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van den Muijsenbergh METC, LeMaster JW, Shahiri P, Brouwer M, Hussain M, Dowrick C, Papadakaki M, Lionis C, MacFarlane A. Participatory implementation research in the field of migrant health: Sustainable changes and ripple effects over time. Health Expect 2020; 23:306-317. [PMID: 32035009 PMCID: PMC7104649 DOI: 10.1111/hex.13034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/24/2019] [Accepted: 01/21/2020] [Indexed: 12/20/2022] Open
Abstract
Objective This study aimed to explore whether positive impacts were sustained and unanticipated ripple effects had occurred four years after the implementation of interventions to improve cross‐cultural communication in primary care. Background Sustaining the implementation of change using complex interventions is challenging. The EU‐funded “RESTORE” study implemented guidelines and training on cross‐cultural communication in five Primary Care sites in Europe, combining implementation theory (Normalisation Process Theory) with participatory methodology (participatory learning and action—PLA). There were positive impacts on knowledge, skills and clinical routines. Design, setting and participants Four of the five original sites (England, Ireland, Greece, The Netherlands) were available for this qualitative follow‐up study. The study population (N = 44) was primary healthcare staff and migrants, most of whom had participated in RESTORE. Intervention; main outcome measures PLA‐style focus groups and interviews explored routine practice during consultations with migrants. Etic cards based on the effects of RESTORE stimulated the discussion. Deductive framework analysis was performed in each country followed by comparative data analysis and synthesis. Results Changes in knowledge, attitudes and behaviour with regard to consultations with migrants were sustained and migrants felt empowered by their participation in RESTORE. There were ongoing concerns about macro level factors, like the political climate and financial policies, negatively affecting migrant healthcare. Conclusion There were sustained effects in clinical settings, and additional unanticipated positive ripple effects, due in part, from the participatory approach employed.
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Affiliation(s)
- Maria E T C van den Muijsenbergh
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands.,Centre of Expertise on Health Disparities, Pharos, Utrecht, The Netherlands
| | | | - Parmida Shahiri
- University of Kansas School of Medicine, Kansas City, KS, USA.,Department of Health Services Research, University of Liverpool, Liverpool, UK
| | - Michelle Brouwer
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Mohammed Hussain
- Graduate Entry Medical School and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Chris Dowrick
- Department of Health Services Research, University of Liverpool, Liverpool, UK
| | - Maria Papadakaki
- Department of Social Work, Hellenic Mediterranean University, Heraklion, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Anne MacFarlane
- Graduate Entry Medical School and Health Research Institute, University of Limerick, Limerick, Ireland
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Arnold TJ, Malki A, Leyva J, Ibarra J, Daniel SS, Ballard PJ, Sandberg JC, Quandt SA, Arcury TA. Engaging Youth Advocates in Community-Based Participatory Research on Child Farmworker Health in North Carolina. Prog Community Health Partnersh 2019; 13:191-199. [PMID: 31178454 PMCID: PMC6559374 DOI: 10.1353/cpr.2019.0019] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Wake Forest School of Medicine (WFSM) investigators and Student Action with Farmworkers' (SAF) Levante Leadership Institute, a farmworker youth program, are collaborating on a community-based participatory research (CBPR) study. OBJECTIVES 1) Describe the collaborative process between WFSM investigators and the Levante advisory board during the strategic planning and implementation phase and 2) highlight practices that support the collaboration and project success. METHODS The longitudinal Hired Child Farmworker Study examines the health and safety of hired Latino child farm-workers in North Carolina. Two Levante alumni co- investigators lead research-related activities with the Levante advisory board. LESSONS LEARNED Challenges to CBPR with youth are overcome by the longstanding partnership between WFSM and SAF, attention to logistical details, power sharing, building on shared values, and assessment of youth preferences. CONCLUSIONS The partnership between WFSM and Levante demonstrates the mutual benefit of CBPR and will continue during the upcoming study phases.
