Photovoice and Youth Empowerment in Environmental Justice Research: A Pilot Study Examining Woodsmoke Pollution in a Pacific Northwest Community

Citizen Science Studies in Nursing: A Systematic Review

BACKGROUND

Citizen science is a research approach wherein citizens actively participate alongside professionals in some or all stages of the research process. The bidirectional benefits it generates, especially in the field of health, including empowerment, new hypotheses, and results, and addressing issues truly important to society, justify the necessity to establish a common framework and address barriers to ensure a fruitful evolution of this new approach within nursing research. The aim was to analyze nursing projects with a citizen science focus that have been conducted.

METHODS

PRISMA guidelines were employed to conduct a systematic review. Searches were conducted on PubMed, CINHAL, LILACS, IBECS, and Cochrane. Following the identification and screening process, 13 studies were included. The quality of the articles was assessed using the Joanna Brigg Institute (JBI) critical appraisal checklist and the quality of citizen science research using the Citizen Science Appraisal Tool.

RESULTS

Citizen science studies in nursing were notably recent (2017-2023). Five research areas were identified, with environmental health being the most predominant. Multiple tools, both technological and traditional, were utilized, with the "Photovoice" and "Our Voice" methodologies being prominent. Citizen participation was limited to data collection and analysis in 7 out of the 13 studies, with most studies working with small samples. Findings regarding the application of this practice were positive, but no study exceeded 26 points on the CSAT scale to be considered high quality in citizen science.

CONCLUSIONS

Citizen science can be a promising approach within the field of nursing. There is a need to increase individual participation to fully realize the potential bidirectional benefits. It is imperative to establish a common theoretical framework and continue working on the development of this methodology within nursing.

Positive Impacts of Adolescent Involvement in Health Research: An Umbrella Review

Despite an increased recognition of the right of adolescents to be involved in decisions that affect them, young people continue to be under-involved in health research. One of the reasons is a lack of awareness among researchers on the current evidence base around the benefits of involving adolescents. To address this, we conducted an umbrella review to synthesize the evidence on the positive impacts of adolescent involvement in health research. This umbrella review was preregistered with PROSPERO (CRD42021287467). We searched 11 databases, Google Scholar, PROSPERO, reference lists, 10 journals, websites of 472 organizations, and sought input from experts. Ultimately, we included 99 review articles. We found that adolescent involvement has many positive impacts on young people, including increased knowledge and skills; personal development; financial benefits; career and academic growth; enhanced relationships; and valuing their experience. The positive impacts of adolescent involvement on the research itself include increased relevance of the study to adolescents, improved recruitment, development of more adolescent-friendly materials, enhanced data collection and analysis, and more effective dissemination. Researchers also benefited from adolescents' involvement through increased knowledge, skills, and a shift in their attitudes. The evidence supporting the positive impacts of adolescent involvement in research is substantial but limited by a lack of rigorous evaluation, inconsistent reporting, and unclear evaluation methods.

The Eyewitness Community Survey: An Engaging Citizen Science Tool to Capture Reliable Data while Improving Community Participants' Environmental Health Knowledge and Attitudes

Many youths and young adults have variable environmental health knowledge, limited understanding of their local environment's impact on their health, and poor environmentally friendly behaviors. We sought to develop and test a tool to reliably capture data, increase environmental health knowledge, and engage youths as citizen scientists to examine and take action on their community's challenges. The Eyewitness Community Survey (ECS) was developed through several iterations of co-design. Herein, we tested its performance. In Phase I, seven youths audited five 360° photographs. In Phase II, 27 participants works as pairs/trios and audited five locations, typically 7 days apart. Inter-rater and intra-rater reliability were determined. Changes in participants' knowledge, attitudes, behaviors, and self-efficacy were surveyed. Feedback was obtained via focus groups. Intra-rater reliability was in the substantial/near-perfect range, with Phase II having greater consistency. Inter-rater reliability was high, with 42% and 63% of Phase I and II Kappa, respectively, in the substantial/near-perfect range. Knowledge scores improved after making observations (p ≤ 0.032). Participants (85%) reported the tool to be easy/very easy to use, with 70% willing to use it again. Thus, the ECS is a mutually beneficial citizen science tool that rigorously captures environmental data and provides engaging experiential learning opportunities.

