Community-engaged Research Approach Research Articles

Using a community engaged research approach to develop the social skills training program for adults with Williams syndrome.

This article describes the development of a distance-delivered social skills training program for adults with Williams syndrome (SSTP-WS) through a community engaged approach. Throughout six phases of development, the research team received input from adults with Williams syndrome, caregivers, service providers, educators, and researchers on (a) the need for a training program and topics to be addressed (Phase 1), (b) an initial draft of the SSTP-WS (Phase 3), (c) the intervention pilot study (Phase 5), and (d) feedback to provide context for the results of the study (Phase 6). The development of the SSTP-WS resulted in an intervention aligned with the Williams syndrome community's values and needs that supports the unique cognitive and behavioral phenotypes and social characteristics of this low incidence disability population.

Using an Equity in Research Framework to Develop a Community-Engaged Intervention to Improve Preexposure Uptake Among Black Women Living in the United States South

Abstract In the U.S. South, over half of new HIV diagnoses occur among Black Americans with research lagging for women who face increased HIV rates and low PrEP uptake, among other health inequities. Community engaged research is a promising method for reversing these trends with established best practices for building infrastructure, implementing research, and translating evidence-based interventions into clinical and community settings. Using the 5Ws of Racial Equity in Research Framework (5Ws) as a racial equity lens, the following paper models a review of a salon-based intervention to improve PrEP awareness and uptake among Black women that was co-developed with beauty salons, stylists, and Black women through an established community advisory council. In this paper we demonstrate how the 5Ws framework was applied to review processes, practices, and outcomes from a community-engaged research approach. The benefits of and challenges to successful collaboration are discussed with insights for future research and community impact.

Military community engagement to prevent firearm-related violence: adaptation of project safe guard for service members

BackgroundSuicide, especially by firearm, remains a leading cause of death in military populations in the USA. Reducing access to firearms, especially during high risk times, may help prevent suicide and other forms of violence. The purpose of this study was to adapt a promising existing lethal means safety intervention (Project Safe Guard, PSG) for cross-cutting violence prevention and peer support in active-duty service communities using community engagement methods.MethodsA two-pronged community-engaged research approach was employed, including the Community Translation (CT) process that engaged 15 Service Members from one installation to help adapt PSG successfully. In addition, qualitative data was collected from 40 active-duty service members and military violence prevention specialists through in-depth interviews and focus group discussions.ResultsQualitative data and CT feedback led to site-specific PSG adaptations. Participants emphasized the importance of peer-to-peer discussions and highlighted resource allocation, leadership support, and stigma on firearm ownership as potential implementation challenges.ConclusionsFindings demonstrate the feasibility of community-engaged research to adapt lethal means safety interventions within military populations. PSG implementation should consider resource allocation, leadership support, and addressing stigma. This study has implications for future policies and standards for performing research on sensitive topics, particularly among military populations.

A typology of Inuit youth engagement in environmental research

The roles of Indigenous youth in environmental research remain largely unexplored with little practical guidance for achieving meaningful engagement in environmental research. This paper aims to characterize the varying types of Inuit youth engagement in environmental research conducted in Inuit Nunangat. Findings were derived from a community-engaged participatory research approach in Mittimatalik (Pond Inlet, Nunavut). Our typology of Inuit youth engagement in environmental research suggests three types of engagements: “participate”, “conduct”, and “control”. Results highlight that Inuit youth who are interested in undertaking their own environmental research projects expect to enhance their knowledge of natural and life sciences more than those who may seek short-term supportive research roles. Strategies employed by researchers seeking to enhance youth research capacity may also vary based on youth wants and expectations. Our findings suggest that there is no one-size-fits all solution. None of the engagement types identified were necessarily and inherently considered better than the others by project contributors, unlike what has been proposed in other, hierarchical, typologies. Our proposed typology contributes to a better understanding of the varying roles that Inuit youth can play in environmental research, as well as inform potential frameworks for enhancing Inuit youth engagement and leadership in research.

"What if that's your last sleep?" A qualitative exploration of the trauma of incarceration and sleep.