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Dawson JB, Galvin K, Thorne PS, Rohlman DS. Organophosphorus pesticide residue levels in homes located near orchards. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2018; 15:847-856. [PMID: 30138040 PMCID: PMC6372327 DOI: 10.1080/15459624.2018.1515489] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/10/2018] [Accepted: 08/20/2018] [Indexed: 06/08/2023]
Abstract
Organophosphorus pesticides (OPs) are commonly applied to agricultural crops. Families living in these communities may have higher exposure to OPs due to take home exposures and close proximity to agricultural fields. The objectives of this study were to measure OP concentrations in home carpet dust in agricultural and non-agricultural households and examine factors that may impact OP concentrations such as occupation, housing characteristics, and resident behaviors. Agricultural households had at least one parent who worked in agriculture during the previous 5 years. Carpet dust samples were collected at two time points from 278 households in an agricultural community located in the Pacific Northwest from 2008-2011. Samples were analyzed for four types of OPs: azinphos-methyl, phosmet, malathion, and chlorpyrifos. Overall, OP detection frequencies and concentrations were higher in agricultural households compared to non-agricultural households. Factors associated with higher OP concentrations in home carpet dust were identified and included: (1) homes with two or more agricultural workers living in the home, (2) homes located in close proximity to an agricultural field or orchard, (3) having an entry floor mat, and (4) frequently vacuuming the house. Having air conditioning in the home had a protective effect with OP concentrations. While the use of these four OPs is restricted or limited for residential use in the United States, results show that they were still found in the indoor environment. The understanding of the impact of agricultural work and other factors that elevate levels of OPs in the home is crucial to mitigating pesticide exposure in agricultural communities.
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Affiliation(s)
- Jaime Butler Dawson
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Kit Galvin
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington
| | - Peter S. Thorne
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Diane S. Rohlman
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa
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McCauley LA, Michaels S, Rothlein J, Muniz J, Lasarev M, Ebbert C. Pesticide Exposure and Self Reported Home Hygiene: Practices in Agricultural Families. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/216507990305100304] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Little is known about environmental exposure to pesticides and the extent to which exposure is affected by drift from agricultural applications and take home exposure from agricultural workers. The study focused on 24 agricultural families in the northwestern United States and measured levels of organophosphate pesticides (OP) in house dust. Pesticide residues were significantly associated with the number of individuals in the home whose work included high exposure pesticide activities. Mean levels of pesticides were higher in the homes of workers who reported waiting more than 2 hours before changing out of their work clothes compared with homes where workers change within 2 hours after returning from work (p < .01). The results of this study provide evidence that workers can inadvertently carry agricultural chemicals from their work into their homes, thereby increasing the risk of pesticide exposure to other family members inside the home.
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Affiliation(s)
- Linda A. McCauley
- Center for Research on Occupational and Environmental Toxicology at Oregon Health & Science University, Portland, Oregon
| | - Sarah Michaels
- Louisiana Office of Public Health, New Orleans, Louisiana
| | - Joan Rothlein
- Center for Research on Occupational and Environmental Toxicology at Oregon Health & Science University, Portland, Oregon
| | - Juan Muniz
- Center for Research on Occupational and Environmental Toxicology at Oregon Health & Science University, Portland, Oregon
| | - Michael Lasarev
- Center for Research on Occupational and Environmental Toxicology at Oregon Health & Science University, Portland, Oregon
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Drahota A, Meza RD, Brikho B, Naaf M, Estabillo JA, Gomez ED, Vejnoska SF, Dufek S, Stahmer AC, Aarons GA. Community-Academic Partnerships: A Systematic Review of the State of the Literature and Recommendations for Future Research. Milbank Q 2016; 94:163-214. [PMID: 26994713 PMCID: PMC4941973 DOI: 10.1111/1468-0009.12184] [Citation(s) in RCA: 188] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
POLICY POINTS Communities, funding agencies, and institutions are increasingly involving community stakeholders as partners in research, to provide firsthand knowledge and insight. Based on our systematic review of major literature databases, we recommend using a single term, community-academic partnership (CAP), and a conceptual definition to unite multiple research disciplines and strengthen the field. Interpersonal and operational factors that facilitate or hinder the collaborative process have been consistently identified, including "trust among partners" and "respect among partners" (facilitating interpersonal factors) and "excessive time commitment" (hindering operational factor). Once CAP processes and characteristics are better understood, the effectiveness of collaborative partner involvement can be tested. CONTEXT Communities, funding agencies, and institutions are increasingly involving community stakeholders as partners in research. Community stakeholders can provide firsthand knowledge and insight, thereby increasing research relevance and feasibility. Despite the greater emphasis and use of community-academic partnerships (CAP) across multiple disciplines, definitions of partnerships and methodologies vary greatly, and no systematic reviews consolidating this literature have been published. The purpose of this article, then, is to facilitate the continued growth of this field by examining the characteristics of CAPs and the current state of the science, identifying the facilitating and hindering influences on the collaborative process, and developing a common term and conceptual definition for use across disciplines. METHODS Our systematic search of 6 major literature databases generated 1,332 unique articles, 50 of which met our criteria for inclusion and provided data on 54 unique CAPs. We then analyzed studies to describe CAP characteristics and to identify the terms and methods used, as well as the common influences on the CAP process and distal outcomes. FINDINGS CAP research spans disciplines, involves a variety of community stakeholders, and focuses on a large range of study topics. CAP research articles, however, rarely report characteristics such as membership numbers or duration. Most studies involved case studies using qualitative methods to collect data on the collaborative process. Although various terms were used to describe collaborative partnerships, few studies provided conceptual definitions. Twenty-three facilitating and hindering factors influencing the CAP collaboration process emerged from the literature. Outcomes from the CAPs most often included developing or refining tangible products. CONCLUSIONS Based on our systematic review, we recommend using a single term, community-academic partnership, as well as a conceptual definition to unite multiple research disciplines. In addition, CAP characteristics and methods should be reported more systematically to advance the field (eg, to develop CAP evaluation tools). We have identified the most common influences that facilitate and hinder CAPs, which in turn should guide their development and sustainment.
