Enhancing community preparedness: an inventory and analysis of disaster citizen science activities

Understanding context of violence against healthcare through citizen science and evaluating the effectiveness of a co-designed code of conduct and of a tailored de-escalation of violence training in Eastern Democratic Republic of Congo and Iraq: a study protocol for a stepped wedge randomized controlled trial

BACKGROUND

Violence against health care workers (HCWs) is a multifaceted issue entwined with broader social, cultural, and economic contexts. While it is a global phenomenon, in crisis settings, HCWs are exposed to exceptionally high rates of violence. We hypothesize that the implementation of a training on de-escalation of violence and of a code of conduct informed through participatory citizen science research would reduce the incidence and severity of episodes of violence in primary healthcare settings of rural Democratic Republic of Congo (DRC) and large hospitals in Baghdad, Iraq.

METHODS

In an initial formative research phase, the study will use a transdisciplinary citizen science approach to inform the re-adaptation of a violence de-escalation training for HCWs and the content of a code of conduct for both HCWs and clients. Qualitative and citizen science methods will explore motivations, causes, and contributing factors that lead to violence against HCWs. Preliminary findings will inform participatory meetings aimed at co-developing local rules of conduct through in-depth discussion and input from various stakeholders, followed by a validation and legitimization process. The effectiveness of the two interventions will be evaluated through a stepped-wedge randomized-cluster trial (SW-RCT) design with 11 arms, measuring the frequency and severity of violence, as well as secondary outcomes such as post-traumatic stress disorder (PTSD), job burnout, empathy, or HCWs' quality of life at various points in time, alongside a cost-effectiveness study comparing the two strategies.

DISCUSSION

Violence against HCWs is a global issue, and it can be particularly severe in humanitarian contexts. However, there is limited evidence on effective and affordable approaches to address this problem. Understanding the context of community distrust and motivation for violence against HCWs will be critical for developing effective, tailored, and culturally appropriate responses, including a training on violence de-escalation and a community behavioral change approach to increase public trust in HCWs. This study aims therefore to compare the effectiveness and cost-effectiveness of different interventions to reduce violence against HCWs in two post-crisis settings, providing valuable evidence for future efforts to address this issue.

TRIAL REGISTRATION

ClinicalTrial.gov Identifier NCT05419687. Prospectively registered on June 15, 2022.

Children in All Policies (CAP) 2030 Citizen Science for Climate Change Resilience: a cross-sectional pilot study engaging adolescents to study climate hazards, biodiversity and nutrition in rural Nepal

Background

Young people will suffer most from climate change yet are rarely engaged in dialogue about it. Citizen science offers a method for collecting policy-relevant data, whilst promoting awareness and capacity building. We tested the feasibility and acceptability of engaging Nepalese adolescents in climate change and health-related citizen science.

Methods

We purposively selected 33 adolescents from two secondary schools in one remote and one relatively accessible district of Nepal. We contextualised existing apps and developed bespoke apps to survey climate hazards, waste and water management, local biodiversity, nutrition and sociodemographic information. We analysed and presented quantitative data using a descriptive analysis. We captured perceptions and learnings via focus group discussions and analysed qualitative data using thematic analysis. We shared findings with data collectors using tables, graphs, data dashboards and maps.

Results

Adolescents collected 1667 biodiversity observations, identified 72 climate-change related hazards, and mapped 644 geolocations. They recorded 286 weights, 248 heights and 340 dietary recalls. Adolescents enjoyed learning how to collect the data and interpret the findings and gained an appreciation of local biodiversity which engendered 'environmental stewardship'. Data highlighted the prevalence of failing crops and landslides, revealed both under- and over-nutrition and demonstrated that children consume more junk foods than adults. Adolescents learnt about the impacts of climate change and the importance of eating a diverse diet of locally grown foods. A lack of a pre-established sampling frame, multiple records of the same observation and spurious nutrition data entries by unsupervised adolescents limited data quality and utility. Lack of internet access severely impacted feasibility, especially of apps which provide online feedback.

Conclusions

Citizen science was largely acceptable, educational and empowering for adolescents, although not always feasible without internet access. Future projects could improve data quality and integrate youth leadership training to enable climate-change advocacy with local leaders.

Is there a role for citizen science in death and dying research?

The COVID-19 pandemic has brought conversations about death and dying to the fore in a way not experienced for generations. This raises questions around perceptions of death and dying; the role of healthcare and the community in care; and the use of digital media for information and support. Public engagement can provoke a two-way conversation between researchers and the public and includes techniques that can engage the community not only with the topic but also in research. This perspective article considers the potential role of citizen science in death and dying research, including considerations around its potential benefits and constraints.

