Environmental Health Promotion of a Contaminated Site in Mexico

Impact of Cognitive Intervention on Neurocognitive Development of Schoolchildren Exposed to Lead in a Semi-Urban Community in Mexico

Lead exposure is a severe public health issue that can adversely affect children's neurocognitive development. A semi-urban community in Mexico has been exposed to lead from food cooked in glazed clay pots. A cognitive intervention was conducted from 2015 to 2016 to minimize this negative impact. This intervention aimed to improve the neurocognitive development of the affected children.

METHODS

A quasi-experimental study with a control group was conducted in children aged 7 to 12 years from 2 communities in Morelos, Mexico. Blood lead levels were determined, and the neurocognitive function was assessed pre- and postintervention with the Wechsler Intelligence Scale for Children and Children's Auditory Verbal Learning Test-2. A cognitive intervention was conducted at the school. The difference-in-differences method adjusted for variables known as priori and evaluated the impact of cognitive intervention.

RESULTS

The differences-in-differences models indicated a significant average increase in scores on the Verbal Comprehension Index (9.58 points), Processing Speed Index (5.33 points), intelligence quotient (5.63 points) level of learning (7.66 points), interference trial (10.12 points), immediate memory span (7.98 points), and recognition accuracy (1.18 points) subtests after the cognitive intervention.

CONCLUSION

The results suggest that cognitive intervention improves neurocognitive development in schoolchildren exposed to Pb.

"I Do Not Have the Time of Being sick": Para-Occupational Exposure and Women's Health Risk Perception in an Agricultural Community

INTRODUCTION

Few studies have explored the relationship between para-occupational exposure and risk perception in farmers' families. Women are indirectly involved in agricultural activities, even though their roles most of the time are hidden. Women's para-occupational exposure and risk perceptions are important to describe, since women have a key gender role in the family's health care and possibly in the impact of acting regarding pesticide safety education. Furthermore, in farmer families, the impact of para-occupational pesticide exposure on women's health has been neglected.

AIM

Analyze pesticide para-occupational exposure scenario, knowledge, and health risk perception among women living in a farmer community.

METHODS

A mixed methodology was used. Two groups of women were identified to screen the exposure scenario: Women living in a farming family and women not living in a farming family. Data on para-occupational pesticide exposure and intradomicile practices were collected by questionnaire and semi-structured interviews to identify health risk perception and risk practices.

RESULTS

We observed a complex pesticide exposure scenario. All women were potentially exposed to pesticides through several pathways. One-third of the participants lived near a farming family or in proximity to neighbors that used pesticides at home, and one of every three women referred to spending time in a farmer's home. Among the group of women in a farming family (n = 18) stored pesticides inside the home was common; having the "safety practice" of storing pesticides in high places to avoid children being exposed. Women not living in farmimg families (n = 11) felt overexposed due to living in an agricultural community and agricultural drift exposure. Women from this group also mentioned feeling fear of developing cancerous diseases as well as fertility problems.

CONCLUSIONS

Knowledge and risk perception of pesticide exposure are similar between groups; however, women living in farming families were less willing to attend preventive health check-ups or educational programs than women not living in a farming family.

Popular education to improve water quality and hygiene in a Mexican indigenous community

Long-term research has identified significant water contamination and associated poor health outcomes in the indigenous community of Alpuyeca, located in south-central Mexico. We set out to develop a popular education initiative in this community to improve water, sanitation and hygiene (WaSH) knowledge and practices. In order to avoid recreating hierarchical power dynamics in this vulnerable community, a participatory action research (PAR) design was used, wherein the community took leadership and facilitation roles in each stage of the research process. In qualitative interviews and design sessions, community members identified unsatisfied WaSH needs in households and community institutions and articulated a clear worldview of the spiritual role of water, which guided the development of a series of popular education-based workshops and discussions. The popular education initiative process was documented with a mixed methods framework, using before-and-after surveys, semi-structured interviews and participatory observation. Increases in knowledge and practices related to water purification, water consumption and hand hygiene were noted in the community. The community identified locally installed and managed ecotechnologies as a key opportunity for sustainable development, community participation and the adoption of water and sanitation systems, compatible with public imaginaries of the role of water.

