Talking the Walk: Perceptions of Neighborhood Characteristics from Users of Open Streets Programs in Latin America and the USA

Urban Care for Unpaid Caregivers: Community Voices in the Care Block Program, in Bogotá, Colombia

The Care Block of Bogotá, Colombia, is an urban program that offers services for low-income unpaid caregivers. This study aimed to (i) characterize unpaid caregivers' subjective well-being, mental health symptoms, physical activity levels, and use of public spaces linked to the Care Block; (ii) identify caregivers' perceived built and social environment facilitators and barriers to accessing the Care Block facility; and (iii) document the community-led advocacy process to improve the Care Block program. The quantitative component included a subjective well-being and mental health symptoms survey, and the System for Observing Play and Recreation in Communities (SOPARC) instrument. The qualitative component included the Our Voice citizen science method augmented with portable virtual reality equipment to engage participants in advocacy for changes. Participants (median age of 53 years) dedicated a median of 13.8 h a day to unpaid caregiving, had an average subjective well-being score of 7.0, and 19.1% and 23.8% reported having depression and generalized anxiety symptoms respectively. Caregivers reported that the program fosters their perception of purpose, enjoyment, resilience, and cognitive and emotional awareness. SOPARC evaluation showed that most women engaged in moderate to vigorous physical activity. The caregivers highlighted education, physical activity services, and integration of facilities as facilitators to accessing the Care Block program. Poor quality and lack of sidewalks and roads, limited personal safety, and the risk of pedestrian-vehicle collisions were identified as barriers. Virtual Reality sparked compelling dialogue between participants and stakeholders, allowing stakeholders to reflect on an urban program facilitating unpaid care work.

Effectiveness, barriers, and facilitators of overweight and obesity prevention strategies in Latin America; a scoping review and qualitative study in Colombia

Background

This project aimed to synthesize the quantitative/qualitative evidence on the effectiveness of overweight/obesity prevention strategies implemented in Colombia and their barriers and facilitators.

Methods

A scoping review was conducted by searching PubMed, SciELO, Scopus, and the grey literature (2012–2023). In-depth interviews were also conducted among key stakeholders on their perception of these strategies’ effectiveness, barriers, and facilitators.

Findings

26 records were included; four studies found positive changes in weight/body mass index, five found positive changes in physical activity, two found positive changes in food intake, and four found positive changes in healthy lifestyle knowledge, perception, attitudes, and habits. The main barrier reported was the obesogenic environment, and the facilitators were program flexibility and community engagement. Eighteen interviews were conducted (one interview per strategy); the main barriers reported were political, lack of evaluation access, economic situation, and lack of articulation; the main facilitators were incorporating the strategy into policies, articulation with stakeholders, and strong oversight.

Interpretation

Moderate evidence indicates that these strategies positively impact outcomes related to overweight/obesity in Colombia, but more long-term studies are needed for overweight/obesity reduction. Lack of (1) evaluation and resources (barriers), (2) incorporation into policies (facilitators), and (3) strong stakeholder coordination (facilitators) was identified.

Funding

Global Health Consortium , Department of Global Health , 10.13039/100007681 FIU .

Unintended impacts of the Open Streets program on noise complaints in New York City

BACKGROUND

During the COVID-19 pandemic, several cities allocated more public spaces for physical activity and recreation instead of road transport through Open Streets. This policy locally reduces traffic and provides experimental testbeds for healthier cities. However, it may also generate unintended impacts. For instance, Open Streets may impact the levels of exposure to environmental noise but there are no studies assessing these unintended impacts.

OBJECTIVES

Using noise complaints from New York City (NYC) as a proxy of annoyance caused by environmental noise, we estimated associations at the census tract level between same-day proportion of Open Streets in a census tract and noise complaints in NYC.

METHODS

Using data from summer 2019 (pre-implementation) and summer 2021 (post-implementation), we fit regressions to estimate the association between census tract-level proportion of Open Streets and daily noise complaints, with random effects to account for within-tract correlation and natural splines to allow non-linearity in the estimated association. We accounted for temporal trends and other potential confounders, such as population density and poverty rate.

RESULTS

In adjusted analyses, daily street/sidewalk noise complaints were nonlinearly associated with an increasing proportion of Open Streets. Specifically, compared to the mean proportion of Open Streets in a census tract (0.11%), 5% of Open Streets had a 1.09 (95% CI: 0.98, 1.20) and 10% had a 1.21 (95% CI: 1.04, 1.42) times higher rate of street/sidewalk noise complaints. Our results were robust to the choice of data source for identifying Open Streets.

CONCLUSION

Our findings suggest that Open Streets in NYC may be linked to an increase in street/sidewalk noise complaints. These results highlight the necessity to reinforce urban policies with a careful analysis for potential unintended impacts to optimize and maximize the benefits of these policies.

