Web and paper survey mode patterns and preferences, Health & Employment Survey, World Trade Center Health Registry

Purpose The purpose of this paper is to evaluate the effectiveness of a targeted outreach program that referred World Trade Center Health Registry (Registry) enrollees, to specific post-disaster health care available through the World Trade Center Health Program (WTCHP) and evaluate differences in outreach effectiveness based on demographic and health characteristics. Design/methodology/approach The Registry’s Treatment Referral Program (TRP) targeted 22,981 enrollees based on symptoms and conditions known to be related to 9/11, reported on a 2011-2012 follow-up survey. A call vendor was utilized for the initial outreach phone call. Enrollees who requested a WTCHP application had follow-up from TRP staff, which typically included 4-6 interactions per enrollee until outreach was completed. Findings As of 12/31/2015, the vendor had reached 8,778 (38 percent) of the targeted sample. TRP staff spoke to 6,016 (68 percent) enrollees reached by the vendor, 5,554 (92 percent) of whom requested a WTCHP application, and 2,425 (43 percent) reported having submitted the WTCHP application. Application requests and submissions differed by survivor or responder status, race, income and health symptoms. Originality/value Registries created for surveillance and research among disaster-exposed populations provide a unique and effective outreach approach. A dedicated treatment referral unit within a disaster registry is an effective means for conducting post-disaster outreach to a large, diverse sample of exposed individuals.

Download Full-text

Post-9/11 Mental Health Comorbidity Predicts Self-Reported Confusion or Memory Loss in World Trade Center Health Registry Enrollees

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17197330 ◽

2020 ◽

Vol 17 (19) ◽

pp. 7330

Author(s):

Howard E. Alper ◽

Rifat A. Tuly ◽

Kacie Seil ◽

Jennifer Brite

Keyword(s):

Mental Health ◽

World Trade ◽

World Trade Center ◽

Memory Loss ◽

Health Conditions ◽

Mental Health Conditions ◽

Binomial Regression ◽

Trade Center ◽

Health Registry ◽

World Trade Center Attacks

Numerous studies report elevated levels of chronic mental health conditions in those exposed to the World Trade Center attacks of 11 September 2001 (9/11), but few studies have examined the incidence of confusion or memory loss (CML) or its association with mental health in 9/11 attack survivors. We investigated the incidence of CML and its association with the number of post-9/11 mental health conditions (PTSD, depression, and anxiety) in 10,766 World Trade Center Health Registry (Registry) enrollees aged 35–64 at the time of the wave 4 survey (2015–2016) that completed all four-wave surveys and met the study inclusion criteria. We employed log-binomial regression to evaluate the associations between CML and the number of mental health conditions. A total of 20.2% of enrollees in the sample reported CML, and there was a dose-response relationship between CML and the number of mental health conditions (one condition: RR = 1.85, 95% CI (1.65, 2.09); two conditions: RR = 2.13, 95% CI (1.85, 2.45); three conditions: RR = 2.51, 95% CI (2.17, 2.91)). Survivors may be experiencing confusion or memory loss partly due to the mental health consequences of the 9/11 attacks. Clinicians treating patients with mental health conditions should be aware of potential cognitive impairment.

Download Full-text

An Overview of 9/11 Experiences and Respiratory and Mental Health Conditions among World Trade Center Health Registry Enrollees

Journal of Urban Health ◽

10.1007/s11524-008-9317-4 ◽

2008 ◽

Vol 85 (6) ◽

pp. 880-909 ◽

Cited By ~ 159

Author(s):

Mark Farfel ◽

Laura DiGrande ◽

Robert Brackbill ◽

Angela Prann ◽

James Cone ◽

...

Keyword(s):

Mental Health ◽

World Trade ◽

World Trade Center ◽

Health Conditions ◽

Mental Health Conditions ◽

Trade Center ◽

Health Registry

Download Full-text

Hurricane Sandy Evacuation Among World Trade Center Health Registry Enrollees in New York City

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2016.57 ◽

2016 ◽

Vol 10 (3) ◽

pp. 411-419 ◽

Cited By ~ 2

Author(s):

Shakara Brown ◽

Lisa M. Gargano ◽

Hilary Parton ◽

Kimberly Caramanica ◽

Mark R. Farfel ◽

...

