| Literature DB >> 27688822 |
Devon C Payne-Sturges, Katrina Smith Korfmacher, Deborah A Cory-Slechta, Maria Jimenez, Elaine Symanski, Jessie L Carr Shmool, Ogonnaya Dotson-Newman, Jane E Clougherty, Robert French, Jonathan I Levy, Robert Laumbach, Kathryn Rodgers, Roseann Bongiovanni, Madeleine K Scammell.
Abstract
Studies have documented cumulative health effects of chemical and nonchemical exposures, particularly chronic environmental and social stressors. Environmental justice groups have advocated for community participation in research that assesses how these interactions contribute to health disparities experienced by low-income and communities of color. In 2009, the U.S. Environmental Protection Agency issued a request for research applications (RFA), "Understanding the Role of Nonchemical Stressors and Developing Analytic Methods for Cumulative Risk Assessments." Seven research projects were funded to help address this knowledge gap. Each engaged with communities in different ways. We describe the community engagement approaches of the seven research projects, which ranged from outreach through shared leadership/participatory. We then assess the experiences of these programs with respect to the community engagement goals of the RFA. We present insights from these community engagement efforts, including how the grants helped to build or enhance the capacity of community organizations in addition to contributing to the research projects. Our analysis of project proposals, annual grantee reports, and participant observation of these seven projects suggests guidelines for the development of future funding mechanisms and for conducting community-engaged research on cumulative risk involving environmental and social stressors including: 1) providing for flexibility in the mode of community engagement; 2) addressing conflict between research timing and engagement needs, 3) developing approaches for communicating about the uniquely sensitive issues of nonchemical stressors and social risks; and 4) encouraging the evaluation of community engagement efforts.Entities:
Year: 2015 PMID: 27688822 PMCID: PMC4981147 DOI: 10.1089/env.2015.0025
Source DB: PubMed Journal: Environ Justice ISSN: 1937-5174
EPA STAR—2009 Cumulative Risk Research Projects
| Community Stressors and Susceptibility to Air Pollution in Urban Asthma | University of Pittsburgh; West Harlem Environmental Action (WE ACT) | Characterized spatial distribution of community psychosocial stressors and air pollution levels across New York City, and examined their separate and synergistic effects on childhood asthma exacerbation in epidemiologic models. | Community and research team members collaboratively developed community data collection methods and conducted analysis of both focus group data and community survey on perceived stressors. Reports of perceived stress, and exposures to key stressors, were used to validate administrative (GIS-based) stressor indicators. |
| Community co-PI, WE ACT led efforts for dissemination of research results to local agency, academic and community stakeholders. | |||
| Effects-Based Cumulative Risk Assessment in a Low-Income Urban Community near a Superfund Site | Boston University School of Public Health (BUSPH); NorthStar Learning Centers | Developed novel methods for cumulative risk assessment, focusing on a low-income community (New Bedford, MA) living near a Superfund site. Models were developed to estimate exposure to multiple chemicals (lead, PCBs, etc.) and non-chemical stressors, and to associate these exposures with blood pressure and ADHD-like behavior outcomes. | Feedback from community partners informed survey design, analytical model development, and interpretation of model results. Survey implementation was led entirely by the community partner, NorthStar, as were development strategies for dissemination of results within the community. |
| Combined Effects of Metals and Stress on Central Nervous System Function | University of Rochester School of Medicine and Dentistry | Tested the hypothesis that stress and chemical stressors that act on the same biological systems (the hypothalamic-pituitary-adrenal (HPA) axis) produce greater effects when they co-occur. Rodent models were used to assess the effects on offspring of perinatal exposure to lead and mercury in combination with stress. | University staff convened focus groups including community group members, advocacy groups, and health care providers to elicit their interpretations of the implications of results for community education, policy, and practice. |
| Effects of Stress and Traffic Pollutants on Childhood Asthma in an Urban Community | Rutgers, the State University of New Jersey; Ironbound Community Corporation (ICC) | Developed and tested a plausible biological mode of action by which psychosocial stress may worsen asthma responses to air pollution among children. Researchers hypothesized that stress modifies the effects of acute exposures to traffic-related air pollutants by blunting the normally protective roles of the hypothalamic-pituitary-adrenal (HPA) and/or sympathetic-adrenal-medullary (SAM) axes in acute asthma exacerbation. | Community groups, including the Ironbound Community Corporation (ICC), were equal partners in decision making, planning, and executing the project. Trained ICC staff were directly engaged in the research through planning and executing study protocols. Research findings were shared and interpreted with community members in ways that can be useful to achieve community goals. |