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Affiliation(s)
- Amy Drahota
- San Diego State University
- Child and Adolescent Services Research Center
| | - Rosemary D Meza
- Child and Adolescent Services Research Center
- University of Washington, Seattle
| | - Brigitte Brikho
- San Diego State University
- Child and Adolescent Services Research Center
| | | | | | - Emily D Gomez
- San Diego State University
- Child and Adolescent Services Research Center
| | - Sarah F Vejnoska
- Child and Adolescent Services Research Center
- University of California, San Diego
| | | | - Aubyn C Stahmer
- Child and Adolescent Services Research Center
- University of California, Davis, MIND Institute
| | - Gregory A Aarons
- Child and Adolescent Services Research Center
- University of California, San Diego
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Butler-Dawson J, Galvin K, Thorne PS, Rohlman DS. Organophosphorus pesticide exposure and neurobehavioral performance in Latino children living in an orchard community. Neurotoxicology 2016; 53:165-172. [PMID: 26820522 DOI: 10.1016/j.neuro.2016.01.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 01/20/2016] [Accepted: 01/21/2016] [Indexed: 01/29/2023]
Abstract
Children living in agricultural communities have a greater risk from pesticides due to para-occupational pathways. The goal of this study was to assess the impact of exposure to organophosphorus pesticides on the neurobehavioral performance of school-aged Latino children over time. Two exposure measures were used to estimate children's pesticide exposure: parent's occupation (agricultural or non-agricultural) and organophosphate residues in home carpet dust samples. During 2008-2011, 206 school-aged children completed a battery of neurobehavioral tests two times, approximately one year apart. The associations between both exposure measures and neurobehavioral performance were examined. Pesticide residues were detected in dust samples from both agricultural and non-agricultural homes, however, pesticides were detected more frequently and in higher concentrations in agricultural homes compared to non-agricultural homes. Although few differences were found between agricultural and non-agricultural children at both visits, deficits in learning from the first visit to the second visit, or less improvement, was found in agricultural children relative to non-agricultural children. These differences were significant for the Divided Attention and Purdue Pegboard tests. These findings are consistent with previous research showing deficits in motor function. A summary measure of organophosphate residues was not associated with neurobehavioral performance. Results from this study indicate that children in agricultural communities are at increased risk from pesticides as a result of a parent working in agricultural. Our findings suggest that organophosphate exposure may be associated with deficits in learning on neurobehavioral performance, particularly in tests of with motor function. In spite of regulatory phasing out of organophosphates in the U.S., we still see elevated levels and higher detection rates of several organophosphates in agricultural households than non-agricultural households, albeit lower levels than prior studies.
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Affiliation(s)
- Jaime Butler-Dawson
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa, United States
| | - Kit Galvin
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, United States
| | - Peter S Thorne
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa, United States
| | - Diane S Rohlman
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa, United States; Oregon Institute for Occupational Health Sciences, Oregon Health & Science University, Portland, OR, United States.