Mind the Gaps: The Need for Inclusion of Male-Identified Voices in Adolescent Sexual and Reproductive Health

Adolescent sexual and reproductive health (ASRH) inequities are well documented for historically excluded youth (i.e., youth of color, LGBTQIA+ youth, youth with disabilities, recently im/migrated youth) living in the U.S. Northeast. However, the lived experience of male-identifying young people from historically excluded backgrounds in ASRH remains largely unexamined. The purpose of this paper is to present findings related to male-identified perspectives on social constructions of sexuality, sexual and reproductive health, and sexuality education. A research team composed of two local youth-serving organizations, eight youth researchers, and university researchers, used Youth Participatory Action Research (YPAR) methods to examine how structural violence contributes to inequitable ASRH outcomes for historically excluded youth. Photovoice and community mapping were used as YPAR methods. We also completed individual interviews on the same topic with the youth and with 17 key stakeholders that either provide services to youth or are emerging adult service recipients. Community-driven data reveal two major themes around the silencing of male-identified voices in ASRH: lack of culture-centered and gender-expansive approaches for ASRH, and the subsequent toll of sexism and (cis)gendered social and educational norms on young people. Our findings highlight that sexuality education, cisgender hetero culture, and social norms have put the onus of responsibility on people identifying as women for sexual and reproductive health. An unintended consequence of that is that young people identifying as men may feel powerless and uninformed around their own SRH. Our findings illustrate the importance of using culture-centered and gender-transformative approaches to ASRH to address inequity.

Photovoice Reveals Residents' Concerns for Air and Water Quality in Industry-Impacted Rural Community

Rural communities of color in the southeastern U.S. experience a high burden of environmental hazards from concentrated industry placement. Community-engaged research and qualitative methods can improve our understanding of meaning-making in a community impacted by polluting facilities. This study applies the photovoice method to assess how a predominantly African American community in rural North Carolina, impacted by a landfill and confined animal feeding operations (CAFOs), perceives their health-related quality of life (HRQoL). Two research questions were developed with community-based partners: (a) How do environmental health concerns in this community influence residents' perceptions of their HRQoL? and (b) How do community and county factors facilitate or inhibit community organizing around these concerns? Three photo assignment sessions were held to engage participants in discussions related to the research questions. Researchers analyzed discussion audio recordings and identified themes related to concerns about the following issues: health and quality of life, the landfill industry's influence on community cohesion and self-determination, and actions to address environmental injustice in Sampson County. Photovoice benefits community-engaged researchers by providing a process for assessing the research interests of a community. Photovoice also serves community organizers by providing residents with a structured way to discuss their lived experiences and strategize ways to reduce hazard exposure.

Environmental Justice: Where It Has Been, and Where It Might Be Going

Taking stock of environmental justice (EJ) is daunting. It is at once a scholarly field, an ongoing social movement, and an administrative imperative adopted by government agencies and incorporated into legislation. Moreover, within academia, it is multidisciplinary and multimethodological, comprising scholars who do not always speak to one another. Any review of EJ is thus necessarily restrictive. This article explores several facets of EJ activism. One is its coalitional and "inside-outside" orientation. EJ activists are constantly forming alliances with other stakeholders, but these coalitions do not flout the importance of engaging with formal institutions. The review next turns to one set of such institutions-the courts and regulatory agencies-to see how well EJ claims have fared there. I then survey scientific findings that have been influenced by EJ. The review concludes with future directions for activists and scholars to consider: the changing nature of EJ coalitions, fragmentation within EJ and with other fields, the historical roots of environmental injustice, and opportunities for stronger infusion of the EJ lens.

Engaging communities in addressing air quality: a scoping review

BACKGROUND

Exposure to air pollution has a detrimental effect on health and disproportionately affects people living in socio-economically disadvantaged areas. Engaging with communities to identify concerns and solutions could support organisations responsible for air quality control, improve environmental decision-making, and widen understanding of air quality issues associated with health. This scoping review aimed to provide an overview of approaches used to engage communities in addressing air quality and identify the outcomes that have been achieved.

METHODS

Searches for studies that described community engagement in air quality activities were conducted across five databases (Academic Search Complete, CABI, GreenFILE, MEDLINE, Web of Science). Data on study characteristics, community engagement approach, and relevant outcomes were extracted. The review process was informed by a multi-stakeholder group with an interest in and experience of community engagement in air quality. Thirty-nine papers from thirty studies were included in the final synthesis.

CONCLUSION

A range of approaches have been used to engage communities in addressing air quality, most notably air quality monitoring. Positive outcomes included increased awareness, capacity building, and changes to organisational policy and practice. Longer-term projects and further exploration of the impact of community engagement on improving air quality and health are needed as reporting on these outcomes was limited.

