Partnerships for Environmental Public Health
- John Sullivan – Setting the Stage for Healthier Communities
- Erin Haynes, Dr.P.H. – Partnering for Healthier Communities
- Annie Belcourt, Ph.D. - Increasing Awareness of Native American Environmental Health Disparities
- Asa Bradman, Ph.D. – Advocating for Children's Environmental Health
- Allison Patton and Kevin Lane – Working with communities to understand near-highway air pollution
- Edith Parker, Dr.P.H. – Community-Engaged Researcher
- Edward (Ted) Emmett, M.D. – An innovator in occupational medicine, communication, and community empowerment
- Naomi Hirsch – Using Web technologies to engage with stakeholders
- Denise Moreno Ramírez – Empowering communities through research translation and outreach activities
- Related Links
John Sullivan – Setting the Stage for Healthier Communities
John Sullivan never expected he would have a career in the field of environmental health. He is trained in the arts and has worked as a writer, playwright, director, poet, performance artist, and arts educator. When he learned that the NIEHS-funded Center in Environmental Toxicology (CET) at the University of Texas Medical Branch at Galveston (UTMB) was interested in using theatre to educate and engage environmental justice communities, he saw an opportunity to use his background to help people understand the science behind the issues that were affecting their health and quality of life. Sullivan is now director of the Public Forum and Toxics Assistance (Division 3) within the CET’s Community Outreach and Engagement Core (COEC). He is also an instructor in the UTMB Department of Preventive Medicine & Community Health and an associate member in the Institute for Medical Humanities.
Sullivan uses a technique called Forum Theatre to help communities understand science and to help scientists understand communities. Created by Augusto Boal, a ground-breaking director and playwright from Brazil, Forum Theatre promotes positive community change. The technique encourages the audience, or “spect-actors,” to step into the show when they have a different idea or solution about how to solve the problem being portrayed. “Forum Theatre is community driven, community members create and act in their own shows, the audience is attentive and interactive, and the process gets people to think about realistic ways to solve a community problem,” Sullivan explained
Many Gulf Coast families live in communities bordering oil refineries or industrial plants. These families often cannot afford to move to healthier, safer places. Sullivan organizes Forum Theatre workshops around environmental health issues of immediate concern to these communities. Over the years, workshops have covered topics such as hazardous air pollutants, lead poisoning, environmental asthma triggers, the built environment, and trichloroethene vapor intrusion.
Sullivan also trains community leaders to facilitate their own Forum Theatre workshops. In partnership with the Houston-based community group de Madres a Madres, Sullivan trained a troupe of volunteers in Forum Theatre techniques, and a team of CET researchers taught them about community-relevant environmental health issues. The troupe delivered over 30 bilingual and culturally sensitive performances, raising awareness of childhood lead exposure and environmental asthma triggers and teaching families how to reduce or eliminate these hazards from their homes. The project, Communities Organized against Asthma & Lead (COAL), was funded by the NIEHS Environmental Justice: Partnerships for Communication Program.
More recently, Sullivan has been working alongside Gulf Coast Health Alliance: Health Risks Related to the Macondo Spill (GC-HARMS) project. GC-HARMS is one of several projects funded by the NIEHS to examine the health effects stemming from the 2010 Deepwater Horizon oil spill. The goal of GC-HARMS is to examine the impact of the oil spill on seafood safety and ultimately develop seafood consumption guidelines.
Sullivan helps coordinate the community involvement component of GC-HARMS, giving presentations to local fishermen about how the knowledge gained from the project could benefit their families and communities and training them to collect samples. The fishermen used their local knowledge of inland and coastal waters to develop with the exposure assessment team a multi-species sampling matrix that eventually became a GPS-coded map of all of the project sampling sites. “I’ve been closely connected with the local fishermen for several years now and working with them has been a really rewarding part of this project. We couldn’t do this without their help and knowledge of the local environment,” said Sullivan.
For more information, including a video and articles, about some of the workshops Sullivan has facilitated, visit the UTMB Center to Eliminate Health Disparities’ Forum Theatre Skills & Concept Demonstration page.
- Sullivan J. 2010. Engaging neighbors, transforming toxic realities: community environmental forum theatre using Augusto Boal’s Theatre of the Oppressed to promote environmental justice. In: Creative Arts in Interdisciplinary Practice: Inquiries for Hope and Change (McLean CL, Kelly R, eds). Edmonton: Brush Education.
- Sullivan J, Lloyd RS. 2007. The forum theatre of Augusto Boal: a dramatic model for dialogue and community-based environmental science. Local Environment: The International Journal of Justice and Sustainability 11(6):627-646.[Abstract ]
Erin Haynes, Dr.P.H. – Partnering for Healthier Communities
Erin Haynes has always loved both people and the environment, so when she first learned about the field of environmental health as an undergrad at Wilmington College of Ohio, she saw the perfect opportunity to marry her two passions. Haynes has since dedicated her life to studying how chemicals in the environment affect people and to working with communities to ensure they understand how to protect their health.
After receiving her Dr.P.H. in Environmental Health Science from the University of Michigan’s School of Public Health, Haynes was hired as a postdoctoral fellow in the NIEHS T32 Molecular Epidemiology in Children’s Environmental Health training program. From there, she moved to the University of Cincinnati (UC), where she now serves as an associate professor and director of the UC master’s program in Clinical and Translational Research. Haynes played an integral role in establishing and shaping the program, which offers a community-based participatory research course that emphasizes the role of community engagement in clinical research.