Sleep is an underexplored factor in the health of people involved in the criminal legal system. This study addresses the paucity of research on how individual, social, and physical environmental factors impact sleep health during and after incarceration by highlighting the voices of people involved in the criminal legal system through a community-engaged qualitative research approach. We conducted 20 semi-structured interviews with men recently released from prison for a study on trauma and healthcare during incarceration and after release. Interviews were coded and analyzed using reflexive thematic analysis and a critical realist framework. Our research team included people with a history of incarceration who performed central roles in the research process. Three themes emerged from participants' descriptions of sleep during and after incarceration: (1) concerns about health contributing to sleep problems, (2) lack of access to treatment for sleep disorders leading to ongoing sleep problems, and (3) issues of safety contributing to sleep problems during incarceration and after release. This study identifies factors and domains influencing sleep during and after incarceration. By identifying which interpersonal, environmental, and structural factors impact sleep quality, medical and carceral staff are better equipped to ameliorate sleep health disparities within populations with a history of incarceration and those actively bound by the criminal legal system. Future research should examine other factors impacting sleep in incarcerated and recently released populations and develop multi-level interventions to improve sleep health. This paper is part of the Sleep and Circadian Health in the Justice System Collection.

Healthcare experiences among Black and White sexual and gender minority cancer survivors: a qualitative study.

The purpose of this study was to explore healthcare experiences of Black and White sexual and gender minority (SGM) cancer survivors across the cancer care continuum. This was a qualitative analysis of two focus groups and eight individual interviews completed as part of a larger initiative using a community-engaged research approach to reduce cancer disparities in marginalized communities. There was a total of 16 participants in the study (9 were White, 7 were Black) and data were collected between 2019 and 2020. Three main themes emerged from the thematic analysis: strategically coming out, provider preferences, and health system challenges. Participants noted that they often came out through their support system, decided to come out based on the relevance of their SGM identity that they perceived, and expressed a desire for privacy. Lack of an accessible and competent PCP was tied to delayed cancer diagnosis and many participants voiced a preference for consistency when they found a provider they liked. Providers across specialties can address barriers for SGM patients by not making assumptions about patient sexual orientation or gender identity. Institutions should systematically collect sexual orientation and gender identity information. Primary care providers should be aware that due to resistance to switching from trusted providers, they may need to take greater initiative to facilitate cancer screenings for their patients when appropriate or take special care when making referrals to ensure they are using SGM-affirming providers. SGM cancer survivors often benefit from a cultivating relationship with a trusted PCP or other provider.

Sonic play: on the B-side of literacy and songwriting

PurposeThis paper aims to explore sonic play in close proximity to a music, literacy and songwriting for social change community-based initiative. The authors leverage ideas about time, space and narrative under the concept of sonic flux to understand youth’s sonic and aural play on digital beatmaking technologies. In doing so, the authors break from a fixation on the written and spoken word and address sound, aurality and Blacktronika creative technologies that are often present but muted in literacies and songwriting scholarship.Design/methodology/approachThe authors’ team consisted of three community-based teaching artists who situated this inquiry around their own practice with youth. The authors conducted this inquiry through a qualitative, participatory and community-engaged research approach. As such, the authors codeveloped and carried out research questions and sense-making protocols that balance the power of interpretation and epistemologies among us.FindingsThe findings address how the joy, laughter and play of one young musician, Malik, moved across different conceptions of time while learning to make beats in proximity to peers writing lyrics for songs. Specifically, the authors unpack how Malik’s play with mobile sound-making technologies moved across linear and nonlinear time that characterize sonic space and sound art, not music and lyric writing. In doing so, the loops and durations of his sonic play were sometimes unbound by narrative structures that often code literacy and songwriting initiatives.Originality/valueThe authors’ inquiry speaks into literacy and songwriting initiatives that privilege spoken, written and performed word over sound. The authors ask what kind of participating structures, collaborations, ontologies and youth epistemologies open up if we think of youth in these spaces not only as performers but as programmers tinkering with time in the machine. In addition, the authors ask what literacy and songwriting spaces might look like when the duration, loops and drones of sonic space and not music are the structuring codes over narratives and linearity.