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Panhwar A, Sheikh S, Soomro A, Abro G. Removal of Pesticide Residues from Tomato and its Products. ACTA ACUST UNITED AC 2014. [DOI: 10.6000/1927-5129.2014.10.75] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Thompson B, Griffith WC, Barr DB, Coronado GD, Vigoren EM, Faustman EM. Variability in the take-home pathway: farmworkers and non-farmworkers and their children. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2014; 24:522-31. [PMID: 24594649 PMCID: PMC4141015 DOI: 10.1038/jes.2014.12] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 12/17/2013] [Indexed: 05/27/2023]
Abstract
Organophosphate pesticides (OPs) are related to ill health among adults, including farmworkers who are exposed to OPs as part of their regular work. Children of both farmworkers and non-farmworkers in agricultural communities may also be affected by pesticide exposure. Study groups of 100 farmworkers with a referent child (aged 2-6 years) and 100 non-farmworkers with a referent child were recruited to participate in three data collection periods over the course of a year. At each collection, participants provided three urine samples within 5 days, and homes and vehicles were vacuumed to collect pesticide residues in dust. In thinning and harvest seasons, farmworkers and their children had higher dimethyl urinary metabolites than non-farmworkers and their children. During the non-spray season, the urinary metabolites levels decreased among farmworkers to a level comparable to that of non-farmworkers. Farmworkers consistently had higher pesticide residues in their home and vehicle dust. Differences exist between farmworkers and non-farmworkers in urinary metabolites, and the differences extended throughout the agricultural seasons.OP metabolites are seen at much higher levels for farmworkers and their children than for non-farmworkers and their children during agricultural seasons when OPs are in use. These metabolite levels were significantly higher than the nationwide NHANES IV survey and up to 10-fold higher than other rural agricultural studies.
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Affiliation(s)
- Beti Thompson
- Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, M3-B232, P.O. Box 19024, Seattle, WA 98109; 206-667-4673 (Phone); 206-667-5977 (fax)
| | - William. C. Griffith
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98105
| | - Dana Boyd Barr
- Department of Environmental Health, Rollins School of Public Health 1518 Clifton Road, NE Claudia Nance Rollins Bldg, Room 2007 Atlanta, GA 30322
| | - Gloria D. Coronado
- The Merwyn “Mitch” R. Greenlick Endowed Senior Investigator in Health Disparities Research The Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave. Portland, OR 97227
| | - Eric M. Vigoren
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98105
| | - Elaine M. Faustman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98105
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9
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Shippee ND, Domecq Garces JP, Prutsky Lopez GJ, Wang Z, Elraiyah TA, Nabhan M, Brito JP, Boehmer K, Hasan R, Firwana B, Erwin PJ, Montori VM, Murad MH. Patient and service user engagement in research: a systematic review and synthesized framework. Health Expect 2013; 18:1151-66. [PMID: 23731468 DOI: 10.1111/hex.12090] [Citation(s) in RCA: 390] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2013] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is growing attention towards increasing patient and service user engagement (PSUE) in biomedical and health services research. Existing variations in language and design inhibit reporting and indexing, which are crucial to comparative effectiveness in determining best practices. OBJECTIVE This paper utilizes a systematic review and environmental scan to derive an evidence-based framework for PSUE. DESIGN A metanarrative systematic review and environmental scan/manual search using scientific databases and other search engines, along with feedback from a patient advisory group (PAG). ELIGIBLE SOURCES English-language studies, commentaries, grey literature and other sources (including systematic and non-systematic reviews) pertaining to patient and public involvement in biomedical and health services research. DATA EXTRACTED Study description (e.g. participant demographics, research setting) and design, if applicable; frameworks, conceptualizations or planning schemes for PSUE-related endeavours; and methods for PSUE initiation and gathering patients'/service users' input or contributions. RESULTS Overall, 202 sources were included and met eligibility criteria; 41 of these presented some framework or conceptualization of PSUE. Sources were synthesized into a two-part framework for PSUE: (i) integral PSUE components include patient and service user initiation, reciprocal relationships, colearning and re-assessment and feedback, (ii) sources describe PSUE at several research stages, within three larger phases: preparatory, execution and translational. DISCUSSION AND CONCLUSIONS Efforts at developing a solid evidence base on PSUE are limited by the non-standard and non-empirical nature of much of the literature. Our proposed two-part framework provides a standard structure and language for reporting and indexing to support comparative effectiveness and optimize PSUE.