Haynes is also director of the UC Community Outreach and Engagement Core (COEC) within the NIEHS-funded Center for Environmental Genetics and is currently leading three community-based research projects in Ohio. All three studies were prompted by community concerns about local air quality and its effect on health.
Through the Communities Actively Researching Exposure Study (CARES), Haynes has been studying how airborne manganese emissions from a Marietta, Ohio industrial plant are affecting local children’s health. The community helped shape the research direction of CARES. After meeting with community groups and sharing with them what was known about the health effects of manganese, the question of how exposure was affecting their children’s mental development stood out as the major concern. This was also a primary question among scientists at the time.
The communities I work with influence the path of my research. I listen to their questions and concerns which then drive the research. My research has benefited tremendously from community involvement. – Erin Haynes, Dr.P.H.
Before launching CARES, Haynes conducted a community-wide survey and learned that Marietta residents looked primarily to physicians and journalists to get environmental health information. In response, Haynes and her UC COEC colleagues developed educational resources , including modules for physicians and nurses and a video for journalists, to ensure they had accurate information to educate the community about air pollution and health.
Since starting CARES, Haynes has partnered with a second Ohio community, East Liverpool, which also experiences high levels of airborne manganese. Haynes first learned of the manganese issue in East Liverpool after residents, who had heard of her work in Marietta, expressed their desire to have a similar study conducted in their community. Haynes is now replicating CARES in East Liverpool, and she has also teamed up with colleagues from the UC College of Engineering to develop a portable sensor that can measure blood metal levels in real time. This partnership was driven by Haynes’s desire to get results back to CARES participants faster than the six to nine months it can take to analyze samples using traditional blood-testing methods. Both CARES studies and the development of the sensor are funded by NIEHS.
Most recently, community members have expressed concerns about how chemicals used in the hydraulic fracturing (fracking) process could affect their health. Their concerns have prompted Haynes to initiate two community-engaged research projects. She worked with COECs at the University of Rochester and the University of North Carolina, Chapel Hill to gauge community perception of fracking. She has also teamed up with researchers from Oregon State University to study the effects of fracking on air quality in Carroll County, Ohio, which contains a growing number of fracking sites. To do this, the researchers set up passive air sampling devices at residences near fracking sites and also enlisted study participants to wear personal wristband monitors. The stationary sampling devices can measure more than 1,000 chemicals in the air.
Under Haynes’s leadership, the UC COEC received a community-health award for helping protect families from exposures associated with demolition of a lead-painted bridge in their neighborhood. UC COEC staff created bilingual educational materials and talked with residents about ways to keep their families safe from lead exposure. Intervention was also a critical part of the project – the COEC gave out sticky mats to pick up lead dust from people’s shoes before they entered their homes.
What’s next for Haynes? She hopes to continue following the CARES children to examine the effects of manganese and other metals on their behavior, brain chemistry, structure, and function. According to Haynes, the community continues to ask questions and is very interested in keeping CARES alive and in expanding it to study manganese-induced Parkinsonism in adults. She also hopes to continue her fracking research so that she can provide answers to community questions about potential health effects and provide training for emergency response crews who respond to spills or fires related to the process.
- Rugless F, Bhattacharya A, Succop P, Dietrich KN, Cox C, Alden J, Kuhnell P, Barnas M, Wright R, Parsons PJ, Praamsma ML, Palmer CD, Beidler C, Wittberg R, Haynes EN. 2014. Childhood exposure to manganese and postural instability in children living near a ferromanganese refinery in Southeastern Ohio. Neurotoxicol Teratol 41:71-79.[Abstract ]
- Parin ML, Yancey E, Beidler C, Haynes EN. 2014. Efficacy of environmental health e-training for journalists. Studies in Media and Communication 2(1): 71-80.[Abstract ]
- Korfmacher KS, Elam S, Gray KM, Haynes EN, Hughes MH. 2014. Unconventional natural gas development and public health: toward a community-informed research agenda. Rev Environ Health.[Abstract ]
- Haynes EN, Ryan P, Chen A, Brown D, Roda S, Kuhnell P, Wittberg D, Terrell M, Reponen T. 2012. Assessment of personal exposure to manganese in children living near a ferromanganese refinery. Sci Total Environ 427-428:19-25.[Abstract ]
- Haynes EN, Beidler C, Wittberg R, Meloncon L, Parin M, Kopras EJ, Succop P, Dietrich KN. 2011. Developing a bidirectional academic-community partnership with an Appalachian-American community for environmental health research and risk communication. Environ Health Perspect 119(10): 1364-1372.[Abstract ]
Annie Belcourt, Ph.D. - Increasing Awareness of Native American Environmental Health Disparities
American Indian and Alaska Native (AI/AN) peoples suffer from both a historic legacy of trauma (stemming from European colonization) and current socioeconomic disparities. According to the U.S. Census Bureau , AI/AN peoples have higher rates of poverty, lower median incomes, and lower rates of high school and college completion. In addition, according to the Centers for Disease Control and Prevention , AI/AN peoples have higher rates of infant mortality; substandard housing; smoking; binge drinking; and death from drug abuse, motor vehicles, and suicide.
