政策制定者组成的跨学科和多方利益攸关方小组，以了解目标社区以及每个小组在结束儿童铅检测循环和将家庭与提供减排干预措施的资源联系起来方面所具有的重叠作用和责任。这些设计思考会议和讨论将为部署社区卫生工作者提供框架，他们直接与受影响的社区合作，并以应用程序的形式提供信息和技术解决方案，该应用程序将由社区和大学研究人员共同设计，作为试点项目的一部分。在接下来的第二阶段项目中，应用程序和确定的解决方案将通过试点计划与先前开发的低成本Lead筛查工具包的性能一起部署和评估。技术社会学框架将使人们能够更好地了解边缘化患者的声音是否以及如何被倾听、理解和采取行动。该项目是对公民创新挑战计划的响应-轨道B-弥合基本资源和服务以及社区需求之间的差距-是NSF、国土安全部和能源部的合作。该奖项反映了NSF的法定使命，并通过使用基金会的智力优势和更广泛的影响审查标准进行评估，被认为值得支持。

Even in communities where lead (Pb) exposure pathways are well understood, there are significant barriers to getting resources to the most affected individuals. These disparities in access to healthcare lead to a generational disadvantage as the households that face lead poisoning are disproportionately composed of racial minorities that live in low-income neighborhoods. This CIVIC research is at the intersection of community-based research and technology-driven frameworks. The goal of this research is to understand how to close communication gaps among households, healthcare providers, and policymakers. This has the potential to increase access to in-time health care, and enables quick and aggressive interventions via an app to be developed to tie all relevant parties together to improve the coordination of care to prevent child lead poisoning. The initial target community is St. Joseph County, Indiana. The research engages all relevant stakeholders in the process of lead poisoning diagnosis, intervention, and remediation/abatement. Broader impacts of the work include better health outcomes and less lead poisoning in children from low-income neighborhoods as well as engagement and training of engineering and chemistry undergraduate students. Students will be involved in developing accessible educational materials to inform households about the risks of lead exposure, especially in children, with the goal of helping community members identify and pursue lead assessment/abatement resources to protect the health of their loved ones. Student teams involved in the Stage 1 and follow-on Stage 2 program, if funded, will receive experiential learning opportunities and work with communities to translate community challenges into problem statements and help with the implementation of possible solutions. Research findings and developed technologies and informational materials will be scalable to other localities in the US and elsewhere with high soil and home lead concentrations.Although Community-Based Participatory Research encourages multidisciplinary case review teams to evaluate the effectiveness of interventions, an understanding of the relationship between individual, community, provider, and system factors is presently underexplored. This prevents the critical insight necessary to create risk reduction strategies, improve clinical pathways, and eliminate barriers to care. Through the CIVIC Stage 1 planning period, an interdisciplinary and multi stakeholder group of community members, health providers, researchers, and policymakers will be convened to understand the targeted community and the overlapping roles and responsibilities that each group has in closing the loop of lead detection in children and connecting households to resources that provide abatement interventions. These design thinking sessions and discussions will inform a framework for deploying community health workers, who work directly with impacted communities, and provide informational and technological solutions in the form of an app which will be co-designed by the community and university researchers as part of the pilot project. In the following Stage 2 project, the app and identified solutions will be deployed and evaluated alongside the performance of a previously developed, low-cost, lead, screening kit through a pilot program. The techno-sociological framework will enable a greater understanding about if and how the voices of marginalized patients are being heard, understood, and acted upon. This project is in response to the Civic Innovation Challenge program—Track B. Bridging the gap between essential resources and services & community needs—and is a collaboration between NSF, the Department of Homeland Security, and the Department of Energy.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.