在一项针对金王矿泄漏事件后环境暴露研究的个体化结果报告的以迪内为中心的方法中，使用环境健康对话。
Using environmental health dialogue in a Diné-centered approach for individualized results reporting in an environmental exposure study following the Gold King Mine Spill.
机构信息
Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
Native Nations Institute at the Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, 85721, USA; Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
出版信息
Environ Res. 2023 Aug 15;231(Pt 2):116196. doi: 10.1016/j.envres.2023.116196. Epub 2023 May 19.
BACKGROUND
On August 5, 2015, the Gold King Mine Spill (GKMS) resulted in 3 million gallons of acid mine drainage spilling into the San Juan River impacting the Diné Bikeyah (traditional homelands of the Navajo people). The Gold King Mine Spill Diné Exposure Project was formed to understand the impacts of the GKMS on the Diné (Navajo). Reporting individualized household results in an exposure study is becoming more common; however, materials are often developed with limited community input with knowledge flowing in one direction - from researcher to participant. In this study we examined the development, dissemination, and evaluation of individualized results materials.
METHODS
In August 2016, Navajo Nation Community Health Representatives (Navajo CHRs) sampled household water, dust, and soil, and resident blood and urine for lead and arsenic, respectively. From May-July 2017, iterative dialogue with a wide range of community partners and a community focus groups guided the development of a culturally-based dissemination process. In August 2017, Navajo CHRs reported individualized results and they surveyed the participants on the report-back process at that time.
RESULTS
All of the 63 Diné adults (100%) who participated in the exposure study received their results by a CHR in person and 42 (67%) completed an evaluation. Most of those participants (83%) were satisfied with the result packets. Respondents ranked the individual and overall household results as the most important information they received (69% and 57%, respectively), while information on metals exposures and their health effects were the least helpful.
CONCLUSIONS
Our project illustrates how a model of environmental health dialogue, defined by iterative, multidirectional communication among Indigenous community members, trusted Indigenous leaders, Indigenous researchers, non-Indigenous researchers, can improve reporting individualized study results. Findings can inform future research to encourage multi-directional environmental health dialogue to craft more culturally responsive and effective dissemination and communication materials.
背景
2015 年 8 月 5 日，“黄金国王矿泄漏事件”（GKMS）导致 300 万加仑酸性矿山排水涌入圣胡安河，影响了 Diné Bikeyah（纳瓦霍人的传统家园）。为了了解 GKMS 对 Diné（纳瓦霍人）的影响，成立了“黄金国王矿泄漏 Diné 暴露项目”。在暴露研究中报告个别家庭的结果越来越常见；然而，材料通常是在社区投入有限的情况下开发的，知识是单向流动的——从研究人员流向参与者。在这项研究中，我们检查了个体化结果材料的开发、传播和评估。
方法
2016 年 8 月，纳瓦霍族社区卫生代表（纳瓦霍 CHR）分别对家庭用水、灰尘和土壤，以及居民血液和尿液进行采样，以检测铅和砷含量。2017 年 5 月至 7 月，与广泛的社区合作伙伴进行了迭代对话，并进行了社区焦点小组，为以文化为基础的传播过程提供了指导。2017 年 8 月，纳瓦霍族 CHR 报告了个体化结果，并在当时调查了参与者对报告反馈过程的看法。
结果
所有 63 名参与暴露研究的 Diné 成年人（100%）都由 CHR 亲自收到了他们的结果，其中 42 人（67%）完成了评估。大多数参与者（83%）对结果包表示满意。受访者将个人和整体家庭结果列为他们收到的最重要信息（分别为 69%和 57%），而有关金属暴露及其对健康影响的信息则最不有用。
结论
我们的项目说明了在印第安社区成员、受信任的印第安领袖、印第安研究人员、非印第安研究人员之间进行迭代、多方向沟通的环境健康对话模式如何能够改进报告个体化研究结果。调查结果可以为未来的研究提供信息，鼓励多方向的环境健康对话，制定更具文化响应性和有效的传播和沟通材料。
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