Annie Belcourt (Otter Woman), an enrolled member of the Three Affiliated Tribes and a descendent of the Blackfeet and Chippewa, is working to address these health issues. Belcourt received her Ph.D. in clinical psychology from the University of Montana and currently teaches at its School of Public & Community Health Sciences and Department of Pharmacy Practice.
In addition to her psychological research on trauma, Belcourt also has participated in environmental health research. Health problems related to environmental exposures play a large role in the lives of Native Americans in Montana. This includes poor water quality stemming from factors such as hydraulic fracturing and a lack of safe water supplies and waste disposal facilities, as well as poor indoor air quality related to mold, wood stoves, and tobacco.
Belcourt is working to improve indoor air quality in two Native American communities, Nez Perce and the Navajo Nation, as part of an NIEHS-funded, two-level health intervention. Highlighting the health risks associated with burning wet wood , the researchers are helping the communities establish wood banks so that residents have access to dry wood for fuel. At the household level, the researchers are comparing the efficacy of (1) an educational intervention focusing on healthy wood-burning practices with (2) an indoor air-filtration system and (3) a placebo (dummy air filters).
Belcourt conducts focus groups and key-informant interviews to help make the educational intervention accessible and culturally appropriate. Part of the intervention involves digital storytelling, a format that allows Native Americans (and others) to create and distribute their own stories in their own words and, in turn, promote health and environmental protection. Storytellers receive training on scriptwriting and digital technology, and they own the rights to their material. The format enables community members to weave together personal narrative, reflections on Native American spirituality, and activism using their native language and images. (See some examples of digital stories from nDigiDreams , which conducts media workshops with Native American communities.)
More broadly, Belcourt is part of the University of Montana’s push to hire more Native American tenure-track professors , and she believes that the key to bringing more Native Americans into academia lies in developing the infrastructure to do so. She is grateful for the postdoctoral research opportunities she had with the Native Elder Research Center and the Indigenous HIV/AIDS Research Training Program , which allowed her to interface with other Native scholars from around the country, and for the support that the National Institute on Minority Health and Health Disparities provided through an endowment grant to the University of Montana – a grant that allowed the University to hire her.
NIEHS is pleased to be a part of Annie Belcourt’s career development and to support her involvement in interdisciplinary research that combines environmental science, cultural literacy, and educational interventions – research that is necessary to address Native American health disparities.
- Beals J, Belcourt-Dittloff A, Garroutte EM, Croy C, Jervis LL, Whitesell NR, Mitchell CM, Manson SM; AI-SUPERPFP Team. 2013. Trauma and conditional risk of posttraumatic stress disorder in two American Indian reservation communities. Soc Psychiatry Psychiatr Epidemiol 48(6):895-905.[Abstract ]
- Jervis LL, Spicer P, Belcourt A, Sarche M, Novins DK, Fickenscher A, Beals J; AI-SUPERPFP Team. 2014. The social construction of violence among Northern Plains tribal members with antisocial personality disorder and alcohol use disorder. Transcult Psychiatry 51(1):23-46.[Abstract ]
- Kelley A, Belcourt-Dittloff A, Belcourt C, Belcourt G. 2013. Research ethics and indigenous communities. Am J Public Health 103(12):2146-2152.[Abstract ]
Asa Bradman, Ph.D. – Advocating for Children's Environmental Health
"Children are not little adults!" This refrain that one sometimes hears in the medical world reminds us that we must take into account children's distinct developmental and physiological concerns. What is true in the clinical setting also applies to environmental exposures. Children eat, breathe, and drink more than adults (per unit of body weight); they engage in behaviors that increase their levels of exposure (e.g., crawling on the floor, putting their hands into their mouths); and their bodies are less able to metabolize and remove chemicals to minimize toxic effects. Since children’s bodies change so rapidly, environmental exposures may impact developmental trajectories.
Asa Bradman knows this better than most. Though he started his career working in environmental chemistry, particularly focusing on acid rain and snow melt chemistry in the Rockies, he later became interested in research that was more directly engaged with people and their wellbeing. He worked for several years at the California Department of Public Health, a crucible for the emerging field of children's environmental health in the 1980s, and he immersed himself in the issue of pediatric lead exposure while completing his Ph.D. in environmental health sciences. He later cofounded the University of California – Berkeley's Center for Environmental Research and Children's Health (CERCH), where he currently serves as its Associate Director for Exposure Assessment.
Under CERCH’s CHAMACOS project, which is examining the connection between environmental exposures and health in a cohort of children (birth through 14 years) in California’s Salinas Valley, he has led studies on pesticide and flame-retardant exposures in pregnant women and children. These exposures have been associated with poorer neurodevelopment in the CHAMACOS children.
Bradman’s flame-retardant work has had a particularly significant impact. Because of the Golden State’s flammability standards that resulted in heavy use of chemicals, the flame-retardant levels in California children are much higher than in children elsewhere. As a result, Governor Jerry Brown has ordered new regulations that meet fire-safety goals and minimize or eliminate chemical exposures.
(Under a new NIEHS-funded grant, Bradman is continuing this line of research by examining the exposure of mothers to organophosphate flame retardants (OPFRs), the prenatal exposure of their children to OPFRs, and the subsequent neurodevelopment of those children.)