Environmental contaminants and child development: Developmentally-informed opportunities and recommendations for integrating and informing child environmental health science

Child environmental health (CEH) science has identified numerous effects of early life exposures to common, ubiquitous environmental toxicants. CEH scientists have documented the costs not only to individual children but also to population-level health effects of such exposures. Importantly, such risks are unequally distributed in the population, with historically marginalized communities and the children living in these communities receiving the most damaging exposures. Developmental science offers a lens and set of methodologies to identify nuanced biological and behavioral processes that drive child development across physical, cognitive, and socioemotional domains. Developmental scientists are also experts in considering the multiple, hierarchically-layered contexts that shape development alongside toxicant exposure. Such contexts and the individuals acting within them make up an overarching "child serving ecosystem" spanning systems and sectors that serve children directly and indirectly. Articulating how biobehavioral mechanisms and social-ecological contexts unfold from a developmental perspective are needed in order to inform CEH translation and intervention efforts across this child-serving ecosystem. Developmentalists can also benefit from integrating CEH science findings in their work by considering the role of the physical environment, and environmental toxicants specifically, on child health and development. Building on themes that were laid out by Trentacosta and Mulligan in 2020, this commentary presents recommendations for connecting developmental and CEH science and for translating such work so that it can be used to promote child development in an equitable manner across this child-serving ecosystem. These opportunities include (1) Using Developmentally-Informed Conceptual Models; (2) Applying Creative, Sophisticated, and Rigorous Methods; (3) Integrating Developmentally-Sensitive Intervention Considerations; and (4) Establishing Interdisciplinary Collaborations and Cross-Sector Partnerships.

Using the Community Engagement Framework to Understand and Assess EJ-Related Research Efforts

Within an environmental justice frame, capacity-building has been an important component of efforts to address health disparities at the policy, system, and environment levels. While the literature is replete with studies that discuss the necessity of collective action as a means to generate power to overcome inequities, limited attention has been given to the structure of these efforts to build capacity and challenge environmental injustices. This study applies the community engagement continuum as a framework for understanding the scope of capacity-building strategies and the manner in which research investigators engage with their intended target community. Paired teams of independent analysts screened articles for relevance (n = 8452), identified records for content abstraction (n = 163), and characterized relevant studies (n = 58). Many articles discussed community engagement as being either collaborative or shared leadership (n = 32, 55.2%). While the most commonly used capacity-building strategies were organizing/social action (58.6%) and CBPR (50%), few studies were able to make an environmental impact (n = 23; 39.7%), and fewer had a direct legislative policy-related outcome (n = 13; 22.4%). This review identifies levels of collaborative involvement and strategic approaches used for strengthening community capacity in efforts of making transformative policy, systems, and environmental change.

The Role of Citizen Science in Promoting Health Equity

While there are many definitions of citizen science, the term usually refers to the participation of the general public in the scientific process in collaboration with professional scientists. Citizen scientists have been engaged to promote health equity, especially in the areas of environmental contaminant exposures, physical activity, and healthy eating. Citizen scientists commonly come from communities experiencing health inequities and have collected data using a range of strategies and technologies, such as air sensors, water quality kits, and mobile applications. On the basis of our review, and to advance the field of citizen science to address health equity, we recommend (a) expanding the focus on topics important for health equity, (b) increasing the diversity of people serving as citizen scientists, (c) increasing the integration of citizen scientists in additional research phases, (d) continuing to leverage emerging technologies that enable citizen scientists to collect data relevant for health equity, and (e) strengthening the rigor of methods to evaluate impacts on health equity. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Children and Youth Environmental Action: The Case of Children and Youth with Disabilities

Youth environmental activism is on the rise. Children and youth with disabilities are disproportionally impacted by environmental problems and environmental activism. They also face barriers towards participating in activism, many of which might also apply to their participation in environmental activism. Using a scoping review approach, we investigated the engagement with children and youth with disabilities by (a) academic literature covering youth environmental activism and their groups and (b) youth environmental activism group (Fridays For Future) tweets. We downloaded 5536 abstracts from the 70 databases of EBSCO-HOST and Scopus and 340 Fridays For Future tweets and analyzed the data using directed qualitative content analysis. Of the 5536 abstracts, none covered children and youth with disabilities as environmental activists, the impact of environmental activism or environmental problems such as climate change on children and youth with disabilities. Fourteen indicated that environmental factors ‘caused’ the ‘impairments’ in children and youth with disabilities. One suggested that nature could be beneficial to children and youth with disabilities. The tweets did not mention children and youth with disabilities. Our findings suggest the need for more engagement with children and youth with disabilities in relation to youth environmental activism and environmental challenges.

