Co-creating a local environmental epidemiology study: the case of citizen science for investigating air pollution and related health risks in Barcelona, Spain

Citizen science in environmental health research: A comparison with conventional approaches and creation of a guidance tool issued from the LILAS initiative

CONTEXT

Public interest for citizen science (CS) in environmental health is growing. The goals of environmental health research projects are diverse, as are the methods used to reach these goals. Opportunities for greater implication of the civil society and related challenges differ at each step of such projects. These methodological aspects need to be widely shared and understood by all stakeholders. The LILAS initiative (acronym for "application of citizen science approaches such as LIving LAbS to research on environmental exposures and chronic risks") aimed to 1) favor a mutual understanding of the main issues and research methods in environmental health, of their stakes for different actors, but also of the requirements, strengths and limitations of these methods and to 2) identify expected benefits and points of attention related to stronger degrees of participation as part of environmental health research projects.

METHODS

The LILAS initiative gathered institutional researchers, academics and civil society representatives interested in environmental exposures. Five meetings allowed to collectively identify different types of environmental health research studies and reflect about the benefits, limitations, and methodological issues related to the introduction of growing citizen participation as part of such studies. An analytic table matrix summarizing these aspects was co-created and filled by participants, as a tool devoted to help stakeholders with the definition of future CS research projects in environmental health.

RESULTS

For different fields of research (e.g.: studies for assessment of environmental exposures, interventions on these exposures, quantitative risk assessment, epidemiological studies), the matrix lists expected benefits for various stakeholders, the fundamental principles of research methods and related practical constraints, but also advantages and limitations related to the use of CS or conventional research approaches.

CONCLUSION

The LILAS initiative allowed to develop a tool which provides consolidated grounds for the co-creation of research projects on environmental exposures involving CS.

Implementing co-created citizen science in five environmental epidemiological studies in the CitieS-Health project

BACKGROUND AND AIM

Scientists and scientific institutions are adopting more extensive participatory models, hoping to revisit the existing relationship between science and society. Though citizen science has become more common in environmental monitoring, it is seldom utilized in environmental epidemiology. In the CitieS-Health project, we co-created epidemiological studies with citizens in five European countries. The aim of this paper is to share our experiences and impart methodological insight into the application of co-created citizen science strategies in environmental epidemiology.

METHODS

We applied the CitieS-Health framework, involving citizens in all the phases of the studies: identifying research questions, designing research protocols, collecting data, analysing data, interpreting data, formulating conclusions, authoring scientific articles and communicating the results to diverse audiences. These epidemiological studies, conducted in specific areas in Italy, Lithuania, the Netherlands, Slovenia and Spain, covered diverse local environmental issues and health effects ranging from air pollution and mental health to industrial pollution and kidney disease.

RESULTS

Together with citizens, we successfully conducted environmental epidemiological studies that generated new scientific knowledge reflecting the concerns and knowledge of citizens. Citizens contributed in all the research activities, including activities beyond formulating the research questions, though the researchers initiated several design discussions and conducted time-consuming and complex tasks (e.g. data analysis, measurement of specific exposures and health outcomes). The challenges we encountered were engaging effectively with citizens throughout the study, harmonizing citizens' knowledge and values with the academics' expertise, managing civic expectations, making complex concepts understandable to citizens and representativeness of participating citizens. The co-created studies were able to empower citizens to address local health concerns by sharing and using scientific knowledge generated from studies.

CONCLUSIONS

Integration of co-created citizen science in environmental epidemiology is feasible and has the potential to improve the quality of research whilst promoting civic trust in research and results.

Consumer Informatics and One Health: Shifting the Focus from the Individual to the Globe. Findings from the Yearbook 2023 Section on Education and Consumer Health Informatics

OBJECTIVE

To summarise the state of the art during the year 2022 in consumer health informatics and education, with a special emphasis on "One Health".

METHODS

We conducted a systematic search of articles published in PubMed. We build queries to merge terms related to "consumer health informatics", "one health", and "digital". We retrieved 94 potential articles for review. These articles were screened according to topic relevance and 12 were selected for consideration of best paper candidates, which were then presented to a panel of international experts for full paper review and scoring. The top five papers were discussed in a consensus meeting. Three papers received the highest score from the expert panel, and these papers were selected to be representative papers on consumer informatics for exploring one health from consumer perspective in the year 2022.