Bradman also has focused on the environmental health risks in childcare centers. Under a contract with the California Air Resources Board, he conducted a groundbreaking study of the level of formaldehyde(373KB) (a human carcinogen) and other toxins in childcare centers. He and other researchers also developed an integrated pest management (IPM) curriculum for childcare professionals . IPM is a healthier, more environmentally sound method of dealing with pests; it either avoids chemicals altogether or (if chemicals prove necessary) aims for the least toxic options. For his effort, Bradman won a 2012 IPM Innovator Award from the California Department of Pesticide Regulation.
[We need] careful evaluation of indoor environments and the materials that are used there, particularly when we're thinking of very young children. – Asa Bradman, Ph.D.
Bradman would like more resources put toward understanding environmental exposures in childcare and school environments. He sees big opportunities to support education and outreach that can inform decisions about the materials used in indoor environments and thereby reduce chemical exposures to children.
More broadly, Bradman stresses that when we consider widely used chemicals like flame retardants, we should note that virtually every American has these chemicals in their bodies. Thus, we must ensure that decisions to use chemicals that will expose all of us, starting in the womb, are fully informed and protect public health.
- Bradman A, Castorina R, Gaspar F, Nishioka M, Colón M, Weathers W, Egeghy PP, Maddalena R, Williams J, Jenkins PL, McKone TE. 2014. Flame retardant exposures in California early childhood education environments. Chemosphere. [Epub ahead of print][Abstract ]
- Bradman A, Castorina R, Sjödin A, Fenster L, Jones RS, Harley KG, Chevrier J, Holland NT, Eskenazi B. 2012. Factors associated with serum polybrominated diphenyl ether (PBDE) levels among school-age children in the CHAMACOS cohort. Environ Sci Technol 46(13):7373-7381.[Abstract ]
- Bradman A, Kogut K, Eisen EA, Jewell NP, Quirós-Alcalá L, Castorina R, Chevrier J, Holland NT, Barr DB, Kavanagh-Baird G, Eskenazi B. 2013. Variability of organophosphorous pesticide metabolite levels in spot and 24-hr urine samples collected from young children during 1 week. Environ Health Perspect 121(1):118-124.[Abstract ]
- Eskenazi B, Bradman A, Finkton D, Purwar M, Noble JA, Pang R, Burnham O, Cheikh Ismail L, Farhi F, Barros FC, Lambert A, Papageorghiou AT, Carvalho M, Jaffer YA, Bertino E, Gravett MG, Altman DG, Ohuma EO, Kennedy SH, Bhutta ZA, Villar J; International Fetal and Newborn Growth Consortium for the 21st Century. 2013. A rapid questionnaire assessment of environmental exposures to pregnant women in the INTERGROWTH-21st Project. BJOG 120(Suppl 2):129-138.[Abstract ]
- Gunier RB, Bradman A, Jerrett M, Smith DR, Harley KG, Austin C, Vedar M, Arora M, Eskenazi B. 2013. Determinants of manganese in prenatal dentin of shed teeth from CHAMACOS children living in an agricultural community. Environ Sci Technol 47(19):11249-11257.[Abstract ]
Allison Patton and Kevin Lane – Working with communities to understand near-highway air pollution
Collaboration between environmental health scientists and community groups provides researchers a unique opportunity to strengthen the research process and translate findings to improve community health and inform policy. The NIEHS recognizes the value of community involvement in scientific research and funds many projects that use community-based participatory research (CBPR) approaches. In turn, many of those projects are training a new generation of graduate students and postdoctoral fellows to utilize CBPR methods.
Two such trainees, Allison Patton and Kevin Lane, work on the Community Assessment of Freeway Exposure and Health (CAFEH) (PI: Doug Brugge, Ph.D.) study at Tufts University. CAFEH is working with Boston-area communities to ascertain the relationship between near-highway residential areas and adverse health outcomes. In partnership with local community groups — such as the Chinatown Resident Association, the Chinese Progressive Association, the Committee for Boston Public Housing, and the Somerville Transportation Equity Partnership — CAFEH has conducted research, analyzed results, and published various journal articles, newsletters, and fact sheets regarding particulate matter and the relationship between traffic pollution and health.
Allison Patton received her Bachelor of Science in Environmental Engineering from MIT and is currently a doctoral student in Tufts University’s Civil and Environmental Engineering department; she is also a fellow in the U.S. Environmental Protection Agency (EPA) Science to Achieve Results (STAR) program. She likes measuring the world around her and felt that environmental engineering offered a good way of combining her interests with helping people.
Under the CAFEH study, Patton investigates particulate matter concentrations at varying distances from Interstate 93. For her thesis, she has developed models that predict ambient ultrafine particle (UFP) number concentrations in the study-area neighborhoods under a variety of traffic and meteorological conditions.
Patton measured particulate matter concentrations at different times of day and through different seasons and was in charge of much of the mobile monitoring near the highway, which involved compiling the data and performing quality control.
Patton did not always think her work would involve a major community or public policy component. She figured that she would follow the path of many academics: conduct research, publish findings, and then have the scientific community use her findings to pursue further research. However, she is working on making the data in her models more visual and suitable for those who want to use them for policy development. In addition, she has learned that community members want practical ways to implement research findings. She explained, for example, that people who regularly exercise near a highway should try to avoid doing so during rush hour (when particulate matter concentrations are at their highest), and people who do exercise at a higher-risk time should try to move away from the highway; even just moving to another side of a building — away from the road — can reduce exposure.
More broadly, Patton says that increasing the use of public transportation would decrease air pollution related to traffic congestion (though, she notes, public transportation is losing funding at a time when more people want to switch to it).