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Affiliation(s)
- Nathan D Shippee
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - Juan Pablo Domecq Garces
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Henry Ford Hospital, Detroit, MI, USA
| | - Gabriela J Prutsky Lopez
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine/Detroit Medical Center, Detroit, MI, USA
| | - Zhen Wang
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Tarig A Elraiyah
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Mohammed Nabhan
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Saint Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Juan P Brito
- Endocrinology Division, Mayo Clinic, Rochester, MN, USA
| | - Kasey Boehmer
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Rim Hasan
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Belal Firwana
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | | | - Victor M Montori
- Mayo Clinic, Rochester, MN, USA.,Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - M Hassan Murad
- Mayo Clinic, Rochester, MN, USA.,Knowledge Synthesis Program, Mayo Clinic, Rochester, MN, USA
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Postma J. Balancing power among academic and community partners: the case of El Proyecto Bienestar. J Empir Res Hum Res Ethics 2012; 3:17-32. [PMID: 19385743 DOI: 10.1525/jer.2008.3.2.17] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Balancing power among academic and community partners, addressing community-identified needs, and strengthening community capacity are ethical values unique to community-based participatory research (CBPR). Negotiation of these values in one CBPR environmental justice project was evaluated to advance the environmental and occupational health of a Hispanic agricultural community in central Washington State. Data were collected through document review and participant observation. Applied conversation and discourse analysis were used to interpret the data. Within the organization, farmworkers primarily served an advisory role. Facilitation style influenced how participants negotiated environmental justice. Research goals were advanced in the project, but no direct actions were taken to improve farmworker health. Implementing CBPR's ethical values requires a willingness to confront institutional and interpersonal challenges, and offers a vision of research that builds knowledge and strengthens communities.
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Scammell MK. Qualitative environmental health research: an analysis of the literature, 1991-2008. CIENCIA & SAUDE COLETIVA 2012; 16:4239-55. [PMID: 22031153 DOI: 10.1590/s1413-81232011001100030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Qualitative research uses nonnumeric data to understand people's opinions, motives, understanding, and beliefs about events or phenomena. In this analysis, I report the use of qualitative methods and data in the study of the relationship between environmental exposures and human health. A primary search for peer-reviewed journal articles dated from 1991 through 2008 included the following three terms: qualitative, environ*, and health. Searches resulted in 3,155 records. Data were extracted and findings of articles analyzed to determine where and by whom qualitative environmental health research is conducted and published, the types of methods and analyses used in qualitative studies of environmental health, and the types of information qualitative data contribute to environmental health. The results highlight a diversity of disciplines and techniques among researchers who used qualitative methods to study environmental health. Nearly all of the studies identified increased scientific understanding of lay perceptions of environmental health exposures. This analysis demonstrates the potential of qualitative data to improve understanding of complex exposure pathways, including the influence of social factors on environmental health, and health outcomes.
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Affiliation(s)
- Madeleine Kangsen Scammell
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, Boston, MA, USA.
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12
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Scammell MK. Qualitative environmental health research: an analysis of the literature, 1991-2008. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:1146-54. [PMID: 20421191 PMCID: PMC2920087 DOI: 10.1289/ehp.0901762] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 04/26/2010] [Indexed: 05/20/2023]
Abstract
BACKGROUND Recent articles have advocated for the use of qualitative methods in environmental health research. Qualitative research uses nonnumeric data to understand people's opinions, motives, understanding, and beliefs about events or phenomena. OBJECTIVE In this analysis of the literature, I report the use of qualitative methods and data in the study of the relationship between environmental exposures and human health. DATA SOURCES A primary search on ISI Web of Knowledge/Web of Science for peer-reviewed journal articles dated from 1991 through 2008 included the following three terms: qualitative, environ*, and health. Inclusion and exclusion criteria are described. DATA EXTRACTION Searches resulted in 3,155 records. Data were extracted and findings of articles analyzed to determine where and by whom qualitative environmental health research is conducted and published, the types of methods and analyses used in qualitative studies of environmental health, and the types of information qualitative data contribute to environmental health. DATA SYNTHESIS Ninety-one articles met inclusion criteria. These articles were published in 58 different journals, with a maximum of eight for a single journal. The results highlight a diversity of disciplines and techniques among researchers who used qualitative methods to study environmental health, with most studies relying on one-on-one interviews. Details of the analyses were absent from a large number of studies. Nearly all of the studies identified increased scientific understanding of lay perceptions of environmental health exposures. DISCUSSION AND CONCLUSIONS Qualitative data are published in traditionally quantitative environmental health studies to a limited extent. However, this analysis demonstrates the potential of qualitative data to improve understanding of complex exposure pathways, including the influence of social factors on environmental health, and health outcomes.