A religious minority tax in healthcare? Insights from Muslim American physicians

Physicians from marginalized racial, ethnic, sexual, and gender backgrounds often encounter adversity, ranging from overt discrimination to subtle microaggressions, which impacts their professional careers. Consequently, concerted efforts to promote workforce diversity in healthcare have begun to tackle these issues. In this study, we further these efforts by uplifting the voices of a minority religious community, Muslim physicians, and their experiences in the medical profession. Using a community-engaged research approach, we recruited 18 physicians from 3 national Muslim clinician organizations who had worked at a university hospital within the last 20 years to participate in semi-structured interviews focused on how their religious identity intersects with experiences of discrimination and accommodation. Deploying a phenomenological framework, we identified four emergent themes that cut across the 18 interviews. The physicians’ experiences demonstrated that they i) shouldered extra labor to uphold their religious identity, (ii) denied their personal experiences of religious discrimination, (iii) feared religious discrimination, and (iv) mislabeled their personal management of religious practices as institutional accommodations. These experiences suggest that the additional responsibilities and burdens that saddle underrepresented racial and ethnic identities in medicine – dubbed “the minority tax” – extend to this religious minority group. They also highlight a unique set of psychological and professional costs associated with carrying a Muslim identity in the physician workforce. Our findings underscore the need for healthcare systems to take bold action in creating non-discriminatory, inclusive, and equitable working environments that attend to the religious identities of diverse physicians.

Toward a new model of childhood asthma care: community needs assessment in an underserved urban population

Objectives The objective of this study was to utilize a community-engaged research approach to better understand gaps and opportunities for improving asthma care from the perspectives of patients, caregivers, community organization representatives, and healthcare providers in a predominantly minority community. Methods Forty-one participants from four groups (patients, caregivers, community organization representatives, healthcare providers) participated in interviews or focus groups. A phenomenological approach to this qualitative research allowed the research team to better understand the lived experiences of families seeking asthma care in this community. Results Five gaps and five corresponding opportunities were identified. The gaps identified were unequal healthcare resource distribution; underrepresentation of health professionals from diverse backgrounds; experiences of environmental racism; mistrust, bias, and discrimination in healthcare encounters; and systemic marginalization of communities. The opportunities identified include increasing healthcare infrastructure and accessibility; increasing racially, culturally, and linguistically congruent healthcare; implementing equitable improvements to the built environment; building relationships with communities and individuals; and acknowledging communities’ strengths and resilience. Conclusion This study identified systemic gaps to asthma care that are of prominent concern to the community.

0835 Cancer Patient-Caregiver Dyad Reports of Insomnia, Depression, Anxiety, Symptom Management and Healthcare Utilization

Abstract Introduction More than 1.9 million new cases of cancer were diagnosed in 2022; 30,210 of those were in Alabama. Both caregivers and patients report high levels of insomnia, depression, anxiety and stress that can be linked to a cancer diagnosis, cancer therapies, and the stressful cancer journey. Insomnia, depression, and anxiety may lead to poor symptom management at home and inappropriate (over or under) utilization of healthcare resources. However, these relationships in cancer patients and family caregivers need further exploration. This cross-sectional study is using a community-engaged research approach to gather data to support the development and testing of a model of these relationships and targeted interventions. Methods Caregiver-patient dyads are being recruited at a rural oncology clinic. Each dyad completes a role specific survey one-time during a clinic visit. Sleep is assessed with PSQI and ISI, Depression with PHQ-9, Anxiety with GAD-7, and Stress with PSS. Healthcare resource utilization is captured by self-report. Caregivers report patient symptoms and level of confidence with home symptom management. Patients report quality of life with FACT-G. Target enrollment is 50 dyads for the full study. Results To date we have enrolled 33 patient-caregiver dyads (66% of target). Sleep quality (PSQI) and insomnia levels (ISI) ranged from no difficulties to significant difficulties for both groups. Similar variances in depression (PHQ-9), anxiety (GAD-7), and perceived stress (PSS) have been reported. On these measures, some dyad members appeared to mirror each other, whereas others reported vast differences. Caregivers who reported a greater number of patient symptoms tended to report lower levels of confidence in home symptom management. Approximately 50% of the participants have reported healthcare resource utilization, with a majority reporting little to no use of healthcare services. Indicating possible underutilization. Conclusion The cancer journey impacts both patients and caregivers. However, the impact is reflected differently in each member of the dyad. More research is needed to explore the individual and dyadic experiences along the cancer journey and to model the relationships to develop effective interventions for both the cancer patient and family caregiver. Support (if any) Project funding- Office of Research & Economic Development, University of Alabama.

