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Your Environment. Your Health.

2013

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 and Rebecca Cheezum, Ph.D. in Ghana

Edith Parker with student Rebecca Cheezum, Ph.D., in Ghana.
(Photo courtesy of Edith Parker)

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.

Highlighted publications

  • 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

Dr. Emmett presenting study results at a local high school auditorium.

Dr. Emmett presenting study results at a local high school auditorium.
(Photo courtesy of the University of Pennsylvania)

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.

Highlighted publications

  • 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 looking through a magnifying glass.

“My job is helping scientists communicate to the public in a variety of ways, including video and social media.” – Naomi Hirsch
(Photo courtesy of Naomi Hirsch)

 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!

Highlighted resources

Denise Moreno Ramírez – Empowering communities through research translation and outreach activities

Denise Moreno Ramírez leading a training session

Denise Moreno Ramírez leading a training session
(Photo courtesy of the University of Arizona)

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.

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