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Affiliation(s)
- Madeleine Kangsen Scammell
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA.
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13
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Earle-Richardson G, Sorensen J, Brower M, Hawkes L, May JJ. Community collaborations for farmworker health in New York and Maine: process analysis of two successful interventions. Am J Public Health 2009; 99 Suppl 3:S584-7. [PMID: 19890162 DOI: 10.2105/ajph.2009.166181] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We conducted a process evaluation of 2 successful farmworker community-based participatory research intervention development projects (in Maine and New York State). Participant surveys measured satisfaction with the program process. We used qualitative methods to analyze free-text responses. Respondents indicated high satisfaction levels overall. The main concern was long-distance project coordination. Community-based participatory research programs in which (1) the work team defines the target health issue, (2) agricultural employers are meaningfully included, and (3) interventions are carried through to completion, warrant further study.
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Affiliation(s)
- Giulia Earle-Richardson
- New York Center for Agricultural Medicine & Health, Bassett Healthcare, One Atwell Rd, Cooperstown, NY 13326, USA.
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Arcury TA, Marín A, Snively BM, Hernández-Pelletier M, Quandt SA. Reducing farmworker residential pesticide exposure: evaluation of a lay health advisor intervention. Health Promot Pract 2009; 10:447-55. [PMID: 18287581 PMCID: PMC3088730 DOI: 10.1177/1524839907301409] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The goal of this analysis is to evaluate the effectiveness of a promotora program for teaching women in Latino farmworker families about pesticide safety and increasing pesticide safety behaviors. Volunteer promotoras delivered a pesticide safety curriculum (intervention) and nutrition curriculum (control) to farmworker women residing in western North Carolina and Virginia. Pre-and postintervention interviews assessed differences in delivery of the intervention, recognition of the intervention, pesticide knowledge, pesticide exposures behaviors, and integrated pest management behaviors. Participants in the intervention group reported significantly more receipt of pesticide education and greater recognition of the key messages. However, their knowledge, pesticide exposure behaviors, and integrated pest management behaviors did not change. A more structured program is needed to be sure that the dose of interventions is large enough to overcome educational and cultural characteristics of immigrant communities. Policy changes are needed to address circumstances outside of farmworkers' control that affect pesticide exposure.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1084, USA.
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15
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Cook WK. Integrating research and action: a systematic review of community-based participatory research to address health disparities in environmental and occupational health in the USA. J Epidemiol Community Health 2008; 62:668-76. [PMID: 18621950 PMCID: PMC2772828 DOI: 10.1136/jech.2007.067645] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Integrating research and action represents a goal and key principles of community-based participatory research (CBPR), but there has been little effort to synthesise the literature to evaluate whether such integration is occurring. OBJECTIVES (1) To examine the extent to which CBPR integrates action to effect community-level change and (2) to ascertain factors that facilitate such integration. METHODS Original articles reporting on CBPR in environmental and occupational health in the USA were identified primarily through a MEDLINE search. Inceptions, processes, methods and outcomes of the projects were reviewed. RESULTS In 14 of the 20 studies reviewed, CBPR led to community-level action to improve the health and well-being of the community members. Observational studies that investigated problems posed by the affected community and that incorporated qualitative methods were more likely to lead to action. The collaboration among government scientists, university researchers and community partners emerged as a new model of CBPR partnerships that effectively integrates research and action. CONCLUSIONS To help CBPR better integrate research and action, a shift towards community-initiated and action-oriented observational studies might be needed.
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Affiliation(s)
- W K Cook
- Alcohol Research Group, University of California, Berkeley, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608, USA.