173 Delving into Sociocultural Influences in Access to Care in Black Women and Latinas with Uterine Fibroids

OBJECTIVES/GOALS: Uterine fibroids (UF) are a significant public health concern with a lifetime prevalence of over 70% in all women, however Black/African American women (BW) are disproportionately affected by UF, and Hispanic/Latinas (HL) mostly understudied. Our goal is to investigate sociocultural influences on menstrual and UF experiences of BW and HL with UF. METHODS/STUDY POPULATION: We have taken a community engaged research approach and partnered with the Fibroid Foundation, a patient UF advocacy group. Following IRB approval, the study was advertised on the Fibroid Foundation’s various social media platforms, such as Instagram. Screening began on October 25, 2022, the screening survey included participants’ contact information, preferred time of contact, time zone, and confirming identifying as a BW and/or HL diagnosed with UF. Ensuring eligibility, we plan to conduct semi-structured interviews for participants. The interviews will be conducted via phone or video call based on participant preference. The interviews will be sent for transcription to an external HIPAA compliant vendor then analyze the interviews for a priori and new themes using traditional content analysis. RESULTS/ANTICIPATED RESULTS: As of November 13, 2022, over 200 participants have completed the screening survey with a total of 133 (66.5%) being eligible to participate. The demographics are the following: 109 (82%) Black women, 14 (10.5%) Latinas, 4 (3%) Afro-Latinas, and 6 (4.5%) did not disclose ethnoracial identity. The participants were sent a consent form and will be interviewed. We anticipate achieving our goal of interviewing a minimum of 60 women for this study. Based on our previous research, we expect to find sociocultural influences leading to negative experiences of menstruation that affect access to care for UF. We also expect women will lack sufficient and accurate information regarding menstrual symptoms and UF. We additionally anticipate seeing delays in UF diagnosis. DISCUSSION/SIGNIFICANCE: There is a need to discuss sociocultural influences around menstruation as negative perceptions lead to delayed diagnosis of UF and can be translated to other gynecological diseases, such as endometriosis and endometrial and ovarian cancer. This suite of female-specific conditions all share increased disparity in historically minoritized women.

The Community Engaged Digital Alzheimer’s Research (CEDAR) Study: A Digital Intervention to Increase Research Participation of Black American Participants in the Brain Health Registry

BackgroundAlthough Black/African American older adults bear significant inequities in prevalence, incidence, and outcomes of Alzheimer’s disease and related dementias, they are profoundly under-included in Alzheimer’s Disease research. Community-Engaged Research (e.g., equitable community/ science partnerships) is an evidence-based approach for improving engagement of underrepresented populations into Alzheimer’s Disease research, but has lacked scalability to the national level. As internet use among older adults from underrepresented populations continues to grow, internet-based research shows promise as a feasible, valid approach to engagement and longitudinal assessment. The Community Engaged Digital Alzheimer’s Research (CEDAR) study utilizes a community-engaged research approach to increase the engagement and research participation of Black/African American adults in the Brain Health Registry (BHR) and Alzheimer Disease clinical research.ObjectivesTo describe the methods and evaluate the feasibility of the CEDAR culturally-informed digital platform within BHR.DesignAll Black/African American participants in BHR were invited to enroll in CEDAR and to consider serving on a newly convened Community-Scientific Partnership Board to guide the study. The community board guided the development a culturally-informed cadre of engagement materials and strategies to increase research participation. Engagement strategies included incentives for study task completion, culturally-informed communications (e.g., landing page, emails and social media), resources about brain health, and video and written testimonials by CEDAR participants.SettingBHR, an Internet-based registry and cohort.ParticipantsBHR participants self-identifying as Black/African American were invited to enroll. All participants who signed an online informed consent document were enrolled.MeasurementsWe report the number of participants invited, enrolled, completed tasks, and volunteered to join the community board. We compared the demographics, cognitive profile, and baseline BHR task completion rates between CEDAR participants and all those invited to join the study. RESULTS: Of 3738 invited, 349 (9.34%) enrolled in CEDAR. 134 (37% of CEDAR participants) volunteered to join the community board, of which 19 were selected for the community board. Compared to those invited, the CEDAR cohort had a higher percentage of female participants (84.5%) and a lower percentage of participants who identify as belonging to more than one ethnocultural group (21.8%). Compared to those did not enroll in CEDAR, those enrolled in CEDAR had a higher percentage of participants completing all BHR tasks (22%) and a higher percentage of participants completing at least one cognitive test (76%). Those enrolled in CEDAR also had a higher percentage of participants having an enrolled study partner (18%).ConclusionsA culturally-informed Community-Engaged Research approach, including a remotely-convened community board, to engagement of Black/African American participants in an online research registry is feasible. This approach can be adapted for use in various clinical studies and other settings. Future studies will evaluate the effectiveness of the engagement strategies.

