Community Engagement Core

项目摘要 波多黎各探索污染威胁试验场（Testsite for Exploring Contamination Threats，简称STRT）超级基金成立于2010年， 研究中心（SRC）使用研究，培训和利益相关者参与的整体系统来研究 污染物混合物的归宿、运输、接触、健康影响和补救， 分娩（PTB）和其他不良妊娠结局（APO）。波多黎各的PTB和婴儿死亡率 (PR)是美国所有州和地区中最高的。在2008年达到20%之后， PR在2017年下降至11.4%，但仍然是全球最高的PR之一。 接触超级基金化学品会导致APO。污染在PR中广泛存在：有18个 超级基金场地，饮用水污染的证据是广泛的。也有极端的 可能导致环境污染暴露增加的事件（飓风、洪水）。社区 参与核心（CEC），与人类受试者和采样核心（HSSC）密切合作，研究 翻译协调员和研究项目是与社区互动的主要工具 在PR. CITT的方法中，利益相关者强调与两个群体的双向参与， 利益相关者：1）参与CRTT研究队列的女性（1，457名参与者，1280名完成 截至2018年10月的怀孕人数，目标是再增加1000人）; 2）更广泛的居民群体 正在进行地下水研究的地区，包括 作为研究中心的社区卫生中心（CHC）和诊所。中央选举委员会与 HSSC与研究参与者、工作人员和CHCs的临床医生以及私人诊所建立了牢固的关系 诊所、健康教育工作者、社会工作者和护理人员以及社区团体。在此基础上， CEC将继续其强有力的双向沟通战略，包括会议和焦点小组 与参与者和临床工作人员一起，分发关于生殖和儿童问题的广泛教育材料， 健康，并向利益相关者报告研究结果，了解利益相关者的优先事项，需求， 性问题受参与者反馈的启发，我们将继续实施一个新的基于手机的互动式 这款应用程序允许向参与者提供个性化的报告。这一创新将：更充分地包括参与者， 研究过程，改善研究招募/保留，提供个人暴露减少信息， 并为社区参与性研究项目奠定基础。我们将广泛开展工作， 通过在应用程序中提供详细的建议行动，以及与项目4合作， （补救）以测试项目开发的水过滤器。CEC在提供水过滤器和 飓风后的紧急物资使联合国运输和技术援助中心更加值得信赖，我们将继续提供 应急准备培训/支助。我们将继续致力于参与者的能力建设， 保健提供者及其组织，以及开发孕产妇和儿童保健资源。

PROJECT SUMMARY Established in 2010, the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) Superfund Research Center (SRC) uses a holistic system of research, training and stakeholder engagement to study the fate, transport, exposure, health impact and remediation of contaminant mixtures, aimed at reducing preterm birth (PTB) and other adverse pregnancy outcomes (APOs). Rates of PTB and infant mortality in Puerto Rico (PR) are among the highest among all U.S. states and territories. After reaching 20% in 2008, the PTB rate in PR has decreased to 11.4% in 2017, yet continues to be among the highest globally Evidence exists that exposure to Superfund chemicals contributes to APOs. Contamination is extensive in PR: there are 18 Superfund sites, and evidence of contamination of the drinking water is extensive. There are also extreme events (hurricanes, flooding) that may result in elevated exposures to environmental pollution. The Community Engagement Core (CEC), working closely with the Human Subjects and Sampling Core (HSSC), the Research Translation Coordinator, and the research projects, is the main vehicle for interaction with community stakeholders in PR. PROTECT’s approach emphasizes bidirectional engagement with two groups of stakeholders: 1) women participating in the PROTECT study cohort (1,457 participants with 1280 completed pregnancies as of October 2018 with the goal of adding another 1000); and 2) the broader group of residents in the areas where PROTECT’s groundwater study is being conducted, including collaborators at the Community Health Centers (CHCs) and clinics that serve as study sites. The CEC’s continual connection with the HSSC has produced strong relationships with study participants, staff and clinicians at CHCs and private clinics, health educators, social work and nursing staff, and community groups. Building on this foundation, the CEC will continue its strong bidirectional communication strategy, which includes meetings and focus groups with participants and clinical staff, distribution of extensive educational materials on reproductive and child health, and report-back of research findings to stakeholders, informed by stakeholder priorities, needs, and concerns. Inspired by participant feedback, we will continue to implement a new interactive cell phone-based app that allows individualized report-back to participants. This innovation will: more fully include participants in the research process, improve study recruitment/retention, provide individual exposure reduction information, and lay the groundwork for community-based participatory research projects. We will work extensively on exposure reduction by providing detailed suggested actions in the app, and by working with Project 4 (Remediation) to test project-developed water filters. The CEC’s central role in providing water filters and emergency supplies post-hurricane has made PROTECT even more trusted, and we will continue to provide emergency preparedness training/support. We will continue work on capacity-building for participants, health care providers, and their organizations, as well as develop resources for maternal and child health.