There were over 1000 deaths during the 2017 hurricane season in the United States, with the majority occurring in the territories of Puerto Rico and the U.S. Virgin Islands (USVI). Over a third of post-disaster mortality and morbidity was due to complications of non-communicable diseases such as hypertension, diabetes, and cardiovascular disease. With the rising frequency of natural disasters, there is an urgent need for feasible, acceptable, and effective emergency preparedness plans that will reduce morbidity and mortality related to non-communicable diseases after disasters. This is especially true for underserved, under-insured, minority populations that have historically suffered disproportionately after disasters. The proposed research will leverage the unique access of Federally Qualified Health Centers to underserved populations in the U.S. territories to develop both an organizational and disease-specific (i.e., hypertension, diabetes, heart failure) emergency preparedness plan. To achieve this objective, the candidate will use a mixed methods approach to evaluate existing emergency preparedness plans, engage key stakeholders to improve existing plans to address the management of non-communicable diseases after a natural disaster, and conduct a pilot study to test its feasibility and acceptability. This work will lay the foundation for developing a much-needed approach to saving lives and to reaching those populations most in need after a natural disaster. Dr. Hassan is a Medicine and Pediatrics trained physician whose research interest is in applying implementation science tools to design, implement, and evaluate interventions to reduce disparities in cardiovascular risk factors. She has worked with partners in the U.S. territories of Puerto Rico and the USVI for the past 2.5 years as Deputy Director of an NIH/NIMHD funded U54 (U54MD010711; lead PI Nunez-Smith). During this time, she has led a stakeholder engaged approach to implementing and evaluating a diabetes prevention intervention in clinical settings in both the USVI and Puerto Rico. The goal of this K23 proposal is to build on these experiences and provide Dr. Hassan with essential mentored training in mixed methods research, systems science, and disaster planning. These skills will provide her with expertise in methods that can be used to advance the field of implementation science and apply it to the pressing gaps in disaster planning for chronic disease management. This will position her well for future independent funding; enabling pursuit of her long-term goal of being an investigator with expertise in applying implementation science methods to reduce disparities in cardiovascular risk.
Hurricanes Irma and Maria in 2017 killed over 1000 people in the U.S. territories of Puerto Rico and the US Virgin Islands. One third of deaths after natural disasters have been attributed poorly managed chronic diseases such as diabetes and heart disease. This proposal will develop an emergency preparedness plan to reduce morbidity and mortality due to diabetes, hypertension, and heart failure after natural disasters in the U.S Virgin Islands and Puerto Rico.