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Cargo M, Mercer SL. The Value and Challenges of Participatory Research: Strengthening Its Practice. Annu Rev Public Health 2008; 29:325-50. [PMID: 18173388 DOI: 10.1146/annurev.publhealth.29.091307.083824] [Citation(s) in RCA: 515] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Margaret Cargo
- Department of Psychiatry and Douglas Mental Health University Institute, McGill University, Verdun, Quebec H4H 1R3, Canada
- Current address: School of Health Sciences, University of South Australia, City East Campus, Adelaide, South Australia 5001;
| | - Shawna L. Mercer
- The Guide to Community Preventive Services, Division of Health Communications, National Center for Health Marketing, Centers for Disease Control and Prevention, Atlanta, Georgia 30333;
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Rothlein J, Rohlman D, Lasarev M, Phillips J, Muniz J, McCauley L. Organophosphate pesticide exposure and neurobehavioral performance in agricultural and non-agricultural Hispanic workers. ENVIRONMENTAL HEALTH PERSPECTIVES 2006; 114:691-6. [PMID: 16675422 PMCID: PMC1459921 DOI: 10.1289/ehp.8182] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Our understanding of the health risks of farmworkers exposed to pesticides in their work and home environments is rapidly increasing, although studies designed to examine the possible neurobehavioral effects of low-level chronic pesticide exposure are limited. We measured dialkyl phosphate urinary metabolite levels, collected environmental dust samples from a subset of homes, obtained information on work practices, and conducted neurobehavioral tests on a sample of farmworkers in Oregon. Significant correlations between urinary methyl metabolite levels and total methyl organophosphate (azinphos-methyl, phosmet, malathion) house dust levels were observed. We found the neurobehavioral performance of Hispanic immigrant farmworkers to be lower than that observed in a nonagricultural Hispanic immigrant population, and within the sample of agricultural workers there was a positive correlation between urinary organophosphate metabolite levels and poorer performance on some neurobehavioral tests. These findings add to an increasing body of evidence of the association between low levels of pesticide exposure and deficits in neurobehavioral performance.
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Affiliation(s)
- Joan Rothlein
- Center for Research on Occupational and Environmental Toxicology, Oregon Health and Science University, Portland, Oregon, USA
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18
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McCormick S, Brody J, Brown P, Polk R. Public involvement in breast cancer research: an analysis and model for future research. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2005; 34:625-46. [PMID: 15560426 DOI: 10.2190/hpxb-9rk8-etvm-rvea] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Public involvement in health program planning has been taking place for many years, and has provided a precedent for the emergence of public involvement in research conducted since the early 1990s. Such involvement is now widely seen in breast cancer research, due to the large public concern and major social movement activity. This article reviews current practices and general models of public involvement in research and constructs a prototype. The authors interviewed researchers, program officers, and laypeople in order to understand the obstacles, processes, and benefits. They conclude that public involvement has major ramifications for the democratization of science and the construction of knowledge by teaching lay people about science and sensitizing researchers to concerns of the public. There is growing support on the part of scientists and government agents for public involvement.
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Affiliation(s)
- Sabrina McCormick
- Department of Sociology, Brown University, Providence, RI 02912, USA
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Suk WA, Avakian MD, Carpenter D, Groopman JD, Scammell M, Wild CP. Human exposure monitoring and evaluation in the Arctic: the importance of understanding exposures to the development of public health policy. ENVIRONMENTAL HEALTH PERSPECTIVES 2004; 112:113-20. [PMID: 14757538 PMCID: PMC1241818 DOI: 10.1289/ehp.6383] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Arctic indigenous peoples face significant challenges resulting from the contamination of Arctic air, water, and soil by persistent organic pollutants, heavy metals, and radionuclides. International cooperative efforts among governments and research institutions are under way to collect the information needed by environmental health scientists and public health officials to address environmental contamination in the Arctic. However, the climatic, political, and cultural conditions of the land and its native populations combine to present a unique set of scientific and logistic challenges to addressing this important public health issue. Public health officials have the responsibility to respect the cultural traditions of indigenous communities, while simultaneously designing strategies that will reduce their exposure to environmental contaminants and rates of disease and dysfunction. Researchers can better understand the link between environmental exposures and disease through monitoring programs for both the subsistence diets and health status of the indigenous populations. We suggest that the incorporation of community-based participatory research methods into programs designed to assess biomarkers of contaminant exposure in children and adults may be a valuable addition to ongoing and newly developed research programs. This approach could serve as a model for international environmental health initiatives, because it involves the participation of the local communities and seeks to builds trust between all stakeholders.
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Affiliation(s)
- William A Suk
- Center for Risk and Integrated Strategies, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina 27709, USA.
