Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Hubert Department of Global Health, Emory Rollins School of Public Health, Atlanta, GA, USA.
Disaster Med Public Health Prep. 2024 Sep 18;18:e138. doi: 10.1017/dmp.2024.102.
Severe weather events exacerbate existing health disparities due to poorly managed non-communicable diseases (NCDs). Our objective is to understand the experiences of staff, providers, and administrators (employees) of Federally Qualified Health Centers (FQHCs) in Puerto Rico and the US Virgin Islands (USVI) in providing care to patients living with NCDs in the setting of recent climate-related extreme events.
We used a convergent mixed-methods study design. A quantitative survey was distributed to employees at 2 FQHCs in Puerto Rico and the USVI, assessing experience with disasters, knowledge of disaster preparedness, the relevance of NCDs, and perceived gaps. Qualitative in-depth interviews explored their experience providing care for NCDs during recent disasters. Quantitative and qualitative data were merged using a narrative approach.
Through the integration of quantitative and qualitative data, we recognize: (1) significant gaps in confidence and preparedness of employees with a need for more training; (2) challenges faced by persons with multiple NCDs, especially cardiovascular and mental health disorders; and (3) most clinicians do not discuss disaster preparedness with patients but recognize their important role in community resilience.
With these results, we recommend strengthening the capacity of FQHCs to address the needs of their patients with NCDs in disasters.
恶劣天气事件加剧了由于非传染性疾病（NCDs）管理不善而导致的现有健康差距。我们的目标是了解波多黎各和美属维尔京群岛（USVI）的联邦合格健康中心（FQHCs）的员工、提供者和管理人员（员工）在最近与气候相关的极端事件背景下为患有 NCDs 的患者提供护理方面的经验。
我们使用了一种收敛混合方法研究设计。一项定量调查分发给波多黎各和 USVI 的 2 家 FQHC 的员工，评估他们在灾害方面的经验、灾害准备知识、NCDs 的相关性以及感知差距。定性深入访谈探讨了他们在最近的灾害中为 NCDs 患者提供护理的经验。使用叙述方法合并定量和定性数据。
通过整合定量和定性数据，我们认识到：（1）员工的信心和准备不足，需要更多的培训；（2）患有多种 NCDs 的人面临的挑战，尤其是心血管和心理健康障碍；（3）大多数临床医生不会与患者讨论灾难准备情况，但认识到他们在社区恢复力方面的重要作用。
根据这些结果，我们建议加强 FQHC 应对 NCD 患者在灾害中的需求的能力。