Kevin Lane is a doctoral student in environmental health at Boston University and is also an adjunct faculty member in the university’s City Planning and Urban Affairs program. He was a recipient of the Ruth L. Kirschstein National Research Service Award and is now a fellow in the EPA STAR program. His interest in environmental science and policy developed early when he was an undergraduate at St. Michael’s College, majoring in biology and political science, and when he worked as an intern at the New Hampshire Department of Environmental Services, where he conducted quality assurance/control of data and filter analysis for air pollution.
He says he was “thrown into the fire,” however, when he spent three-and-a-half years working as a research assistant for the Harvard School of Public Health’s Trucking Industry Particle Study. He collected air pollution data in working conditions involving high PM2.5 concentrations, and he reported feeling ill himself after coming home from fieldwork.
While a master’s student in Tufts’ Urban and Environmental Policy and Planning program, his professors convinced him that he could contribute the most to society if he focused on the intersection of science and policy. They said that there are plenty of lawyers to work on the policy front, but more work is needed on science translation and the effective use of epidemiological information in policy development.
“[Community participation] helps train us as doctoral students...to be better translators of science so that we’re not just living in the ivory tower. We’re able to actually communicate with everyday citizens and people that are actually being affected by these pollutants. - Kevin Lane
Under the CAFEH study, Lane investigates the health associations between hourly UFP (from Patton’s models) and markers of cardiovascular health. He conducts data and statistical analysis and serves as the geographic information system (GIS) specialist. The latter involves building maps and collaborating with community members to make sure the maps are accurate — even down to the apartment level — to get as close as possible to the research subjects’ personal exposure levels.
Lane sees policy implications for the CAFEH research. He says that at the federal level, more and larger human epidemiological studies of UFP are needed to inform regulatory determinations. In addition, if roadways are indeed the primary sources of UFP, then more local or mobile monitoring will be needed to capture air pollution data from where people actually live and work.
At the local level, he says that officials and community members could help to inform ordinances that reduce exposure to near-roadway air pollution, such as prohibiting new construction of certain buildings (e.g., schools, public housing complexes) within 200 meters of roadways or requiring HEPA filtration systems for existing buildings. He adds that including policy officials throughout the entire course of an environmental health study is vital. By getting involved early, the officials become familiar with the concerns of community members and researchers and can start to consider policy ideas in tandem with data collection and analysis.
Lane is very happy that community members form an integral part of his research. He recognizes the importance of translating his statistical work at public presentations so that residents can then spread the word to their neighbors and peers. He sees this research communication and translation as an important part of his doctoral program that will help him throughout his career.
- Brugge D, Lane K, Padró-Martínez LT, Stewart A, Hoesterey K, Weiss D, Wang DD, Levy JI, Patton AP, Zamore W, Mwamburi M. 2013. Highway proximity associated with cardiovascular disease risk: the influence of individual-level confounders and exposure misclassification. Environ Health 12(1):84.[Abstract ]
- Fuller CH, Patton AP, Lane K, Laws MB, Marden A, Carrasco E, Spengler J, Mwamburi M, Zamore W, Durant JL, Brugge D. 2013. A community participatory study of cardiovascular health and exposure to near-highway air pollution: study design and methods. Rev Environ Health 28(1): 21-35.[Abstract ]
- Lane KJ, Kangsen Scammell M, Levy JI, Fuller CH, Parambi R, Zamore W, Mwamburi M, Brugge D. 2013. Positional error and time-activity patterns in near-highway proximity studies: an exposure misclassification analysis. Environ Health 12(1):75.[Abstract ]
- Padró-Martínez LT, Patton AP, Trull JB, Zamore W, Brugge D, Durant JL. 2012. Mobile monitoring of particle number concentration and other traffic-related air pollutants in a near-highway neighborhood over the course of a year. Atmos Environ 61:253-264.[Abstract ]
Edith Parker, Dr.P.H. – Community-Engaged Researcher
Edith Parker, Dr.P.H.
Director of the Community Outreach and Engagement Core (COEC) of the Environmental Health Sciences Research Center at the University of Iowa
March 8, 2013
Edith Parker is a strong advocate for community-engaged research, particularly projects aimed at designing interventions to reduce environmental exposures and translating research to inform policy change. Her research reflects the mission of the NIEHS Partnerships for Environmental Public Health (PEPH) program to bring together researchers, community members, and policy makers to advance the impact of environmental public health.
Parker’s passion for community-engaged research began in Africa, when she was assigned to a community health project. In the University of Iowa (UI) College of Public Health newsletter, she describes,
While working in Africa both as a secondary school teacher in Kenya and later as a Program Coordinator with Save the Children in Burkina Faso, I was exposed to public health and what it can do to improve the health of populations. I was also exposed to the power of communities and the need to work with, not for, communities in identifying their needs and designing interventions to address those needs. – Edith Parker
Parker returned to the United States to pursue a public health degree and studied with researchers who were well-versed in a community-based approach.
In Michigan, Parker was involved with a team of researchers and community organizations conducting community-based participatory research (CBPR). They worked at an urban research center funded by the Centers for Disease Control and Prevention that partnered with community members to set priorities for research projects. Children’s health issues, with a focus on asthma and lead poisoning, rose to the top.