RESULTS

Bibliometrics analysis conducted on words found in abstracts of the 12 candidate papers revealed four clusters of articles, where clustering outcomes explained 96.91% of the dispersion. The first cluster composes three papers related to patient engagement in primary care practices, using digital-delivered diabetes prevention programmes, or exploring citizen involvement in co-designing environmental projects (such as air pollution exposure and health). The second cluster represents four papers related to digital health literacy and consumer behavior, such as digital vaccine literacy, and food labelling influences and whether displaying Nutri- and Eco-Score at food product level led to improved consumer choices. The third cluster consists of two papers exploring strategies to involve citizens in various science projects while analyzing the quality of citizen-collected data (e.g., mosquito bites or gastropod community dataset). The last cluster contains three papers related to the relationships between human behavior with their environment and their contribution to citizen science projects (e.g., biological water quality in the Netherlands distribution, composition, abundance of debris across sandy beaches in Australia and its regions, urbanization and reptile biodiversity across Florida).

CONCLUSION

Traditionally, consumer health informatics focuses on providing individuals with tools and resources to actively manage their own health. By incorporating a global health (or one health) perspective, our field is now at a crossroad, demanding us to think beyond the individual and challenging us to instill the thinking that our actions not only have consequences on the individual but also on the population and the environment. Perhaps this is also a reflective time for the consumer informatics field, to consider shifting the focus from the individual to one that is more aligned with one health, helping consumers gain awareness of how their actions impact on the individual, the population and the environment, and providing them with tools to work collectively to help decide how their actions may bring benefits (as well as harms) across these levels.

Environmental Health Knowledge Does Not Necessarily Translate to Action in Youth

Environmental challenges pose serious health problems, especially for children, and lay public action is lacking. This study sought to characterize the relationship between environmental health knowledge and behavior in youth. A cross-sectional, descriptive survey with quantitative and qualitative questions was conducted. Open-ended questions were coded to generate themes/subthemes. Subscales' scores were presented as mean ± SD or median and interquartile range (IQR). T- and Mann-Whitney tests were used to compare groups, and correlations were used to evaluate covariation. A total of 452 children were surveyed. Youth verbalized concerns about their environments and their impact on health. Air pollution was the most concerning issue. Participants had moderate knowledge scores. Few described the three health domains; even fewer included environment. Behavior scores were low and weakly correlated with knowledge, but were moderately correlated with attitude and self-efficacy. Participation in environmental classes, activities, and clubs was associated with higher scores. We found variable environmental health knowledge, limited understanding of the local environment's impact on health, and a weak association between youth's knowledge and behavior. Focused formal and non-formal educational experiences were associated with improved scores, indicating the value of targeted youth educational programming to increase environmental health knowledge and action.

Short-term NO2 exposure and cognitive and mental health: A panel study based on a citizen science project in Barcelona, Spain

BACKGROUND

The association between short-term exposure to air pollution and cognitive and mental health has not been thoroughly investigated so far.

OBJECTIVES

We conducted a panel study co-designed with citizens to assess whether air pollution can affect attention, perceived stress, mood and sleep quality.

METHODS

From September 2020 to March 2021, we followed 288 adults (mean age = 37.9 years; standard deviation = 12.1 years) for 14 days in Barcelona, Spain. Two tasks were self-administered daily through a mobile application: the Stroop color-word test to assess attention performance and a set of 0-to-10 rating scale questions to evaluate perceived stress, well-being, energy and sleep quality. From the Stroop test, three outcomes related to selective attention were calculated and z-score-transformed: response time, cognitive throughput and inhibitory control. Air pollution was assessed using the mean nitrogen dioxide (NO₂) concentrations (mean of all Barcelona monitoring stations or using location data) 12 and 24 h before the tasks were completed. We applied linear regression with random effects by participant to estimate intra-individual associations, controlling for day of the week and time-varying factors such as alcohol consumption and physical activity.

RESULTS

Based on 2,457 repeated attention test performances, an increase of 30 μg/m³ exposure to NO₂ 12 h was associated with lower cognitive throughput (beta = -0.08, 95% CI: -0.15, -0.01) and higher response time (beta = 0.07, 95% CI: 0.01, 0.14) (increase inattentiveness). Moreover, an increase of 30 μg/m³ exposure to NO₂ 12 h was associated with higher self-perceived stress (beta = 0.44, 95% CI: 0.13, 0.77). We did not find statistically significant associations with inhibitory control and subjective well-being.

CONCLUSIONS

Our findings suggest that short-term exposure to air pollution could have adverse effects on attention performance and perceived stress in adults.