Stakeholder experiences of a public safety personnel work reintegration program

Public safety personnel (PSP) are at risk of experiencing operational stress injuries (OSIs). The functional impairments caused by OSIs can contribute to challenges with returning to pre-injury operational requirements. A Canadian municipal policing agency developed a peer-led workplace reintegration program (RP) to assist PSP in their workplace reintegration after an illness or injury. Although this RP has been used internationally, there is a paucity of research on this program and its implementation by PSP organizations. The perspectives of key stakeholders are important for capturing the current state of RPs and future directions for the advocacy, implementation, sustainability, and spread of the RP, and to set the stage for future research. The purpose of this study was to explore the experiences and perspectives of key stakeholders engaged in the creation, implementation, facilitation, and execution of RPs in Alberta, Canada. This will help identify strengths, barriers, facilitators, needs, processes, and attitudes associated with the RPs and direction for future research. A qualitative thematic analysis of focus groups (N=8) involving key stakeholders (N=30) from five PSP organizations with RPs was conducted using a community-engaged research approach as part of a larger mixed-methods study. Four key themes emerged from the participants: (1) Integral elements of success, (2) Integral needs, (3) Key areas of growth, and (4) Evolution of the Program. While RPs are highly regarded by the key stakeholders, it is essential that evidence-based research guide the evaluation, modification, implementation, spread, and scale of RPs globally.

Feasibility of a Community-Based, Online, Peer-Supported Spinal Cord Injury Self-management Intervention: Protocol for a Pilot Wait-Listed Randomized Trial

People with spinal cord injury (SCI) report feeling unprepared to manage their disability upon discharge to the community. This situation is exacerbated when they return to settings where self-management support and resources are sparse, thus increasing the risk of costly secondary conditions and rehospitalizations. These factors make a compelling case for implementing innovative community-based SCI self-management programs that empower and engage individuals with SCI. Using a community-engaged research (CEnR) approach, we developed a peer-supported SCI self-management intervention, known as PHOENIX (Peer-supported Health Outreach, Education, and Information Exchange), which integrates online educational content and support from peer navigators (PNs) through telehealth, to promote health and community participation after SCI. The objective of this pilot study is to evaluate the feasibility and acceptability of PHOENIX and the study design, and to obtain estimates of the variability of relevant outcome measures. We conducted a pilot randomized waitlist-controlled trial (n=30) in collaboration with the South Carolina Spinal Cord Injury Association (SCSCIA), our long-standing community-based nonprofit organization research partner. We recruited 4 PNs through our SCSCIA collaboration using its existing network of trained peer mentors. Our study design supported comparison of the following 2 randomly assigned groups: PHOENIX intervention group and waitlist enhanced usual care (EUC) group. The PHOENIX intervention was administered online by PNs over 16 weeks through scheduled "video visits." The EUC group participated in the study for 16 weeks with usual community services and no navigation, and received 4 monthly newsletters from the SCSCIA on a variety of SCI-relevant topics. At the end of the waitlist period, the waitlist EUC group received the full PHOENIX intervention. Measures of feasibility included PN and participant recruitment and retention, PN workload, protocol adherence, and incidence of technical issues. We conducted qualitative interviews with participants and PNs to evaluate the acceptability of PHOENIX and the study design. Outcome measures, including community participation, quality of life, and the occurrence and subjective impact of medically serious secondary conditions and rehospitalizations, were assessed at baseline after randomization and at subsequent time points to allow between-group comparisons. PN hiring and training were completed in August 2018. Recruitment began in November 2018. A total of 30 participants were recruited across South Carolina, and 28 participants completed follow-up by August 2020. An analysis of the results is being finalized, and the results are expected to be published in 2023. This study will provide valuable information to guide future research seeking to address unmet self-management needs and improve outcomes in individuals with SCI. Feasibility findings of this study will provide evidence from CEnR guided by people with SCI and SCI service providers to inform further development, testing, and dissemination of effective and scalable self-management strategies for people with SCI. RR1-10.2196/42688.