| Analytical Strategies for Assessing Cumulative Effects of Chemical and Nonchemical Stressors | University of Texas School of Public Health | Evaluated how the spatial distribution of ambient chemical exposures across neighborhoods interacts with nonchemical stressors at both the neighborhood and individual levels to account for differences in adverse cumulative health effects. These adverse effects are represented by biologic markers of allostatic load, cardiovascular risk, hormonal stress response, inflammation, and organ dysfunction. | CBPR Plan involved the Texas City Community Advisory Panel (TCCAP), a pre-existing citizen/government advisory panel created when the primary data was gathered in Texas City from 2004–2007. They reviewed the University researchers' modelling results and provided feedback on interpretation. |
| Hypertension in Mexican-Americans: Assessing Disparities in Air Pollutant Risks | University of Texas School of Public Health; Mano-a-Mano Community Advisory Board | Examined the association between fine particulates and other air pollutants and hypertension, with a focus on quantifying modifying effects of nonchemical stressors on air pollutant effects among Mexican Americans in Houston, TX. Developed novel methods for addressing interactions between chemical and non-chemical stressors in a logistic regression context. | University researchers consulted with the Mano-a-Mano Community Advisory Board which is associated with an ongoing cohort study of the Mexican American community from which this project drew data. In addition the University researchers established a Neighborhood Council of Advisors to provide guidance, validation and feedback on all project activities. Community focus groups helped identify chemical and nonchemical stressors that are of concern to community residents, participated in dissemination of the research findings to communities, and development interventions to reduce disparities. |
| New Methods for Analysis of Cumulative Risk in Urban Populations | Boston University School of Public Health (BUSPH); Chelsea Collaborative | Used qualitative research methods and quantitative structural data analysis techniques to characterize environmental burden on an individual and community level in the City of Chelsea, MA, and to share results of analyses with community members and public health officials. | The Green Space Committee of the Chelsea Collaborative shared in management and decisions regarding research directions: such as writing the grant proposal; defining the recruitment area and procedures; hiring and training bilingual (English and Spanish) project coordinators and interviewing teams; developing the interview guide; analyzing the data; and reporting results at community meetings. |
Community-Based Participatory Research (CBPR) Plan Requirements
| “A CBPR Plan will be required for each proposed project. Although a range of levels of community involvement can be considered CBPR, CBPR is characterized by substantial community input in the project. In the application, the applicant will need to justify the level of community involvement that he or she has proposed. For additional information on CBPR, see Minkler and Wallerstein ( |
| • Focus on research issues of significance to a community that is interested in the proposed work. |
| • Identify the role of community members in the proposed research plan (i.e., the degree of community input or engagement in the conceptualization, design, methods, analyses, or dissemination of research). |
| • Describe how this research will enhance the capacity of the community. |
| • Include resources for partnership development (e.g., to hire community liaisons or to provide participant support costs for community involvement). |
| • If a host organization (any organization/institution other than the applicant) is used to facilitate community participation or partnerships, evaluate the organization's mission and practices concerning community partnerships (e.g., how the staff has or can develop skills to sustain community participation). |
| • Determine how to disseminate research findings to the identified community as well as the scientific community. |
| • Provide evidence of community support.” (USEPA2009) |
Peer Review Criteria for STAR Community-Based Participatory Research (CBPR) Plan
| “Demonstration that the focus is on research issues of significance to a community that is interested in the proposed work and that the role of the community members is appropriate for the research; the ability of the research to enhance community capacity; the plan for disseminating research findings to the community; if a host organization is used to facilitate community participation, evaluation of the organizations community partnership mission and practices; and evidence of community support” (USEPA2009). |