Community Engagement and Data Disclosure in Environmental Health Research

Summary: Federal funding agencies increasingly support stakeholder participation in environmental health studies, and yet there is very little published research on engagement of community members in the development of data disclosure (DD) strategies. The Ohio Environmental Protection Agency reported airborne manganese (Mn) concentrations in East Liverpool, Ohio, 30 times higher than the reference concentration, which led to an academic–community research partnership to address community concern about Mn exposure, particularly among children. Children and their families were recruited to participate in a pilot study. Samples of blood and hair were collected from the children and analyzed for metals. DD mechanisms were developed using an iterative approach between community and academic partners. Individual DD letters were mailed to each participating family, and a community meeting was held. A post-meeting survey was administered to gauge community perception of the DD strategies. The purpose of this article is to demonstrate the effectiveness of engaging community partners in the conduct of environmental health research and in the development of DD strategies for individuals and the community at large. Scientists should include community partners in the development of DD strategies to enhance translation of the research findings and support the right of study participants to know their individual results.     

Community Engagement in Youth Violence Prevention: Crafting Methods to Context

The purpose of the Youth Violence Prevention Centers (YVPC) Program at the Centers for Disease Control and Prevention is to reduce youth violence in defined high-risk communities through the implementation and evaluation of comprehensive, evidence based prevention strategies. Within this common framework, each YVPC varies in its structure and methods, however all engage communities in multiple ways. We explore aspects of community engagement employed by three centers that operate in very different contexts: a rural county in North Carolina; a suburban area of Denver, Colorado; and an urban setting in Flint, Michigan. While previous research has addressed theories supporting community involvement in youth violence prevention, there has been less attention to the implementation challenges of achieving and sustaining participation. In three case examples, we describe the foci and methods for community engagement in diverse YVPC sites and detail the barriers and facilitating factors that have influenced implementation. Just as intervention programs may need to be adapted in order to meet the needs of specific populations, methods of community engagement must be tailored to the context in which they occur. We discuss case examples of community engagement in areas with varying geographies, histories, and racial and ethnic compositions. Each setting presents distinct challenges and opportunities for conducting collaborative violence prevention initiatives and for adapting engagement methods to diverse communities. Although approaches may vary depending upon local contexts, there are certain principles that appear to be common across cultures and geography: trust, transparency, communication, commitment. We also discuss the importance of flexibility in community engagement efforts.     

Community Health and Wellness Fair: A strategy for Assessment of Social Determinants of Health,Inclusion and Engagement of Newcomers

Journal of Community Health - Community health fair has been used informally as a way of offering health promotion, education, and screening services onsite to underserved and hard to reach...     

Community Epidemiology of Risk and Adolescent Substance Use: Practical Questions for Enhancing Prevention

To promote an effective approach to prevention, the community diagnosis model helps communities systematically assess and prioritize risk factors to guide the selection of preventive interventions. This increasingly widely used model relies primarily on individual-level research that links risk and protective factors to substance use outcomes. I discuss common assumptions in the translation of such research concerning the definition of risk factor elevation; the equivalence, independence, and stability of relations between risk factors and problem behaviors; and community differences in risk factors and risk factor–problem behavior relations. Exploring these assumptions could improve understanding of the relations of risk factors and substance use within and across communities and enhance the efficacy of the community diagnosis model. This approach can also be applied to other areas of public health where individual and community levels of risk and outcomes intersect.Although federal and state laws and policies seek to prevent adolescent use of alcohol, tobacco, and illegal recreational drugs, many youths nonetheless experiment with these substances, and some become regular users. Evidence suggests that the earlier exposure occurs, the more likely it is that the individual will become a regular user or abuser later in life.1,2 Considerable research has focused on the factors that lead adolescents toward experimentation and substance use.3,4 This important body of research is used to guide decisions about prevention programs and policy.Most research concerns relations of risk factors to problem behaviors at the level of individuals, but decisions regarding prevention policy are frequently made at the community level. A major gap in our understanding, which may affect resource and policy decisions, concerns the distribution of risk factors and relations of risk factors to problem behaviors both within and across communities. To the extent that the distributions of risk factors and problem behaviors, or the relations between them, are not uniformly distributed across the entire population, regardless of community boundaries, the use of individual-level data to inform community-level intervention planning may be inappropriate.The potential disjunction of individual-level research and community-level assessment, priority setting, planning, and implementation has not been thoroughly addressed. Relatively little multilevel epidemiological data have been examined to assess risk factor–outcome associations among adolescents both within and across communities. The translation of individual-level findings to community-level policies assumes that correlations detected at the individual and the community level are identical. This assumption belongs to either the ecological or the atomistic fallacy category, depending on whether the group-level dynamics are assumed to correspond to individual-level findings or vice versa.5 Moreover, and perhaps more important, the use of individual-level data assumes that the role of risk factors does not vary across communities.     

Health Care and End-of-Life Decisions: Community Engagement with Adults in East Harlem

This was a model of community engagement for a Hispanic population in East Harlem, New York City to assess health care decision-making processes, with a focus on end-of-life decisions, among older men and women. The design involved two senior center-based semi-structured focus groups conducted in Spanish and English followed by a series of bilingual skills-building workshops focusing on situational decision-making. All program aspects were conducted between April and June of 2013. The themes for the workshops included: “Getting the most from your pharmacist encounter;” “How to prepare for your primary care visit;” and “I am getting discharged from the hospital: what do I do?” For the two focus groups, 21 community members participated, each of whom self-identified as Hispanic or Latina/o. Ten common themes emerged from a two-stage/two coder, grounded theory-based qualitative analysis and included: Where Community Members Receive Care; General Challenges, Cultural Challenges, and Benefits of Health Care in New York City/East Harlem; Key Facilitators in Health Care Decision Making; Key Facilitators in End-of-Life Decision Making; and Perceptions of Health Care Disparity. Themes and their subcategories, discussed herein, may offer guidance for area health providers and health care delivery entities. This project served as formative, qualitative data collection for a larger scale forthcoming community assessment while offering community benefit related to health decision-making, especially end-of-life decision making, in the context of a rapidly changing urban American health care delivery landscape. Application of this synergistic community benefit and data collection model is recommended for similar and other communities in the U.S. and other countries.     

