危地马拉的塑料废物和人类健康影响 (Ecolectivos)

实验性的：社区工作组

15 岁以上的女性参与者被随机分配到干预组，将参加为期 12 周的工作组会议，讨论塑料废物问题，并介绍减少使用、回收和重新利用塑料的策略。 干预小组参与者的社区成员也将被邀请参加工作组。

行为的：社区工作组

干预措施包括12周内教育工作组（WG）会议。 八个核心模块讨论基本要素（例如固体废物管理的主要问题，暴露于燃烧塑料的健康影响，可持续的塑料垃圾替代品）和四个外围模块，以帮助识别社区驱动的干预措施，以减少家庭火灾中的塑料燃烧，消耗较少的塑料，回收，回收和重新释放塑料，将持有。

参与者将在接下来的9个月内优先考虑一项任务，并在社区工作者（Propertoras）的指导下，例如：

• 参与社区清理
• 开始一个有机堆肥，没有塑料废物
• 培训社区回收，专注于塑料回收
• 制作有机肥皂，用于个人修饰或洗衣服，消除塑料包装
• 用塑料制作材料，例如瓶花盆

其他名称：

• 干预组

无干预：对照组。

在干预小组的干预活动期间，对照村庄的参与者将获得小树造林。

PM2.5 exposure

Air pollution exposure will be assessed using repeated 24-hour measurements. This study will compare differences in personal PM2.5 exposure among women participating in the two study arms.

Black carbon (BC) exposure

Air pollution exposure will be assessed using repeated 24-hour measurements. This study will compare differences in personal BC exposure among women participating in the two study arms.

Urinary bisphenols

To assess urinary biomarkers of exposure to plastic combustion, this study will compare differences in bisphenol concentrations among women participating in the two study arms.

Urinary phthalates

To assess urinary biomarkers of exposure to plastic combustion, this study will compare differences in phthalate concentrations among women participating in the two study arms.

Urinary polycyclic aromatic hydrocarbons (PAHs)

To assess urinary biomarkers of exposure to combustion by-products, including plastic, this study will compare differences in PAH concentrations among women participating in the two study arms.

使用RE-AIM实施科学框架的干预覆盖范围

运用Reach（覆盖范围）、Effectiveness（有效性）、Adoption（采纳度）、Implementation（实施）、Maintenance（维持）的实施科学框架（RE-AIM），评估干预组中干预措施的覆盖范围，通过以下指标衡量：1）受邀参与者中参加工作小组的人数及比例；2）参与者的家庭成员中参与工作小组活动的人数及比例；3）干预村成员中参与工作小组活动的人数。

基于RE-AIM实施科学框架的干预有效性

运用RE-AIM实施科学框架（涵盖覆盖范围、有效性、采纳度、实施度及维持度），通过统计报告行为改变的干预组参与者数量来评估干预措施的有效性。 这些行为改变根据工作小组出席率、活动参与度及报告减少塑料燃烧情况等因素，被归类为“高”或“低”行为。

使用RE-AIM实施科学框架分析干预措施采纳的促进因素与障碍因素

运用实施科学领域的RE-AIM框架（覆盖度、效果、采纳度、实施度、维持度），通过焦点小组访谈及参与者与环境健康促进员访谈收集的定性数据，评估干预措施采纳过程中的促进因素与阻碍因素。 这将有助于识别影响村庄层面干预措施采纳情况的相关因素。 无度量单位。

采用RE-AIM实施科学框架通过直接观察来采纳干预措施

运用覆盖范围、有效性、采纳度、实施度和维持度（RE-AIM）实施科学框架，通过直接观察干预活动评估干预措施的采纳情况，并采用定性数据分析方法评估社区层面的实施程度。 无度量单位。

