Understanding the needs of Post Maria PR Migrants in New Growth Communities

项目摘要 飓风玛丽亚过后三年多，近13万波多黎各人--占该岛人口的4%-- 已经永久性地搬到了美国，大多数人定居在佛罗里达。许多玛丽亚幸存者正在重新安置 到佛罗里达的新发展社区寻找更好的工作机会和负担得起的住房。先前 研究表明，波多黎各人的精神疾病发病率明显上升， 在美国，波多黎各人和其他西班牙裔/拉丁裔群体之间存在心理健康差异。 与居住在佛罗里达中部的波多黎各人的关系表明， 增加心理困扰和抑郁的风险。初步证据表明， 幸存者受到飓风和在美国重新安置过程的负面影响。 研究发现，重新安置到佛罗里达的幸存者有明显更高的创伤后压力率 与那些留在岛上的人相比，他们更有可能符合PTSD诊断的标准。 飓风玛丽亚幸存者也更有可能经历文化压力，紧张的家庭关系， 减少获取资源的机会。然而，关于心理健康的影响， 飓风和流离失所到美国，特别是在波多黎各人搬迁到新的增长 大城市以外的社区。通过这项研究，我们将进一步了解飓风 目标1：利用定性研究来检查受害者的心理状况， 按地点分列的玛丽亚幸存者家庭的保健需求。我们将进行深入的定性访谈， 新成长社区和有波多黎各历史的社区的父母-青年（10-20岁）二人组 波多黎各/拉丁美洲移民。目的2：采用前瞻性调查比较精神卫生保健需求 生活在新增长社区的玛丽亚幸存者家庭与生活在有波多黎各历史的社区的玛丽亚幸存者家庭相比， 哥斯达黎加/拉丁美洲移民，从而促进了文化压力理论的测试。目标3：与心理接触 卫生从业人员和社区领导人在新的增长社区传播我们的研究结果， 以满足玛丽亚幸存者家庭的心理健康需求。本研究将使用一种收敛混合- 方法设计比较定性和定量数据。我们将收集定量和定性数据 同时（并行）进行数据分析。我们将比较定量和 定性结果，以进行综合分析，并确定是否存在趋同或分歧 之间的结果得到。该提案的总体目标是为循证医学的发展提供信息， 采取干预措施，减少曾接触过酒精的家庭之间的心理健康和酒精滥用差异 自然灾害考虑到未来几年与气候有关的移民预计会增加，这项工作是 特别重要和及时。

Project Summary More than three years after Hurricane Maria, close to 130,000 Puerto Ricans—4% of the island’s population— have permanently relocated to the U.S., with the majority settling in Florida. Many Maria survivors are relocating to new-growth communities in Florida in search of better job opportunities and affordable housing. Previous research has shown that rates of psychiatric disorders are markedly elevated among Puerto Ricans and a clear mental health disparity exists between Puerto Ricans and other Hispanic/Latino groups in the U.S. Research with Puerto Ricans living in Central Florida indicates that higher levels of cultural stress are associated with increased risk of psychological distress and depression. Initial evidence suggests that the mental health of survivors has been negatively impacted by the hurricane and the process of resettling in the U.S. Recent research has found that survivors who relocated to Florida had significantly higher rates of posttraumatic stress and were more likely to meet the criteria for PTSD diagnosis, compared to those who remained on the island. Hurricane Maria survivors are also more likely to experience cultural stress, strained family relations, and diminished access to resources. Yet, pressing questions remain regarding the mental health impact of the hurricane and displacement to the U.S., particularly among the Puerto Ricans relocating to new-growth communities outside of large urban areas. Through this study we will advance our understanding of Hurricane Maria survivor families by addressing the following aims: Aim 1: Use qualitative research to examine the mental health care needs of Maria survivor families, by location. We will conduct in-depth qualitative interviews with parent-youth (aged 10-20) dyads in new-growth communities and in communities with a history of Puerto Rican/Latin American migration. Aim 2: Employ prospective surveys to compare the mental health care needs of Maria survivor families living in new-growth communities to those in communities with a history of Puerto Rican/Latin American migration, thereby facilitating a test of cultural stress theory. Aim 3: Engage with mental health practitioners and community leaders in new-growth communities to disseminate our findings in an effort to address the mental health care needs of Maria survivor families. This study will use a convergent mixed- methods design to compare qualitative and quantitative data. We will collect quantitative and qualitative data simultaneously (in parallel), and conduct the data analyses separately. We will compare the quantitative and qualitative results to produce an integrated analysis and identify whether there was convergence or divergence between the results obtained. The overall goal of this proposal is to inform the development of evidence-based interventions to reduce mental health and alcohol misuse disparities among families who have been exposed to natural disasters. Given the expected rise in climate-related migration in the coming years, this work is particularly relevant and timely.