An Ecological Approach to Disaster Mitigation: A Literature Review

Disasters, whether natural or manmade, disrupt the functioning of communities, significantly impacting people's lives and health. To build community resilience, the Centers for Disease Control and Prevention recommends community preparedness, where multiple stakeholders work together. Disaster Preparedness Science Research (DPSR) similarly encourages the improvement of disaster relief outcomes. This literature review assesses the vulnerability of communities for prioritized intervention, summarizes disaster effects, and suggests the scope for improvement in disaster preparedness (DP). Twenty-one articles were reviewed based on disaster mitigation and economic factors from 90 studies identified through a PubMed search till September 2021. Vulnerable communities with higher hazard risks are identified by vulnerability indices (VI), including the Climate Risk Index, Environmental VI, and Socio-Economic VI. However, VI predicting one disaster may not predict another. Disaster behavioral response involves five phases. Disaster effects include medical, mental, environmental, and economic effects, as well as the unique recovery time from each domain effect. Medical effects include malnutrition, malaria, diarrhea, heat stress, exacerbations of chronic conditions, infectious disease outbreaks, trauma, and death. Mental effects are post-traumatic stress disorders, depression, anxiety, somatic complaints, psychological distress, sleep problems, and suicides. Environmental effects include isolation, migration, injury to family members, life threats, and property damage. Loss of livelihood and property are associated with worse outcomes. Disaster recovery, which is seldom measured and not clearly defined, affects measurement and comparison across settings. A uniform validated VI, including multiple indicators assessing vulnerability to various disasters, is required. Livelihood restoration is integral to mental health recovery in some disaster types. Fund diversification, prioritized to the vulnerable and to each domain effect of disaster in the immediate post-disaster phase, expedites recovery. Later recovery investments focused on helping people rebuild their community enhance psychological outcomes. Promoting job insurance in highly vulnerable labor-based communities with high VI, wherein willing-to-pay is high, could facilitate faster recovery. DPSR should be encouraged.

Building Public Health Emergency Preparedness, Response, and Recovery Capabilities Through Disaster Citizen Science: Perspectives From Local Health Department, Academic, and Community Representatives

CONTEXT

Disaster citizen is the use of scientific methods by the public to address preparedness, response, or recovery needs. Disaster citizen science applications with public health relevance are growing in academic and community sectors, but integration with public health emergency preparedness, response, and recovery (PHEPRR) agencies is limited.

OBJECTIVE

We examined how local health departments (LHDs) and community-based organizations have used citizen science to build public health preparedness and response (PHEP) capabilities. The purpose of this study is to help LHDs make use of citizen science to support PHEPRR.

DESIGN

We conducted semistructured telephone interviews (n = 55) with LHD, academic, and community representatives engaged or interested in citizen science. We used inductive and deductive methods to code and analyze interview transcripts.

SETTING

US and international community-based organizations and US LHDs.

PARTICIPANTS

Participants included 18 LHD representatives reflecting diversity in geographic regions and population sizes served and 31 disaster citizen science project leaders and 6 citizen science thought leaders.

MAIN OUTCOMES

We identified challenges LHDs and academic and community partners face in using citizen science for PHEPRR as well as strategies to facilitate implementation.

RESULTS

Academic and community-led disaster citizen science activities aligned with many PHEP capabilities including community preparedness, community recovery, public health surveillance and epidemiological investigation, and volunteer management. All participant groups discussed challenges related to resources, volunteer management, collaborations, research quality, and institutional acceptance of citizen science. The LHD representatives noted unique barriers due to legal and regulatory constraints and their role in using citizen science data to inform public health decisions. Strategies to increase institutional acceptance included enhancing policy support for citizen science, increasing volunteer management support, developing best practices for research quality, strengthening collaborations, and adopting lessons learned from relevant PHEPRR activities.

CONCLUSIONS

There are challenges to overcome in building PHEPRR capacity for disaster citizen science but also opportunities for LHDs to leverage the growing body of work, knowledge, and resources in academic and community sectors.

Designing Equitable, Transparent Community-Engaged Disaster Research

Disaster research faces significant infrastructure challenges: regional and federal coordination, access to resources, and community collaboration. Disasters can lead to chemical exposures that potentially impact human health and cause concern in affected communities. Community-engaged research, which incorporates local knowledge and voices, is well-suited for work with communities that experience impacts of environmental exposures following disasters. We present three examples of community-engaged disaster research (CEnDR) following oil spills, hurricanes, and wildfires, and their impact on long-term social, physical, and technical community infrastructure. We highlight the following CEnDR structures: researcher/community networks; convenient research tools; adaptable data collection modalities for equitable access; and return of data.

Digital Citizen Science for Responding to COVID-19 Crisis: Experiences from Iran

The Coronavirus Disease 2019 (COVID-19) pandemic has so far been the most severe global public health emergency in this century. Generally, citizen science can provide a complement to authoritative scientific practices for responding to this highly complex biological threat and its adverse consequences. Several citizen science projects have been designed and operationalized for responding to COVID-19 in Iran since the infection began. However, these projects have mostly been overlooked in the existing literature on citizen science. This research sheds light on the most significant online citizen science projects to respond to the COVID-19 crisis in Iran. Furthermore, it highlights some of the opportunities and challenges associated with the strengths and weaknesses of these projects. Moreover, this study captures and discusses some considerable insights and lessons learned from the failures and successes of these projects and provides solutions to overcome some recognized challenges and weaknesses of these projects. The outcomes of this synthesis provide potentially helpful directions for current and future citizen science projects-particularly those aiming to respond to biological disasters such as the COVID-19 pandemic.

Science Policy to Advance a Climate Change and Health Research Agenda in the United States

Climate change is thought to be one of the greatest public health threats of the 21st century and there has been a tremendous growth in the published literature describing the health implications of climate change over the last decade. Yet, there remain several critical knowledge gaps in this field. Closing these gaps is crucial to developing effective interventions to minimize the health risks from climate change. In this commentary, we discuss policy trends that have influenced the advancement of climate change and health research in the United States context. We then enumerate specific knowledge gaps that could be addressed by policies to advance scientific research. Finally, we describe tools and methods that have not yet been fully integrated into the field, but hold promise for advancing the science. Prioritizing this advancement offers the potential to improve public health-related policies on climate change.