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O'Fallon LR, Wolfle GM, Brown D, Dearry A, Olden K. Strategies for setting a national research agenda that is responsive to community needs. ENVIRONMENTAL HEALTH PERSPECTIVES 2003; 111:1855-60. [PMID: 14644657 PMCID: PMC1241757 DOI: 10.1289/ehp.6267] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Setting a national environmental health research agenda requires broad public input, including that from leading scientists, health care professionals, and communities. Contributions from these diverse constituencies are essential to formulating a research and education strategy that both advances our understanding of the causes and mechanisms of environmentally related diseases and translates such findings into effective prevention and clinical applications to protect those most affected by adverse environmental exposures. Given the increasing number of individual researchers working with communities to address environmental health needs during the past decade, it is also essential for research institutions to foster relationships with communities to understand and respond to their unique public health needs, as well as to communicate research advances in a manner that is both understandable and culturally appropriate. To achieve broad public input and to foster community-university partnerships, the National Institute of Environmental Health Sciences (NIEHS) supports various workshops, roundtables, and advisory groups. In particular, the NIEHS finds Town Meetings to be a successful model for bringing academic researchers together with community residents, state and local departments of health, and community-based organizations to foster greater awareness of community needs, public health needs, and environmental health science research. Since 1998, the NIEHS has supported 16 Town Meetings across the country. In this article we highlight the major outcomes of these meetings to demonstrate the effectiveness of this mechanism for enhancing cooperation among researchers, community residents, and public health officials with the goal of improving public health and setting a national research agenda.
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Affiliation(s)
- Liam R O'Fallon
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina 27709, USA.
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Arcury TA, Quandt SA, Dearry A. Farmworker pesticide exposure and community-based participatory research: rationale and practical applications. ENVIRONMENTAL HEALTH PERSPECTIVES 2001; 109 Suppl 3:429-34. [PMID: 11427392 PMCID: PMC1240561 DOI: 10.1289/ehp.01109s3429] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The consequences of agricultural pesticide exposure continue to be major environmental health problems in rural communities. Community-based participatory research (CBPR) is an important approach to redressing health disparities resulting from environmental causes. In this article we introduce a collection of articles that describe projects using CBPR to address the health disparities resulting from pesticide exposure in agricultural communities, particularly the communities of migrant and seasonal farmworkers. The articles in this collection are based on a workshop convened at the 1999 American Public Health Association meeting. The goals in presenting this collection are to provide those endeavoring to initiate CBPR projects needed information, guidelines, and procedures to improve the quality of the CBPR experience; to increase the scientific validity of CBPR projects; and to reduce the potential difficulties and stress of these collaborations. In this introduction we discuss the context in which these projects operate, summarizing background information about farmworkers in the United States, what is known about farmworker pesticide exposure, and the concept of community-based participatory research. Finally, the articles in this collection are summarized, and major themes common to successful CBPR projects are identified. These common features are taking the time to interact with the community, using multiple approaches to engage the different parts of the community, understanding different participants often have different goals, appreciating each group's strengths, valuing community knowledge, and being flexible and creative in conducting research. The final article in this collection describes the translational research program at the National Institute of Environmental Health Sciences (NIEHS) highlighting activities pertinent to the health of rural communities, giving an overview of NIEHS-supported projects addressing health concerns of Native Americans and rural African-American communities in addition to farmworkers, and discussing future plans for CBPR at NIEHS.
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Affiliation(s)
- T A Arcury
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem NC 27157-1084 USA.
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O'Fallon LR, Dearry A. Commitment of the National Institute of Environmental Health Sciences to community-based participatory research for rural health. ENVIRONMENTAL HEALTH PERSPECTIVES 2001; 109 Suppl 3:469-73. [PMID: 11427398 PMCID: PMC1240567 DOI: 10.1289/ehp.109-1240567] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The National Institute of Environmental Health Sciences (NIEHS) is the leading biomedical research institution in the United States whose mission is to support research that seeks to understand how environmental exposures affect human health. NIEHS possesses a longstanding interest in the health effects of agrochemical and other environmental exposures in rural America, including pesticides, to farmers and their families and to migrant farmworkers and their families. In recent years, NIEHS has begun augmenting traditional basic science investigations with innovative programs that translate findings from the laboratory to affected populations. It is through community-based participatory research that NIEHS strives to advance the public health field by fostering the development of culturally relevant interventions that will reduce exposures to environmental contaminants and the risk of environmentally induced disease. In this article, we describe the translational research program at NIEHS as it relates to the NIEHS mission and highlight activities pertinent to the health of rural communities, especially underserved populations. We provide an overview of NIEHS-supported projects addressing health concerns of Native American and rural African-American communities in addition to farmworkers. We conclude with a discussion of future plans for community-based participatory research at NIEHS.
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Affiliation(s)
- L R O'Fallon
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina 27709, USA.
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