Context matters: Leveraging anthropology within one health

Anthropologists develop long-term engagements with communities, animals, and the ecosystems they all share. This approach can provide important context that is necessary for One Health research, which may otherwise overlook the perspectives and lived experiences of community members. This paper presents two case studies that illustrate the importance of leveraging long-term, holistic, engagements with communities in moving the One Health concept forward. The first illustrates the complexity of understanding the health of people and animals within the context of environmental change in South India. The second provides insights into how the conservation of endangered species requires considering the entanglements of people, domestic animals, and the landscapes they share with wildlife in Madagascar. We demonstrate the value of integrating anthropological perspectives within interdisciplinary One Health research and interventions to better understand the complexity of systems.

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One Health research should incorporate anthropologists and/or social scientists.

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Anthropology provides unique approaches to improve One Health research.

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Long-term engagements with communities will improve One Health research.

Participatory Research for Environmental Justice: A Critical Interpretive Synthesis

BACKGROUND

Environmental health risks are disproportionately colocated with communities in poverty and communities of color. In some cases, participatory research projects have effectively addressed structural causes of health risk in environmental justice (EJ) communities. However, many such projects fail to catalyze change at a structural level.

OBJECTIVES

This review employs Critical Interpretive Synthesis (CIS) to theorize specific elements of participatory research for environmental health that effectively prompt structural change in EJ communities.

METHODS

Academic database search was used to identify peer-reviewed literature describing participatory research with EJ communities to address environmental health. Synthetic constructs were developed iteratively related to study characteristics, design elements, and outcomes; and data were extracted for included records. Statistical analyses were performed to assess correlations between study design elements and structural change outcomes. Through critical, comparative, and contextual analyses of the "structural change" case study group and "non- structural change" group, informed by relevant theoretical literature, a synthesizing argument was generated.

RESULTS

From 505 total records identified, eligibility screening produced 232 case study articles, representing 154 case studies, and 55 theoretical articles for synthesis. Twenty-six case studies resulted in a structural change outcome. The synthesizing argument states that participatory research with EJ communities may be more likely to result in structural change when a) community members hold formal leadership roles; b) project design includes decision-makers and policy goals; and c) long term partnerships are sustained through multiple funding mechanisms. The assumption of EJ community benefit through research participation is critically examined.

DISCUSSION

Recommended future directions include establishing structural change as a goal of participatory research, employing participatory assessment of community benefit, and increased hiring of faculty of color at research institutions. The power, privilege, and political influence that academic institutions are able to leverage in partnership with EJ communities may be as valuable as the research itself. https://doi.org/10.1289/EHP6274.

Fostering social innovation and building adaptive capacity for dengue control in Cambodia: a case study

Background

The social-ecological systems theory, with its unique conception of resilience (social-ecological systems & resilience, SESR), provides an operational framework that currently best meets the need for integration and adaptive governance as encouraged by the Sustainable Development Goals. SESR accounts for the complex dynamics of social-ecological systems and operationalizes transdisciplinarity by focusing on community engagement, value co-creation, decentralized leadership and social innovation. Targeting Social Innovation (SI) in the context of implementation research for vector-borne diseases (VBD) control offers a low-cost strategy to contribute to lasting and contextualized community engagement in disease control and health development in low and middle income countries of the global south. In this article we describe the processes of community engagement and transdisciplinary collaboration underpinning community-based dengue management in rural primary schools and households in two districts in Cambodia.

Methods

Multiple student-led and community-based interventions have been implemented focusing on empowering education, communication for behavioral change and participatory epidemiology mapping in order to engage Cambodian communities in dengue control. We describe in particular the significance of the participatory processes that have contributed to the design of SI products that emerged following iterative consultations with community stakeholders to address the dengue problem.

Results

The SI products that emerged following our interaction with community members are 1) adult mosquito traps made locally from solid waste collections, 2) revised dengue curriculum with hands-on activities for transformative learning, 3) guppy distribution systems led by community members, 4) co-design of dengue prevention communication material by students and community members, 5) community mapping.

Conclusions

The initiative described in this article put in motion processes of community engagement towards creating ownership of dengue control interventions tools by community stakeholders, including school children. While the project is ongoing, the project’s interventions so far implemented have contributed to the emergence of culturally relevant SI products and provided initial clues regarding 1) the conditions allowing SI to emerge, 2) specific mechanisms by which it happens and 3) how external parties can facilitate SI emergence. Overall there seems to be a strong argument to be made in supporting SI as a desirable outcome of project implementation towards building adaptive capacity and resilience and to use the protocol supporting this project implementation as an operational guiding document for other VBD adaptive management in the region.