在阿斯托尔地区推广气候变化干预措施以扩大抗灾韧性 (PICCTURE)
阿斯托尔地区推广气候变化干预措施以升级韧性的试验（PICCTURE）
研究概览
详细说明
阿斯特尔区位于吉尔吉特-巴尔蒂斯坦的山区，极易受到气候相关风险的影响，包括冰川湖溃决洪水（GLOFs）、山体滑坡、极端天气事件和气温上升。其崎岖的地形、地理隔离、对气候敏感生计的依赖以及有限的基础设施加剧了环境冲击对健康和社会经济状况的影响。这些脆弱性使阿斯特尔成为评估旨在加强社区韧性的可扩展干预措施的合适环境。
本研究是一项三臂群组随机对照试验，其中群组为村庄或村庄群。从所有可用群组中，将随机选取30个群组并平均分配到三个研究臂。在每个群组内，通过简单随机抽样从完整的住户名单中选取住户。
本研究包括两个干预臂和一个对照臂。第一个干预臂通过村庄管理委员会（VMCs）开展结构化、社区主导的适应和韧性活动，VMCs由当地利益相关者代表组成。第二个干预臂在此基础上，正式纳入女性卫生工作者（LHWs）和初级医疗保健提供者（HCPs），以加强健康相关组成部分、改善服务联系并增强对弱势群体的覆盖。对照臂不接收额外的干预投入。
干预内容基于先前的脆弱性评估，包括灾害防备和应对、生计多样化、金融素养和健康意识方面的培训和能力建设活动。这些活动通过参与式小组会议、模拟演练和社区动员活动进行，为期一年。培训频率包括初始阶段的月度会议，随后改为双月会议，课程内容根据当地情况进行了调整。
主要结果是灾害韧性指数（DRI）和多维生计脆弱性指数（MLVI）在基线和终点的变化。次要结果包括粮食安全、饮食多样性、心理健康、发病率和死亡率。过程指标评估干预实施、参与度以及社区层面的防备机制，如应急计划和财务应对策略。
数据收集通过基线和终点的横截面住户调查进行，采用电子数据采集系统。分析遵循意向性治疗原则，应用混合效应回归模型以考虑社区层面的聚集效应。将使用双重差分（DID）估计来评估干预效果随时间的变化，同时调整相关协变量。
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名：Akber Ali, Masters
- 电话号码：+92-307-777-1403
- 邮箱：akber.ali@aku.edu
研究联系人备份
- 姓名：Dr. Jai Kumar Das, PhD
- 电话号码：0213486 69826
- 邮箱：jai.das@aku.edu
学习地点
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Sindh
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Karachi、Sindh、巴基斯坦、74800
- 招聘中
- Aga Khan University
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接触：
- Akber Ali, Masters
- 电话号码：+92-307-777-1403
- 邮箱：akber.ali@aku.edu
-
接触：
- Dr. Jai Kumar Das, PhD
- 电话号码：0213486 69826
- 邮箱：jai.das@aku.edu
-
首席研究员：
- Dr. Jai Kumar Das, PhD
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
纳入标准：
选定研究区域的永久居民 年龄18岁及以上 愿意提供知情同意
排除标准：
未提供知情同意的人员 临时居民或非研究区域的居民
学习计划
研究是如何设计的？
设计细节
- 主要用途：预防
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：社区干预 (CI)
集群通过乡村管理委员会（VMCs）接受一套结构化的社区主导适应与韧性干预包。\n活动包括减少灾害风险、生计多样化、金融素养和健康意识的培训及参与式会议。\n会议采用参与式学习方法进行，以增强家庭和社区的适应能力。
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A structured package of community-led activities delivered through Village Management Committees, including participatory training on disaster risk reduction, livelihood diversification, financial literacy, and health awareness to strengthen household and community resilience.
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实验性的：社区+初级保健干预（CHI）
各群体接受与第1组相同的社区干预措施，额外包括女性健康工作者和初级医疗保健提供者的参与。
卫生系统参与者支持提供与健康相关的组成部分，促进就医行为，并加强社区与卫生服务之间的联系，以增强韧性成果。
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A structured package of community-led activities delivered through Village Management Committees, including participatory training on disaster risk reduction, livelihood diversification, financial literacy, and health awareness to strengthen household and community resilience.
Lady Health Workers and primary healthcare providers to reinforce interventions delivered through VMCs and strengthen linkages between communities and health services.
