Development of a vulnerability profile of the psychological sequelae of Hurricane

描述（由申请人提供）：10月28日，飓风桑迪袭击了美国东海岸，影响了5000多万人的生活和福祉。大纽约市地区受到飓风的严重袭击。飓风造成的心理破坏，以及流离失所、重大财产损失、洪水、发霉、长期缺热、缺水和缺电造成的精神健康后果不得而知。可以从保健提供者、急救人员、医院和收容所的轶事报告中得出估计数，但是，在心理健康影响的普遍程度方面缺乏可靠的数据。目前的研究旨在了解这场飓风的心理影响，以便为当前的干预和未来的预防工作提供信息。这个应用程序代表了一个大型医院系统，北岸- lij卫生系统（NSLIJHS）和拿骚县人类服务部之间的合作关系，拿骚县人类服务部是监督该县所有精神卫生机构的机构。NSLIJHS由16家医院组成，横跨拿骚县、萨福克县、皇后区、曼哈顿和斯塔顿岛，包括受飓风桑迪影响最严重的地区。当前项目的目标包括建立飓风暴露与各种心理健康症状和诊断之间的联系，同时确定最容易受到飓风心理健康影响的个人亚群体。我们将使用多种方法来完成这项工作，包括对居住在拿骚、萨福克、皇后区或里士满（斯塔顿岛）县的至少500人的调查数据，以及使用NSLIJHS组成部分的14个急诊科（ED）的数据。此外，我们还将利用调查数据调查各种流离失所策略对居民心理健康的影响，并将研究飓风对那些表示自己是第一响应者的人的心理影响。最终，我们的研究将产生两个重要的产品。首先是受飓风桑迪影响最严重的人在心理健康和福祉方面的脆弱性概况。该简介将附有表格和其他便于使用的图表和图表，供地方政府机构、精神卫生机构、应急准备机构、卫生保健工作者、以及国家心理健康和社会福利部（除其他外），以便继续针对受飓风严重影响和最易受其影响的人实施当前的干预战略，并通过指出在未来自然灾害期间在心理健康干预方面应优先考虑的地区和群体，为应急准备工作提供信息。二、我们的工作

DESCRIPTION (provided by applicant): On October 28th Hurricane Sandy hit the East Coast of the US, affecting the lives and wellbeing of more than 50 million people. The greater New York City area was heavily struck by the hurricane. The psychological devastation of the hurricane, along with the mental health consequences of being displaced, major loss of property, flooding, mold, prolonged lack of heat, water and power, are unknown. Estimates can be drawn from anecdotal reports from health providers, first responders, hospitals and shelters, however, reliable data is lacking in terms of the prevalence of psychological health effects. The current study aims to understand the psychological impact of this hurricane in an effort to inform current intervention and future prevention efforts. This application represents a partnership between a large hospital system, the North Shore-LIJ Health System (NSLIJHS), and the Nassau County Department of Human Services which is the agency that oversees all mental health agencies in the county. NSLIJHS consists of 16 hospitals spanning across Nassau county, Suffolk county, Queens, Manhattan and Staten Island, encompassing areas most affected by Hurricane Sandy. The goals of the current project include establishing associations between exposure to the hurricane and various mental health symptoms and diagnoses while also defining subgroups of individuals who were most vulnerable to mental health effects due to the hurricane. We will accomplish this using multiple methodologies including survey data from a cohort of at least 500 individuals who reside in Nassau, Suffolk, Queens or Richmond (Staten Island) counties as well as using Emergency Department (ED) data from the 14 EDs that are part of the NSLIJHS. Further, we will also investigate the impact of various displacement strategies on the mental health of residents using the survey data and we will examine the psychological impact of the hurricane on those who indicate that they are first responders. Ultimately, our research will result in two significant products. The first is a vulnerability profle of those most affected by Hurricane Sandy in terms of psychological health and wellbeing. This profile will be accompanied by tables and other user-friendly charts and diagrams for local government agencies, mental health agencies, emergency preparedness agencies, health care workers, and the NSLIJHS (among others) to use in order to continue to target current intervention strategies for those highly affected by the hurricane and most vulnerable to its effects as well as to inform emergency preparedness efforts by indicating areas and groups to prioritize in terms of mental health intervention during future natural disasters. Second, our work will produce a Hurricane Sandy cohort and database that can be tracked and followed over time. The database will be available to researchers and other key stakeholders in order to examine the long-term impact of hurricane exposure, to continue to provide important information as to emergency preparedness for future hurricanes and other natural disasters, as well as for community groups and those in the scientific emergency preparedness community to leverage additional funding for future research and intervention endeavors. Ultimately, we see this work as an integral first step toward the development of a NSLIJHS ED syndromic surveillance system as well as a first step towards the development of an Emergency Preparedness Research Center that will provide important and timely information to community groups and health care providers throughout the region. The goals of this proposal are feasible and reasonable because of the strong community linkages that already exist by all members of the research and Project Advisory Board team. We consulted with many community groups including members of government agencies, hospital administrators, community coalitions and network members among many others in the development of this project. Further, we have already confirmed its feasibility in the community given the successful pilot study that was conducted with 107 participants. We plan to work collaboratively with key stakeholders including our community partners during each step of the project from implementation through dissemination and translation. Our community partners are key to the efficacy of the project especially in terms of the dissemination of our research findings, vulnerability profile and cohort database. We will use multiple methods and media to effectively disseminate to key groups on both local and national levels. Further, given that one of the co-PIs is the Commissioner of the Department of Human Services and has strong connections to government agencies including emergency preparedness groups, mental health agencies and first responders throughout the affected region, we will easily be able to translate our findings into public health practice.