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.

Use of photovoice to explore the potential role of youth in contributing to maternal health in rural Wakiso district, Uganda

Despite youth constituting a large portion of the population in Uganda, their involvement in improving maternal health in their communities has been minimal. This paper explores the potential role of youth in contributing to maternal health in rural communities in Wakiso district, Uganda using photovoice. Photovoice was used as a community-based participatory research method among 10 youth (5 males and 5 females) over a period of 5 months. The photos taken by the youth were discussed in monthly meetings, and emerging data was analysed using thematic content analysis. Four themes emerged regarding how youth can contribute to improving maternal health in their communities. These themes were: community health education; advocacy for health improvement; community voluntary work; and being exemplary. The fifth and final theme provides the avenues, including drama and sports, that the youth suggested they could use for conveying messages to the community concerning maternal and general health. Health education on topics such as the importance of delivering at health facilities was emphasised. Regarding advocacy, the youth said they can be involved in reaching out to various stakeholders to raise concerns affecting maternal health. Voluntary work such as construction of energy stoves for pregnant women emerged. The youth also highlighted that they could be exemplary for instance by males accompanying their spouses during antenatal visits. With the need to continuously engage community actors in health initiatives, youth should be considered and supported as important stakeholders so they may engage in activities to improve health within their communities.

Nursing strategies for environmental justice: A scoping review

OBJECTIVE

To describe types of strategic actions nurses take to promote environmental justice (EJ) through research, education, advocacy, and practice (REAP) reported in peer-reviewed literature.

DESIGN AND SAMPLE

A scoping review of literature was conducted that described EJ nursing strategies and included nurses listed as authors, subjects, partners, or organizational members. The sample consisted of 35 articles, representing 24 primary research studies and 11 nonresearch articles. Data were separately analyzed by research and nonresearch articles for a clearer understanding of evidence-based strategies within domains of REAP.

RESULTS

Articles in the sample highlighted the importance of authentic community partnership and represented diversity of nursing strategies that addressed a range of environmental exposures and subsequent health and racial inequities. Climate justice, a concept that emerged from the EJ movement and intersects with planetary health, is a recent focus in professional nursing.

CONCLUSIONS

This scoping review establishes an understanding of the extent of nursing knowledge and research in EJ and lays the groundwork for further research on effective EJ nursing strategies. Community-Based Participatory Research/Participatory Action Research methods are fundamental for EJ research, and further theoretical development is needed to guide evaluation of EJ nursing strategies for education, advocacy, and practice.

A Scoping Review of Capacity-Building Efforts to Address Environmental Justice Concerns

Environmental justice (EJ) efforts aimed at capacity building are essential to addressing environmental health disparities; however, limited attention has been given to describing these efforts. This study reports findings from a scoping review of community-academic partnerships and community-led efforts to address environmental inequities related to air, water, and land pollution in the United States. Literature published in peer-reviewed journals from January 1986 through March 2018 were included, and community capacity theory was applied as a framework for understanding the scope of capacity-building and community change strategies to address EJ concerns. Paired teams of independent analysts conducted a search for relevant articles (n = 8452 citations identified), filtered records for content abstraction and possible inclusion (n = 163) and characterized selected studies (n = 58). Most articles implemented activities that were aligned with community capacity dimensions of citizen participation (96.4%, n = 53), community power (78%, n = 45), leadership (78%, n = 45), and networks (81%, n = 47); few articles identified a direct policy change (22%, n = 13), and many articles discussed the policy implications of findings for future work (62%, n = 36). This review synthesizes three decades of efforts to reduce environmental inequities and identifies strategic approaches used for strengthening community capacity.

Creating Emancipatory Dialogues About Identity and Health by Modernizing Interviews

Emancipatory insights about health as constituted by demographic identity codifiers remain hidden using current interview methods and analytic techniques. The purpose of this article is to demonstrate how the Identity, Research, and Health Dialogic Open-Ended (I-ReH-DO) Interview was used across 3 separate research topics to enhance emancipatory knowledge development. Three featured research topics focus on health issues relevant to populations worldwide, including asthma management, hypertension management, and preconception care. The use of the I-ReH-DO Interview across multiple studies supports the power of participants to define identity and its health significance, contextualizes research analysis, and advances emancipatory understandings.