Parker was part of several NIEHS-funded projects using CBPR approaches to study childhood asthma. The community partners were instrumental in designing the project, from their input on the length and content of the survey to their suggestion that home visits were a more effective way to recruit participants in the air filter part of the study. One project focused on an intervention for childhood asthma using air filters and air conditioning. The team is currently analyzing the results of the intervention, but they have initially found that the air filters reduced particulate matter when used properly. Parker thinks the CBPR approach was critical for this project; she explains, “The project was so effective because there were a lot of logistics, and the input and guidance from the community partners, both in designing the intervention and in the research design, were invaluable in strengthening the research.”
Parker became interested in methods for communicating study data to participants. She got a chance to analyze risk communication in the Community Perceptions of Dioxin (CPOD). The CPOD project focused on examining community members’ perceptions of risk and any behavior changes that resulted from their involvement in the University of Michigan Dioxin Exposure Study (UMDES) study. The team used the mental models approach to assess what is important to the community participants through qualitative interviews and surveys with a large number of people, which was very time intensive. The team is preparing for a stakeholder meeting where they will discuss the study findings. Parker emphasizes how this type of investigation is invaluable in developing successful risk communication messages.
PEPH is a tremendous resource for researchers in terms of helping us find others to help with certain issues or with working with different populations. – Edith Parker
What’s next for Parker? She’s excited about advancing the work with the UI community outreach and engagement core (COEC) that she joined in 2010. The Community Advisory Board of the COEC has been instrumental in suggesting education and outreach activities focused on radon, environmental effects of floods, the farm bill, and other issues relevant to the rural Midwest. She also is exploring future research with Peter Thorne, Ph.D., of the UI Environmental Health Research Center, to work on rural asthma issues related to environmental exposures in Iowa.
- Zikmund-Fisher BJ, Turkelson A, Franzblau A,Diebol JK, Allerton L, Parker EA. 2013. The effect of misunderstanding the chemical properties of environmental contaminants on exposure beliefs: A case involving dioxins. Science of the Total Environment 447:293-300.
- Parker EA, Chung L, Israel BA, Reyes A, Wilkins DW. 2010. Community organizing network for environmental health: Using a community health development approach to increase community capacity around reduction of environmental triggers. Journal of Primary Prevention 31:41–58.[Abstract ]
- Hammond DM, Dvonch JT, Keeler GJ, Parker EA, Kamal AS, Barres JA, Yip FY, Brakefield-Caldwell W. 2008. Sources of ambient fine particulate matter at two community sites in Detroit, Michigan. Atmospheric Environment 42:720-732.
- Parker EA, Lewis TC, Israel BA, Robins TG, Mentz G, Lin X, et al. 2008. Evaluation of Community Action Against Asthma: A community health worker intervention to improve children's asthma-related health by reducing household environmental triggers for asthma. Health Education & Behavior 35(3) 376-395.
- Edgren KK, Parker EA, Israel BA, Lewis TC, Salinas MA, Robins TG, Hill YR. 2005. Community involvement in the conduct of a health education intervention and research project: The Community Action Against Asthma Project. Health Promot Pract 6(3):263-269.[Abstract ]
- Du L, Batterman S, Parker E, Godwin C, Chin JY, O’Toole A, Robins T, Brakefield-Caldwell W, Lewis T. Accepted 13 May 2011. Particle concentrations and effectiveness of free-standing air filters in bedrooms of children with asthma in Detroit, Michigan. J Build Env.
Edward (Ted) Emmett, M.D. – An innovator in occupational medicine, communication, and community empowerment
Edward A. Emmett, M.D., MS
Director of the Community Outreach and Engagement Core of the Center for Excellence in Environmental Toxicology at the Perelman School of Medicine at the University of Pennsylvania
February 11, 2013
Dr. Ted Emmett is an innovator in the field of occupational and environmental medicine, creating training programs and helping set standards for occupational medicine that have laid a foundation for excellence. His approach to research that combines quality science, practical training, and community empowerment represents the type of action-oriented research at the heart of the NIEHS Partnerships for Environmental Public Health program.
I think a good researcher needs to ask the question: Is there a better way of communication that engages people to think for themselves and then follow up on that. – Ted Emmett
After founding occupational medicine programs at Johns Hopkins University and serving as Chief Executive of the body that set standards for health and safety in Australia, Emmett developed the innovative NIOSH-funded occupational medicine residency at the University of Pennsylvania (UPenn). This program allows residents to work in the field and learn through hands-on work in the community where they intend to practice as well as receiving supplemental education and training at UPenn. A trainee from this program, Hong Zhang, M.D., of Parkersburg, W. Va., learned that a manufacturing facility was causing perfluorooctanoic acid (PFOA) contamination in the water distributed the Little Hocking Water Authority(LHWA) in nearby southeastern Ohio.
Emmett partnered with Zhang and the Decatur Community Association in a NIEHS-funded study to address the exposure of residents of the LHWA district to PFOA. As part of this project, Emmett and partners developed the acclaimed “Community-First Communication” model based on discussions with affected community members. Together they established an information hierarchy where the study participants would be the first notified about test results, a procedure that was previously unheard of in environmental health research.
Most notably, 95% of people involved in the study made a change to their behavior as a result of this project, thereby reducing their exposures and risks to their health. This level of compliance with the recommendations of a public health research project is remarkable. – Ted Emmett about his PFOA study in Little Hocking and surrounding communities.