Clinical and Translational Science Awards and Community Engagement: Now Is the Time to Mainstream Prevention into the Nation's Health Research Agenda

Although much attention is devoted to the slow process of cutting-edge “bench science” finding its way to clinical translation, less attention is paid to the fact that basic prevention messages, tests, and interventions never find their way into communities. The NIH Clinical & Translational Science Awards program seeks to address a broad mission of improving health, including both speeding up the incorporation of basic science discoveries throughout the clinical research pipeline and incorporating concerns of communities and practices into research agendas. The preventive medicine community now has an important opportunity to marry their mission of promoting and expanding prevention in communities to the nation's medical research agenda. This article suggests opportunities for collaboration.     

Peer Reviewed: Mapping Cancer for Community Engagement

Introduction

Two research strategies may reduce health disparities: community participation and the use of geographic information systems. When combined with community participation, geographic information systems approaches, such as the creation of disease maps that connect disease rates with community context, can catalyze action to reduce health disparities. However, current approaches to disease mapping often focus on the display of disease rates for political or administrative units. This type of map does not provide enough information on the local rates of cancer to engage community participation in addressing disparities.

Methods

We collaborated with researchers and cancer prevention and control practitioners and used adaptive spatial filtering to create maps that show continuous surface representations of the proportion of all colorectal cancer cases diagnosed in the late stage. We also created maps that show the incidence of colorectal cancer.

Results

Our maps show distinct patterns of cancer and its relationship to community context. The maps are available to the public on the Internet and through the activities of Iowa Consortium for Comprehensive Cancer Control partners.

Conclusion

Community-participatory approaches to research are becoming more common, as are the availability of geocoded data and the use of geographic information systems to map disease. If researchers and practitioners are to engage communities in exploring cancer rates, maps should be made that accurately represent and contextualize cancer in such a way as to be useful to people familiar with the characteristics of their local areas.     

加强性病防治 增进妇女生殖健康

<正> 性病艾滋病疫情在我国逐年上升,形势十分严峻。1999年全国报告8种性病近84万例,较前一年增加了32.29％。继续保持增加的趋势。特别是艾滋病的流行已进入快速增长期,到2000年全国报告艾滋病病毒感染已超过2万例,而估计实际感染人数将达60万例。青壮年是受其危害的主要人群。 1999年我国报告男性性病发病率为     

Community Health Partnerships for Chronic Disease Prevention Among Latinos: The San Diego Prevention Research Center

Over 20 years ago, university–community partnerships (i.e., Prevention Research Centers [PRCs]) across the United States were funded by the Centers for Disease Control and Prevention to conduct research and training in order to promote health and prevent disease in underserved populations. In 2004, the San Diego PRC (SDPRC) became the first PRC to focus on obesity prevention and control in a community of mostly Mexican Americans/Mexican immigrants. The SDPRC was also the first PRC to comprise a university–community partnership with a school of public health, a school of medicine, and a federally qualified health center. In conjunction with two additional funded community partners and involvement of a community advisory board, the SDPRC seeks to develop effective intervention strategies that ultimately lead to behavior change. Now in its second cycle of funding, the SDPRC has identified three primary principles that are important for these and similar efforts: (1) developing culturally appropriate interventions requires community engagement; (2) building the evidence in a systematic and rigorous way yields meaningful strategies for translation to practice; and (3) translating evidence-based interventions to practice involves capacity building for both researchers and community partners. This article describes these principles to help others involved in similar intervention efforts identify the best approach for promoting health in their own communities.     

Community Health Workers Promote Civic Engagement and Organizational Capacity to Impact Policy

Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N?=?1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R ² statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change.     

Patterns of Family,School, and Community Promotive Factors and Health Disparities Among Youth: Implications for Prevention Science

Prevention Science - Increasing knowledge of factors that promote health among youth from diverse backgrounds is an important step towards addressing health disparities. Although many promotive...     

Enhancing Educator Engagement in School Mental Health Care Through Digital Simulation Professional Development

BACKGROUND

Despite the critical role of educators as gatekeepers for school mental health services, they receive limited training to support student mental health. We report findings from a trial of an online mental health role‐play simulation for elementary school teachers on changes in attitudes and self‐reported helping behaviors for students experiencing psychological distress.

METHODS

We randomly assigned 18,896 elementary school teachers to wait‐list control or intervention conditions in which they received the 45‐ to 90‐minute online role‐play simulation. We administered a version of the validated Gatekeeper Behavior Scale at baseline and postintervention, which measures attitudinal dimensions shown to predict teacher helping behavior change. Self‐reported helping behaviors were collected at baseline and 3‐month follow‐up. Outcomes were compared between the intervention follow‐up and control group baseline measures.

RESULTS

The intervention group posttraining scores were significantly higher (p < .001) than the control group for all the preparedness, likelihood, and self‐efficacy Gatekeeper Behavior subscales. All 5 helping behaviors were significantly higher among the intervention group at follow‐up compared to the control group at baseline.

CONCLUSIONS

We found that a brief online role‐play simulation was an effective strategy for improving teacher attitudes and behaviors needed to perform a positive mental health gatekeeper role in schools.