Keyword(s):

New York ◽

Physical Health ◽

World Trade ◽

World Trade Center ◽

Hurricane Sandy ◽

Adverse Outcomes ◽

Community Cohesion ◽

Poor Physical Health ◽

Trade Center ◽

Health Registry

AbstractObjectiveTimely evacuation is vital for reducing adverse outcomes during disasters. This study examined factors associated with evacuation and evacuation timing during Hurricane Sandy among World Trade Center Health Registry (Registry) enrollees.MethodsThe study sample included 1162 adults who resided in New York City’s evacuation zone A during Hurricane Sandy who completed the Registry’s Hurricane Sandy substudy in 2013. Factors assessed included zone awareness, prior evacuation experience, community cohesion, emergency preparedness, and poor physical health. Prevalence estimates and multiple logistic regression models of evacuation at any time and evacuation before Hurricane Sandy were created.ResultsAmong respondents who evacuated for Hurricane Sandy (51%), 24% had evacuated before the storm. In adjusted analyses, those more likely to evacuate knew they resided in an evacuation zone, had evacuated during Hurricane Irene, or reported pre-Sandy community cohesion. Evacuation was less likely among those who reported being prepared for an emergency. For evacuation timing, evacuation before Hurricane Sandy was less likely among those with pets and those who reported 14 or more poor physical health days.ConclusionsHigher evacuation rates were observed for respondents seemingly more informed and who lived in neighborhoods with greater social capital. Improved disaster messaging that amplifies these factors may increase adherence with evacuation warnings. (Disaster Med Public Health Preparedness. 2016;10:411–419)

Download Full-text

Respiratory Health Outcomes And Home Conditions Of Lower Manhattan Residents Enrolled In The World Trade Center Health Registry

10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a6057 ◽

2012 ◽

Author(s):

Vinicius Antao ◽

L. Lászlo Pallos ◽

Youn Shim ◽

James Sapp II ◽

Robert Brackbill ◽

...

Keyword(s):

Health Outcomes ◽

World Trade ◽

Respiratory Health ◽

World Trade Center ◽

The World ◽

Lower Manhattan ◽

Trade Center ◽

Health Registry ◽

Home Conditions

Download Full-text

Air Pollution/Irritants Trigger and Factors Associated with Asthma Control and Quality of Life Among World Trade Center Health Registry Enrollees with Asthma

10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a2500 ◽

2019 ◽

Author(s):

J. Yung ◽

S. Osahan ◽

S. Friedman ◽

J. Cone

Keyword(s):

Quality Of Life ◽

Air Pollution ◽

Asthma Control ◽

World Trade ◽

World Trade Center ◽

Factors Associated ◽

Trade Center ◽

Health Registry

Download Full-text

A Cognitive Reserve and Social Support-Focused Latent Class Analysis to Predict Self-Reported Confusion or Memory Loss among Middle-Aged World Trade Center Health Registry Enrollees

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16081401 ◽

2019 ◽

Vol 16 (8) ◽

pp. 1401 ◽

Cited By ~ 2

Author(s):

Kacie Seil ◽

Shengchao Yu ◽

Howard Alper

Keyword(s):

Social Support ◽

Latent Class Analysis ◽

World Trade ◽

Cognitive Reserve ◽

Latent Class ◽

World Trade Center ◽

Memory Loss ◽

Trade Center ◽

Health Registry ◽

Ptsd Group

The World Trade Center Health Registry includes 9/11 survivors who have been surveyed about their health conditions over time. The prevalence of posttraumatic stress disorder (PTSD) remains high among the cohort and is a risk factor for cognitive impairment or dementia. We thus sought to examine the degree to which confusion or memory loss (CML)—potential symptoms of cognitive decline—are occurring among enrollees aged 35–64 years. Cognitive reserve theory suggests that higher levels of education and engaging in cognitively challenging activities can create stronger neural connections, offering protection against cognitive decline. We hypothesized that enrollees with less cognitive reserve would be more likely to report CML. In this study, we: (1) estimated the incidence of CML in our study sample; (2) identified indicators of cognitive reserve (e.g., indicators of educational attainment, social support); and (3) determined whether CML is associated with cognitive reserve level, stratified by PSTD status. First, we described demographics of the study sample (n = 14,574) and probable PTSD status, also stratifying by CML. Next, we conducted a latent class analysis on two groups: those with probable PTSD and those without probable PTSD, creating classes with varying cognitive reserve levels. Finally, using adjusted log binomial models, we predicted risk of CML based on cognitive reserve level. The probable PTSD group (n = 1213) and not probable PTSD group (n = 13,252) each had four latent classes: low, medium-low, medium-high, and high cognitive reserve. In the probable PTSD model, compared to the high cognitive reserve class, those with medium-low cognitive reserve were 35% more likely to report CML (relative risk (RR) = 1.4, 95% confidence interval (CI): 1.1, 1.7). Among the not probable PTSD group, those with low and medium levels of cognitive reserve were significantly more likely to report CML (RR = 1.8 and 1.4, respectively). Overall, those with less cognitive reserve were more likely to report CML regardless of PTSD status.

Download Full-text