Interventions to Improve Pedestrian and Cyclist Safety in Latin America: a Systematic Review and Metasummary

Road user fatalities account for a leading cause of preventable death in Latin America with pedestrians and bicyclists at higher risk for more extensive injuries as compared to other road users. Despite these vulnerable road user (VRU) risks, encouraging individuals to walk and cycle is an important public health strategy for addressing the region's obesity epidemic through promoting physical activity via active transportation (AT). However, in order to promote AT as a viable source of physical activity, safety of the VRU must be considered. The purpose of this systematic review and metasummary is to describe the effectiveness of interventions that have been implemented in Latin America to improve pedestrian and bicyclist safety. A systematic search of public health, policy, and engineering databases was completed using terms generated through the PICO method. The PRISMA framework was used for article screening. Eight articles detailing nine interventions across four countries were included for final synthesis and organized according to the Three E's Model of Injury Prevention, including three education-based interventions, two engineering, three enforcements, and one utilizing all Three E's. VRU outcomes assessed ranged from attitudes and behaviors to fatal injuries, with only enforcement-based interventions reporting on the latter. No interventions reported on non-fatal injury outcomes. Interventions rooted in each arm of the Three E's demonstrated limited ability to improve VRU outcomes, with enforcement-based interventions providing the strongest body of evidence. Findings demonstrate the limited research on VRU safety in Latin America, and further efforts should be of urgent public health priority.

A Scoping Review of Citizen Science Approaches in Chronic Disease Prevention

Background

Citizen science approaches, which involve members of the public as active collaborators in scientific research, are increasingly being recognized for their potential benefits in chronic disease prevention. However, understanding the potential applicability, feasibility and impacts of these approaches is necessary if they are to be more widely used. This study aimed to synthesize research that has applied and evaluated citizen science approaches in chronic disease prevention and identify key questions, gaps, and opportunities to inform future work in this field.

Methods

We searched six databases (Scopus, Medline, Embase, PsycInfo, PubMed, and CINAHL) in January 2022 to identify articles on the use of citizen science in prevention. We extracted and synthesized data on key characteristics of citizen science projects, including topics, aims and level of involvement of citizen scientists, as well as methods and findings of evaluations of these projects.

Results

Eighty-one articles reported on citizen science across a variety of health issues, predominantly physical activity and/or nutrition. Projects primarily aimed to identify problems from the perspective of community members; generate and prioritize solutions; develop, test or evaluate interventions; or build community capacity. Most projects were small-scale, and few were co-produced with policy or practice stakeholders. While around half of projects included an evaluation component, overall, there was a lack of robust, in-depth evaluations of the processes and impacts of citizen science projects.

Conclusions

Citizen science approaches are increasingly being used in chronic disease prevention to identify and prioritize community-focused solutions, mobilize support and advocacy, and empower communities to take action to support their health and wellbeing. However, to realize the potential of this approach more attention needs to be paid to demonstrating the feasibility of using citizen science approaches at scale, and to rigorous evaluation of impacts from using these approaches for the diverse stakeholders involved.

Intersection of Health Informatics Tools and Community Engagement in Health-Related Research to Reduce Health Inequities: Scoping Review

BACKGROUND

The exponential growth of health information technology has the potential to facilitate community engagement in research. However, little is known about the use of health information technology in community-engaged research, such as which types of health information technology are used, which populations are engaged, and what are the research outcomes.

OBJECTIVE

The objectives of this scoping review were to examine studies that used health information technology for community engagement and to assess (1) the types of populations, (2) community engagement strategies, (3) types of health information technology tools, and (4) outcomes of interest.

METHODS

We searched PubMed and PCORI Literature Explorer using terms related to health information technology, health informatics, community engagement, and stakeholder involvement. This search process yielded 967 papers for screening. After inclusion and exclusion criteria were applied, a total of 37 papers were analyzed for key themes and for approaches relevant to health information technology and community engagement research.

RESULTS

This analysis revealed that the communities engaged were generally underrepresented populations in health-related research, including racial or ethnic minority communities such as Black/African American, American Indian/Alaska Native, Latino ethnicity, and communities from low socioeconomic backgrounds. The studies focused on various age groups, ranging from preschoolers to older adults. The studies were also geographically spread across the United States and the world. Community engagement strategies included collaborative development of health information technology tools and partnerships to promote use (encompassing collaborative development, use of community advisory boards, and focus groups for eliciting information needs) and use of health information technology to engage communities in research (eg, through citizen science). The types of technology varied across studies, with mobile or tablet-based apps being the most common platform. Outcomes measured included eliciting user needs and requirements, assessing health information technology tools and prototypes with participants, measuring knowledge, and advocating for community change.