Community Engagement in Crime Reduction Strategies: A Tale of Three Cities

Violent crimes in the United States rose for the first time in four years in 2020 (FBI, 2020). The typical and seeming logical response by communities and their police departments is to dispatch more officers to areas of criminal activity. But crime data tracked over the years shows that ‘overpolicing’ isn’t an effective tool at lessening crime rates, can be a strain on budgets, and can heighten tense relationships between police and community members. In this research, we test a community-engaged participatory research approach that combines crime data, design, and engagement in developing the needed policies, tools, and strategies for crime prevention in three medium-sized cities in Michigan. This innovative approach enabled action-oriented recommendations for neighborhood improvements that were grounded in the needs, issues, and concerns of each city. Our data collection approach was an iterative process, whereby data collected at one phase informed data collected in subsequent phases. While our crime data were collected between 2017-2019, our findings showed that bringing residents and stakeholders together with decision-makers and experts can be an effective tool to address environmental design and crime prevention policies especially in the postpolice defunding era. Additionally, successful crime prevention should be based on social programs and physical improvements to the built environment that are unique to the city. In summary, this participatory approach offers non-police driven crime prevention strategies and allows community members an opportunity to drive these strategies.

Community perspectives on how decentralising an emergency shelter influences transportation needs and use for persons experiencing homelessness.

Despite steady increases in homelessness in the U.S., only recently has research on transportation needs and use for persons experiencing homelessness (PEH) been the focus of research endeavours. Moreover, limited research has identified how the geographic relocation of homeless community services and resources impacts the transportation needs of PEH and how this process affects access to health and social services. To fill this gap in the literature, using a community-engaged research approach, we conducted a qualitative research study in which 24 professionals working in planning, transportation, local government, and the homelessness services sector were engaged in in-depth, semi-structured interviews. We examined participant perspectives on how PEH transportation needs and use changed after three new emergency shelters replaced a centralised one, and how access to health and social services was impacted. Data were organised into three overarching categories: (1) Changes in transportation need and use following decentralisation; (2) Impact of transportation changes on PEH access to services; and (3) Recommendations for improving transportation access. Findings suggest the need to offer PEH transportation on demand, provide education on transportation and system navigation, and increase transportation-related funding for homeless service providers and PEH to ensure transportation costs are not a barrier to healthcare and social services.

The Benefits of Community Engaged Research in Creating Place-Based Responses to COVID-19.

ObjectiveThe DSU COVID-19 study aims to understand the response to and impact of COVID-19 in nine underserved communities in Delaware and to inform public health messaging. In this article, we describe our community engaged research approach and discuss the benefits of community engaged research in creating place-based health interventions designed to reduce entrenched health disparities and to respond to emerging or unforeseen health crises. We also highlight the necessity of sustained community engagement in addressing entrenched health disparities most prevalent in underserved communities and in being prepared for emerging and unforeseen health crises.MethodOur study is a longitudinal study comprised of three waves: initial, six months follow-up, and twelve months follow-up. Each wave consists of a structured survey administered on an iPad and a serology test. Through community engaged research techniques, a network of community partners, including trusted community facilities serving as study sites, collaborates on study implementation, data interpretation, and informing public health messaging.ResultsThe community engaged approach (CEnR) proved effective in recruiting 1,086 study participants from nine underserved communities in Delaware. The research team built a strong, trusting rapport in the communities and served as a resource for accurate information about COVID-19 and vaccinations. Community partners strengthened their research capacity. Collaboratively, researchers and community partners informed public health messaging.ConclusionThe partnerships developed through CEnR allow for place-based tailored health interventions and education. Policy Implications: CEnR continues to be effective in creating mutually beneficial partnerships among researchers, community partners, and community residents. However, CEnR by nature is transactional. Without sustained partnerships with and in underserved communities, we will make little progress in impacting health disparities and will be ill-prepared to respond to emerging or unforeseen health crises. We recommend that population health strategies include sustainable research practice partnerships (RPPs) to increase their impact.

Wildfire Impact on Indoor and Outdoor PAH Air Quality.