As a result of this project, DuPont reduced its discharges of PFOA, offered free bottled water to affected residents, and entered into a consent agreement with EPA to help any other similarly affected communities. Most notably, 95% of people involved in the study made a change to their behavior as a result of this project, thereby reducing their exposures and risks to their health. This level of compliance with the recommendations of a public health research project is remarkable.
When asked about conducting research to inform policy and change behavior, Emmett said the key to success is to start with a solid project design that will produce results that will be accepted as good science, to respect the people involved in the study, and to disseminate results in multiple formats so information is widely available to different audiences. Emmett summarized, “If the information is trusted and presented in a logical manner and options and risks are understood, people will generally make healthy choices for themselves.”
What’s next for Emmett? He’s interested in health disparities. He’s working with the community of Chester, Pa. , to address health disparities. He has just begun a project with the Chemical Heritage Museum (partnering with Fran Barg, an anthropologist at UPenn, and others) to create an environmental health history of communities around Ambler, Pa., particularly examining exposures to asbestos. Additionally, he is partnering with another former UPenn resident, Amanda Phillips, M.D., and a current UPenn resident in training, Mark Boquet, M.D., to assess the impacts of the Gulf Oil Spill on the Houma Native Americans in Louisiana and on other community groups as part of the NIEHS-funded GuLF study with the University of Texas Medical Branch in Galveston.
- Emmett EA, Zhang H, Shofer FS, Rodway N, Desai C, Freeman D, Hufford M. 2009. Development and successful application of a “community-first” communication model for community based environmental health research. J Occup Environ Med 51: 146-156.
- Emmett EA, Desai C. 2010.Community first communication: reversing information disparities to achieve environmental justice. Environmental Justice 3(3): 79-84.
- Emmett EA, Shofer FS, Zhang H, Freeman D, Desai C, Shaw LM. 2006. Community exposure to perfluorooctanoate: relationships between serum concentrations and exposure sources. J Occup Env Med 48:759-770.
- Emmett EA, Green-McKenzie J. 2001. External practicum-year residency training in occupational and environmental medicine. J Occup Env Med 43:501-511.
Naomi Hirsch – Using Web technologies to engage with stakeholders
Naomi Hirsch, Ed.M.
Project Coordinator for the Superfund Research Program Research Translation Core and the Environmental Health Sciences Center Community Engagement and Outreach Core at Oregon State University
February 11, 2013
Naomi Hirsch is passionate about utilizing Web technologies to enhance communication with stakeholders and reach broader audiences. Throughout her career, she has been at the forefront of incorporating emerging technologies into her work. This vision of adopting the tools used by your target audience to facilitate communication is central to the NIEHS Partnerships for Environmental Public Health program.
Hirsch’s interest in outreach began with her work in the Peace Corps where she used her background in forestry to work with tree crops in Paraguay. The experience in South America brought her to the University of California, Davis fruit and nut breeding research team. After spending time as a research assistant in the lab and field, Hirsch knew she was more interested in outreach. In 1996, the Web was beginning to play an important role in sharing research and information with the public. Hirsch dove into this new method of information sharing with a position managing an online information and research center that brought together the University of California fruit and nut research from around the state. At that time, Hirsch’s longstanding fascination with Web communication began, because she saw its importance, impact, and challenge. In her current position as project coordinator for the Superfund Research Program (SRP) Research Translation Core (RTC) and the Environmental Health Sciences Center Community Engagement and Outreach Core at Oregon State University, she works to encourage the use of emerging technologies such as Twitter to engage with stakeholders. Her motto for scientists is to “be where the people are” to share research findings and educate about environmental health topics of concern.
Curriculum: Hirsch’s work at OSU began with the Hydroville Curriculum Project , which is a NIEHS-funded, problem-based curriculum that uses environmental health topics to enhance connections between science, language arts, math, social studies, health, and technology. There are three modules available, each focusing on a real-world environmental health issue – pesticide spill, water quality, and indoor air quality. Hirsch’s initial role was assisting with developing and piloting the curriculum, and training the high school teachers. She then adapted the indoor air quality module for community audiences . Later, she obtained funding from the Institute for Water and Watersheds to adapt the curriculum for community college audiences working toward degrees in water, environment, and technology, a program retraining many people out of work for positions in the growing field of water science. Hirsch still manages the Hydroville website, and receives regular requests for the curriculum.
Podcasts: In 2006, Hirsch created a series of podcasts with teachers and students to allow them to share positive experiences using the curriculum and called it the Hydroville Café . She was at the front end of podcasting and found that it was successful, and so began another podcast series with Sandra Uesugi focusing on the Linus Pauling Institute . This series interviewed scientists about micronutrient research and its relationship to environmental health, and was well-received. Hirsch and Uesugi then partnered with the National Pesticide Information Center at OSU to help them produce a podcast series called Pestibytes .
Video: Hirsch and the Outreach team have now moved toward video production. Related to her work with the OSU Gulf of Mexico Oil Spill project , two videos were produced in English, Spanish, and Vietnamese to help the public, specifically the communities impacted by the Gulf Oil Spill, understand environmental contaminants. Hirsch produced other technical videos for a scientific audience about the sampling equipment being used in the Gulf. Recently she produced videos of graduate students giving elevator speeches about their research with the goal of providing them practice and experience with communicating their science via the Web.