CONCLUSIONS

This study illustrates the current landscape at the intersection of health information technology tools and community-engaged research approaches. It highlights studies in which various community-engaged research approaches were used to design culturally centered health information technology tools, to promote health information technology uptake, or for engagement in health research and advocacy. Our findings can serve as a platform for generating future research upon which to expand the scope of health information technology tools and their use for meaningful stakeholder engagement. Studies that incorporate community context and needs have a greater chance of cocreating culturally centered health information technology tools and better knowledge to promote action and improve health outcomes.

The Role of Citizen Science in Promoting Health Equity

While there are many definitions of citizen science, the term usually refers to the participation of the general public in the scientific process in collaboration with professional scientists. Citizen scientists have been engaged to promote health equity, especially in the areas of environmental contaminant exposures, physical activity, and healthy eating. Citizen scientists commonly come from communities experiencing health inequities and have collected data using a range of strategies and technologies, such as air sensors, water quality kits, and mobile applications. On the basis of our review, and to advance the field of citizen science to address health equity, we recommend (a) expanding the focus on topics important for health equity, (b) increasing the diversity of people serving as citizen scientists, (c) increasing the integration of citizen scientists in additional research phases, (d) continuing to leverage emerging technologies that enable citizen scientists to collect data relevant for health equity, and (e) strengthening the rigor of methods to evaluate impacts on health equity. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Participation and Physical Activity in Recreovia of Bucaramanga, Colombia

BACKGROUND

Open Streets initiatives have allowed for physical activity (PA) in cities worldwide. However, few studies have evaluated the use of small Open Streets in low- and middle-income countries, such as those in Latin America. Thus, this study aimed to describe participation and PA level of users in the Recreovia program in Bucaramanga, Colombia.

METHODS

A cross-sectional study was conducted during 5 Sundays from September to November 2017. Recreovia use was evaluated at 4 strategic points according to street accessibility (2 points) and aerobics class areas (2 points), using the System for Observing Play and Recreation in Communities.

RESULTS

A total of 38,577 observations were made (34,969 on streets and 3608 in aerobics class areas). Men (63%) and adults (62%), with moderate to vigorous PA (MVPA) (98%) were observed on streets. The most common PAs were biking (50%), walking/dog walking (36%), and jogging (9%). In aerobics class areas, the most common groups were female (65%) and adults (89%). Participants were engaged in moderate to vigorous PA (91%).

CONCLUSION

Measurement of number of participants at moderate to vigorous levels of PA was high. A difference between sexes and age in these street and aerobic class area groups was also observed.

Engaging citizen scientists to build healthy park environments in Colombia

Colombia's Recreovía program offers community-based free physical activity (PA) classes in parks. We evaluated built and social environmental factors influencing Recreovía local park environments, and facilitated a consensus-building and advocacy process among community members, policymakers and academic researchers aimed at improving uptake and impact of the Recreovía program. We used a mixed-methods approach, with individual and contextual PA measurements and a resident-enabled participatory approach (the Our Voice citizen science engagement model). Recreovía participants were likely to be women meeting PA recommendations, and highly satisfied with the Recreovía classes. Reported facilitators of the Recreovía included its role in enhancing social and individual well-being through PA classes. Reported barriers to usage were related to park maintenance, cleanliness and safety. The Our Voice process elicited community reflection, empowerment, advocacy and action. Our Voice facilitated the interplay among stakeholders and community members to optimize the Recreovía program as a facilitator of active living, and to make park environments more welcoming.

A citizen science approach to determine perceived barriers and promoters of physical activity in a low-income South African community

The study's objective was to assess the feasibility of using citizen science to identify and address physical activity (PA) barriers in a low-income South African community. We purposively selected as citizen scientists, eleven participants (21-45 years) from a cohort study who expressed interest in becoming physically active or were already active. They used the Stanford Neighborhood Discovery Tool mobile application to take photos and provide audio narratives of factors in their community that were barriers to or facilitated PA. Thereafter, in a facilitated workshop, citizen scientists thematically reviewed their findings, prioritised issues and proffered potential solutions. Researchers also thematically coded these data. PA levels were measured using standard questionnaires. None of the citizen scientists owned a car, and their PA was either work- or transport-related. Themes identified as priorities that hindered citizen scientists' PA were dirt, sidewalks appropriated by vendors or homeowners, parks and gym vandalisation, and personal safety fears. Access to stadiums and parks enabled PA. Citizen scientists identified their local councillors and street committee chairpersons as fundamental for advocacy for a PA-friendly environment. Low-income community members can be empowered to gather meaningful data using mobile technology and work together to identify potential solutions for promoting PA-friendly environments.