Air quality impacts from wildfires are poorly understood, particularly indoors. As frequencies increase, it is important to optimize methodologies to understand and reduce chemical exposures from wildfires. Public health recommendations use air quality estimates from outdoor stationary air monitors, discounting indoor air conditions, and do not consider chemicals in the vapor phase, known to elicit adverse effects. We investigated vapor-phase polycyclic aromatic hydrocarbons (PAHs) in indoor and outdoor air before, during, and after wildfires using a community-engaged research approach. Paired passive air samplers were deployed at 15 locations across four states. Twelve unique PAHs were detected only in outdoor air during wildfires, highlighting a PAH exposure mixture for future study. Heavy-molecular-weight (HMW) outdoor PAH concentrations and average Air Quality Index (AQI) values were positively correlated (p < 0.001). Indoor PAH concentrations were higher in 77% of samples across all sampling events. Even during wildfires, 58% of sampled locations still had higher indoor PAH air concentrations. When AQI values exceeded 140 (unhealthy for sensitive groups), outdoor PAH concentrations became similar to or higher than indoors. Cancer and noncancer inhalation risk estimates from vapor-phase PAHs were higher indoors than outdoors, regardless of the wildfire impact. Consideration of indoor air quality and vapor-phase PAHs could inform public health recommendations regarding wildfires.

Use of Radioisotope Ratios of Lead for the Identification of Historical Sources of Soil Lead Contamination in Santa Ana, California.

Lead (Pb) is an environmental neurotoxicant that has been associated with a wide range of adverse health conditions, and which originates from both anthropogenic and natural sources. In California, the city of Santa Ana represents an urban environment where elevated soil lead levels have been recently reported across many disadvantaged communities. In this study, we pursued a community-engaged research approach through which trained “citizen scientists” from the surrounding Santa Ana community volunteered to collect soil samples for heavy metal testing, a subset of which (n = 129) were subjected to Pb isotopic analysis in order to help determine whether contamination could be traced to specific and/or anthropogenic sources. Results showed the average 206Pb/204Pb ratio in shallow soil samples to be lower on average than deep samples, consistent with shallow samples being more likely to have experienced historical anthropogenic contamination. An analysis of soil Pb enrichment factors (EFs) demonstrated a strong positive correlation with lead concentrations, reinforcing the likelihood of elevated lead levels being due to anthropogenic activity, while EF values plotted against 206Pb/204Pb pointed to traffic-related emissions as a likely source. 206Pb/204Pb ratios for samples collected near historical urban areas were lower than the averages for samples collected elsewhere, and plots of 206Pb/204Pb against 206Pb/207 showed historical areas to exhibit very similar patterns to those of shallow samples, again suggesting lead contamination to be anthropogenic in origin, and likely from vehicle emissions. This study lends added weight to the need for health officials and elected representatives to respond to community concerns and the need for soil remediation to equitably protect the public.

Community-Engaged Use of Low-Cost Sensors to Assess the Spatial Distribution of PM2.5 Concentrations across Disadvantaged Communities: Results from a Pilot Study in Santa Ana, CA.

PM2.5 is an air pollutant that is widely associated with adverse health effects, and which tends to be disproportionately located near low-income communities and communities of color. We applied a community-engaged research approach to assess the distribution of PM2.5 concentrations in the context of community concerns and urban features within and around the city of Santa Ana, CA. Approximately 183 h of one-minute average PM2.5 measurements, along with high-resolution geographic coordinate measurements, were collected by volunteer community participants using roughly two dozen low-cost AtmoTube Pro air pollution sensors paired with real-time GPS tracking devices. PM2.5 varied by region, time of day, and month. In general, concentrations were higher near the city’s industrial corridor, which is an area of concern to local community members. While the freeway systems were shown to correlate with some degree of elevated air pollution, two of four sampling days demonstrated little to no visible association with freeway traffic. Concentrations tended to be higher within socioeconomically disadvantaged communities compared to other areas. This pilot study demonstrates the utility of using low-cost air pollution sensors for the application of community-engaged study designs that leverage community knowledge, enable high-density air monitoring, and facilitate greater health-related awareness, education, and empowerment among communities. The mobile air-monitoring approach used in this study, and its application to characterize the ambient air quality within a defined geographic region, is in contrast to other community-engaged studies, which employ fixed-site monitoring and/or focus on personal exposure. The findings from this study underscore the existence of environmental health inequities that persist in urban areas today, which can help to inform policy decisions related to health equity, future urban planning, and community access to resources.