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无干预：对照组
在试验期间，集群除了现有服务和标准条件外，不会得到任何额外干预。
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Household vulnerability
大体时间：At baseline and endline (12 month)
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Household vulnerability will be assessed using the Multidimensional Livelihood Vulnerability Index (MLVI), a validated composite measure capturing susceptibility to shocks across three domains.
Adaptive Capacity reflects the ability to cope with and adjust to stressors, including access to resources, livelihood diversity, and social support.
Sensitivity captures the degree to which households are affected by shocks, based on their wellbeing, health, food and water security, and environmental conditions.
Exposure measures the extent to which households experience environmental and socio-economic shocks that threaten livelihoods.
The score ranges from 0 to 1, with higher values indicating greater household vulnerability.
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At baseline and endline (12 month)
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Household disaster resilience (DRI)
大体时间：At baseline and endline (12 month)
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Household disaster resilience will be assessed using the Disaster Resilience Index (DRI), a validated multidimensional composite measure of a household's ability to withstand, adapt to, and recover from shocks.
The DRI comprises three domains: Coping Capacity, reflecting baseline resources and conditions that enable immediate response; Adaptive Capacity, capturing the ability to adjust and respond effectively through access to systems, resources, and support; and Transformative Capacity, measuring longer-term potential to learn, improve, and strengthen resilience over time.
The score ranges from 0 to 1, with higher values indicating greater household resilience.
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At baseline and endline (12 month)
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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"粮食安全"
大体时间：在基线和终末阶段（12个月）
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食品安全将使用由粮食与营养技术援助项目（FANTA）制定的《家庭粮食不安全获取量表》（HFIAS）进行评估。
HFIAS是一种标准化工具，用于衡量过去四周内家庭对食物的获取情况，生成连续评分（范围：0-27分），分数越高表示粮食不安全程度越严重。
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在基线和终末阶段（12个月）
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Mental Health
大体时间：At baseline and endline (12 month)
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Mental health and psychological resilience will be accessed by Psychological Trauma index focused on post-traumatic stressful symptoms following climate related shocks. Mental health and psychological resilience will be assessed using the Psychological Trauma Index, a structured questionnaire measuring post-traumatic stress symptoms following climate related shocks. The index includes six items covering intrusive memories, emotional distress, avoidance, social withdrawal, irritability, and concentration difficulties. Each item is scored on a 5-point Likert scale (1 = Not at all, 5 = Very Frequently). Total scores range from 6 to 30, with higher scores indicating worse outcomes (greater severity of trauma symptoms). Lower scores reflect fewer symptoms and better psychological resilience. |
At baseline and endline (12 month)
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Household dietary diversity
大体时间：At baseline and endline (12 month)
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Dietary diversity will be measured using the Household Dietary Diversity Score (HDDS), following FAO guidelines.
The HDDS is based on a 24-hour recall of foods consumed from 12 standard food groups (cereals, roots/tubers, vegetables, fruits, meat, eggs, fish, legumes/nuts, milk/dairy, oils/fats, sugar/honey, and miscellaneous).
Scores on the Household Dietary Diversity Score range from 0 to 12, with higher values indicating better outcomes (greater dietary diversity and improved household food access).
A score of 0 reflects no food group consumption in the recall period, while a score of 12 reflects consumption from all food groups
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At baseline and endline (12 month)
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Financial Literacy
大体时间：At baseline and endline (12 month)
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Financial literacy will be assessed through structured survey questions on access to financial services (e.g., household members with bank accounts), insurance coverage, savings and borrowing practices, bill payment regularity, expense planning, and ability to meet emergency needs.
Outcomes will be reported as individual indicators (counts and proportions)
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At baseline and endline (12 month)
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Household Disaster Preparedness
大体时间：At baseline and endline (12 month)
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Household disaster preparedness will be assessed through structured survey questions covering awareness of disaster management, integration of preparedness knowledge into household plans, availability of emergency supplies, evacuation knowledge, prior preparedness actions, and exposure to community training or organizations involved in disaster response.
Outcomes will be reported as individual indicators (counts and proportions)
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At baseline and endline (12 month)
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Health Knowledge and Practices
大体时间：At baseline and endline (12 month)
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Health knowledge and practices will be assessed using a structured questionnaire evaluating knowledge and reported practices related to climate-sensitive health risks.
Responses will be summarized as count and proportions
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At baseline and endline (12 month)
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合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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