Social Media: Hirsch has given many presentations outlining the benefits of incorporating social media into programs. She has created a resource page for scientists who want to get started with social media. She helps manage OSU SRP’s social media strategy that includes a Facebook page , a very active Twitter account , a YouTube channel , and a Pinterest page (designed especially to share K-12 environmental health resources with teachers). She encourages people to try out one social media tool at a time, to think strategically about what they want to achieve through it, and to have an internal workgroup to support the learning curve.
What’s next for Hirsch? She’ll continue enhancing her Centers’ social media, sharing resources and best practices, and offering training and ideas to help scientists be “where the people are” so they can better foster trust and have platforms for engagement, dialogue, and sharing. Be sure to follow her on Twitter ( @naomiadventure ) to see what’s next with emerging technology!
Web and Emerging Technology Resources for Scientists
This is the OSU SRP resource page Hirsch created to help scientists communicate with a broader audience.
Oregon State University Superfund Research Program Research Translation Core
This is the home page of the OSU SRP RTC.
Oregon State University Environmental Health Sciences Center
This is the home page of the OSU EHSC.
Denise Moreno Ramírez – Empowering communities through research translation and outreach activities
Denise Moreno Ramírez, M.S.
Community Engagement Coordinator for the University of Arizona Superfund Research Program and the Dean Carter Binational Center for Environmental Health Sciences
February 11, 2013
Denise Moreno Ramírez is dedicated to empowering communities affected by environmental contamination. In her work at the University of Arizona, she ensures that citizens have the information they need to make important decisions about their health. This focus on building the capacity of the community is part of the mission of the NIEHS Partnerships for Environmental Public Health program.
Moreno Ramírez first became interested in community engagement work in the mid-1990s when her hometown of Nogales, Ariz., was on the national news due to health effects (cancer and lupus clusters) as a result of environmental exposures. At this time, researchers approached her high school science club to help conduct a survey of community members concerning these effects. When her club never received the results of the survey and she became more aware of the environmental justices issues in her community, she decided to pursue a career in environmental science. In her job as community engagement coordinator for the University of Arizona Superfund Research Program (UA SRP) and the Dean Carter Binational Center for Environmental Health Sciences , she actively communicates with those affected by UA SRP research. Some recent projects include:
Our collaboration with promotoras is essential because they can effectively convey important environmental information to disadvantaged populations, which we would not necessarily encounter on a day-to-day basis. Promotoras approach community members as neighbors and friends, so they can readily provide a special type of outreach that is very grassroots-driven. - Denise Moreno Ramírez
Train-the-Trainer Module Program – funded by the U.S. Environmental Protection Agency (EPA) Border 2012
The UA SRP Community Engagement Core (CEC) recently created a train-the-trainer program for promotoras to complement outreach in their communities. This program was developed because promotora groups wanted access to training materials UA SRP had developed for local promotoras. The program features four modules – arsenic, environmental toxicology, pesticides, and fate and transport of contaminants – each of which contain background information and additional resources, hands-on activities, a PowerPoint presentation and multi-media materials, and real-time assessment tools. UA leveraged funding from its SRP grant to pilot the trainings, which were led by UA SRP professors, graduate trainees, and environmental promotoras. A number of training workshops were held, and the final workshop was led entirely by promotoras from the Sonoran Environmental Research Institute (SERI). The modules are now being finalized and will be published soon (online and hard copies).
Due to the success of the training program, the UA SRP received an additional grant (from UA) to add another module on risk assessment. The development of this module will be informed by the lessons learned during the pilot tests of the other four modules. It will also expand work with promotoras in the Border region who are working on broadening the scope to environmental themes.
Small Business Pollution Prevention – funded by the EPA
Another collaborative project of the UA SRP and SERI is promoting green business practices in the Tucson, Ariz. area. SERI initiated this project by mapping areas of concern, such as industrial odors, reported to them by community members. The UA SRP and others provided the promotoras with training and resources related to pollution prevention. With this information, the promotoras visited businesses and held workshops to address the community concerns and promote green practices. Some of the businesses the team has approached include printers; woodworking shops; dry cleaners; auto body, paint, and repair shops; and beauty and hair salons. As part of the visits and workshops, the team surveyed the businesses to identify their interest in green practices, knowledge gaps, and practices already in place. They followed up with the businesses later to assess practices that were implemented as a result of their visits. Moreno Ramírez said she has seen an improvement in the way businesses respond in the two years they’ve been conducting these visits. Additionally, she notes, “We were able to document reduced exposures and reduced uses of certain chemicals.” The results have recently been shared at pollution prevention forums, and there are plans to put materials used online.
UA SRP Student Training – funded by the National Institute of Environmental Health Sciences
The CEC has started working with the Training Core to ensure that all new UA SRP students receive an experience in both community engagement and research translation. This program began two years ago and is now required for new students. Each student has a choice of short- or long-term community engagement and research translation related activities, such as attending a community meeting, creating an information sheet, or participating in promotora module trainings. Moreno Ramírez indicated that the program has been a success: “Many of the students say this was one of the most fulfilling experiences they had as SRP training core students because they were able to see how science is applied.”
What’s next for Moreno Ramírez? The next few months will be busy as she works with SERI to publish their work. She is also developing a community engagement project exploring new communication methods, which she plans on implementing in the Border region.
An interview with Moreno Ramírez and team members about the Small Business Pollution Prevention program
Moreno Ramírez's presentation – “Pollution Prevention Success Story: Partnering with Promotoras”
A news story about the Train-the-Trainer program
Bilingual Information Sheets