采用RE-AIM实施科学框架维持干预措施

采用实施科学框架——覆盖、效果、采纳、实施和维持（RE-AIM），从参与者、家庭和村庄层面评估干预策略的维持情况（即干预策略的持续实施），具体通过以下指标衡量：1）报告不再在家庭火灾中焚烧塑料的参与者数量及比例（作为“停止采纳”的衡量指标）；2）在工作组结束后，村庄层面继续参与干预活动的家庭数量及比例；以及3）在干预组的工作组结束后，社区内独立维持或建立类似干预活动的社区成员及组织数量。

Health-related Quality of Life (HRQOL) Score

Using the HRQOL instrument, compare differences in quality of life among women participating in the two study arms. The HRQOL consists of 4 questions measuring: a) overall general health (5 items- excellent, very good, good, fair, or poor; used independently, ordinal outcome); b) number of days physical health was not good in the last 30 days; c) number of days mental health was not good in the last 30 days (b and c are summed together, not to exceed 30 days, continuous outcome); and d) number of days poor physical or mental health limited daily activities in the last 30 days (used independently, continuous outcome). Higher scores typically represent poorer health and quality of life, with individuals reporting more health-related problems and worse functioning in daily activities, mental well-being, and social interactions. Lower scores suggest better health status, with individuals reporting fewer limitations or challenges in their physical, emotional, or social well-being.

Household Decision Making

Using a 7-part instrument, compare differences in household decision-making (e.g., spending earned money, major and minor purchases, job decisions, cooking foods, visiting others) among women participating in the two study arms. The responses are coded on a 4-point scale (respondent's sole decision; husband's decision; joint decision between respondent and husband; other family member makes decision). Scores range from 7 to 28; the lower the score, the greater the woman's agency to make household decisions.

New General Self-Efficacy Scale (NGSE) Score

Using the New General Self-Efficacy Scale (NGSE), an 8-part instrument, compare differences in self-efficacy (e.g., problem-solving, goal setting, confidence, resourcefulness) among women participating in the two study arms. Each item is rated on a 5-point scale (strongly disagree; disagree; neither agree nor disagree; agree; strongly agree). NGSE scores range from 5 to 40; the higher the score, the greater the individual's generalized self-efficacy belief.

Short Social Capital Assessment Tool (SASCAT) Score

Using the 12-part Short Social Capital Assessment Tool, compare differences in group membership, citizenship, and cognitive social capital (trust) among women participating in the two study arms. Responses are Yes/No, and scoring ranges from 0-37. The responses are summed to calculate a total social capital score, with higher scores indicating higher levels of social capital, signifying more support, trust, and participation in community networks.

Community Mobilization Scale Score

Using the Community Mobilization Scale, compare differences in the Critical Consciousness sub-scale (modified 9-item instrument) and the Collective Action sub-scale (modified 2-item instrument) among women participating in the two study arms. The Critical Consciousness sub-scale score is measured using a 3-point Likert scale (agree, somewhat agree, disagree; scores ranging from 9-27, measured continuously). The Collective Action sub-scale asks about the number of times the participant and community have worked on community problems in the last 3 months and is measured continuously. For both scales, higher scores indicate higher levels of mobilization.

Quantification of emissions estimates of air pollutants from plastic incineration.

Using filter-based antimony (Sb) and 1,3,5-Triphenylbenzene (TPB) as tracers of plastic burning and collecting household plastic waste, apportion PM2.5 and quantify emissions estimates of air pollutants from plastic incineration and assess effects of potential emissions reduction on air quality with a chemical transport model.

Urinary bisphenols

To assess urinary biomarkers of exposure to plastic combustion, this study will compare differences in bisphenol concentrations among women participating in the two study arms.

Urinary phthalates

To assess urinary biomarkers of exposure to plastic combustion, this study will compare differences in phthalate concentrations among women participating in the two study arms.

Urinary polycyclic aromatic hydrocarbons (PAHs)

To assess urinary biomarkers of exposure to combustion by-products, including plastic, this study will compare differences in PAH concentrations among women participating in the two study arms.

Urinary volatile organic compounds (VOCs)

To assess urinary biomarkers of exposure to combustion by-products, including plastic, this study will compare differences in VOC concentrations among women participating in the two study arms.