Mixed methods assessment of personal heat exposure, sleep, physical activity, and heat adaptation strategies among urban residents in the Boston area, MA.

The growing frequency, intensity, and duration of extreme heat events necessitates interventions to reduce heat exposures. Local opportunities for heat adaptation may be optimally identified through collection of both quantitative exposure metrics and qualitative data on perceptions of heat. In this study, we used mixed methods to characterize heat exposure among urban residents in the area of Boston, Massachusetts, US, in summer 2020. Repeated interviews of N = 24 study participants ascertained heat vulnerability and adaptation strategies. Participants also used low-cost sensors to collect temperature, location, sleep, and physical activity data. We saw significant differences across temperature metrics: median personal temperature exposures were 3.9 °C higher than median ambient weather station temperatures. Existing air conditioning (AC) units did not adequately control indoor temperatures to desired thermostat levels: even with AC use, indoor maximum temperatures increased by 0.24 °C per °C of maximum outdoor temperature. Sleep duration was not associated with indoor or outdoor temperature. On warmer days, we observed a range of changes in time-at-home, expected given our small study size. Interview results further indicated opportunities for heat adaptation interventions including AC upgrades, hydration education campaigns, and amelioration of energy costs during high heat periods. Our mixed methods design informs heat adaptation interventions tailored to the challenges faced by residents in the study area. The strength of our community-academic partnership was a large part of the success of the mixed methods approach.

Self-rated health and its association with perceived environmental hazards, the social environment, and cultural stressors in an environmental justice population.

BACKGROUND: Communities with large minority populations often are located near sources of pollution and have higher crime rates, which may work in combination with other factors to influence health. Poor self-rated health is related to chronic health conditions and premature mortality, with minority populations most likely to report poor health. To address how both resident perception of neighborhood environments and chronic health conditions individually and collectively influence health, we examined self-rated health and its association with multiple types of perceived environmental hazards in a majority-Hispanic urban population. METHODS: We conducted interviews with 354 residents of Chelsea, Massachusetts, US and asked about self-rated health, perceptions of their neighborhood, including participant-reported environmental hazards (e.g., air quality, odors and noise), aspects of the social environment (e.g., feeling safe, neighborhood crime, social cohesion), and culture-related stressors (e.g., immigration status, language stress, ethnic identity). Log-linear models examined the independent and multivariable associations between these factors and fair/poor self-rated health, controlling for socio-demographic characteristics and preexisting health conditions. RESULTS: Forty-one percent of participants reported fair/poor self-rated health. Participants frequently perceived environmental hazards such as problems with pests and regular noise disturbance as well as feeling unsafe. In a multivariable model, a greater number of reported noise disturbances (≥ 2 noise sources = 1.53 [1.04-2.26]) and reported insecurity with immigration status (1.66 [1.01-2.73]) were positively associated with fair/poor self-rated health. High social cohesion was inversely associated (0.74 [0.48-1.14]) with fair/poor self-rated health in the multivariable model. CONCLUSIONS: Negative perceptions of environmental hazards and reported cultural stressors were significantly associated with fair/poor self-rated health among residents in a low-income majority-minority community, with social cohesion having a beneficial association with self-rated health. Efforts to improve health should recognize the importance of public perceptions of social and environmental hazards found in neighborhood environments, and benefits of strengthening community connections.

Portable Air Cleaner Usage and Particulate Matter Exposure Reduction in an Environmental Justice Community: A Pilot Study.

Particulate matter (PM) exposure is associated with adverse health outcomes, including respiratory illness. A large fraction of exposure to airborne contaminants occurs in the home. This study, conducted over 5 months in a community with high asthma rates (Chelsea, MA, USA), investigated the use of portable air cleaners (PACs) to reduce indoor PM. Seven asthma-affected households participated, receiving a PAC (Austin Air Health Mate HEPA filter), a QuantAQ sensor to measure PM1, PM2.5, PM10 (µg/m3), and a HOBO plug-load data logger to track PAC usage. Results describe hourly and daily PM concentrations and PAC usage for each household. Hourly average PM concentrations decreased when PACs were turned on (vs. when they were turned off) across households during the study period: PM1 decreased by 0.46 µg/m3, PM2.5 decreased by 0.69 µg/m3, and PM10 decreased by 3.22 µg/m3. PAC usage varied for each household, including constant usage in one household and only usage at certain times of day in others. Higher filtration settings led to lower PM, with significant reductions in some, but not all, homes. Our findings highlight some difficulties in implementing household PAC interventions, yet also provide evidence to support household-level interventions to reduce PM and other indoor sources of air pollution. We also highlight academic-community partnerships as contributing to evidence-based solutions.

Facilitators and Barriers for Keeping Cool in an Urban Heat Island: Perspectives from Residents of an Environmental Justice Community.

Background: Extreme heat is a leading cause of morbidity and mortality during summer months in the United States. Risk of heat exposure and associated health outcomes are disproportionately experienced by people with lower incomes, people of color, and/or immigrant populations. Methods: As qualitative research on the experiences of residents in heat islands is limited, this community-based study examined barriers and coping strategies for keeping cool among residents of Chelsea and East Boston, Massachusetts-environmental justice (EJ) areas that experience the urban heat island effect-through semistructured interviews and qualitative content analysis. Results: Results indicate that all participants (n = 12) had air conditioning, but high energy bills contributed to low use. Eight participants were self-described heat-sensitive, with five experiencing poor health in heat. In addition, nine reported insufficient hydration due to work schedules, distaste of water, or perceptions of it being unsafe. Discussion: This research highlights the importance of understanding perceptions of residents in EJ communities to contextualize vulnerability and identify multipronged heat coping strategies and targeted interventions.

Chemicals in the Creek: designing a situated data physicalization of open government data with the community.

Over the last decade growing amounts of government data have been made available in an attempt to increase transparency and civic participation, but it is unclear if this data serves non-expert communities due to gaps in access and the technical knowledge needed to interpret this "open" data. We conducted a two-year design study focused on the creation of a community-based data display using the United States Environmental Protection Agency data on water permit violations by oil storage facilities on the Chelsea Creek in Massachusetts to explore whether situated data physicalization and Participatory Action Research could support meaningful engagement with open data. We selected this data as it is of interest to local groups and available online, yet remains largely invisible and inaccessible to the Chelsea community. The resulting installation, Chemicals in the Creek, responds to the call for community-engaged visualization processes and provides an application of situated methods of data representation. It proposes event-centered and power-aware modes of engagement using contextual and embodied data representations. The design of Chemicals in the Creek is grounded in interactive workshops and we analyze it through event observation, interviews, and community outcomes. We reflect on the role of community engaged research in the Information Visualization community relative to recent conversations on new approaches to design studies and evaluation.

Reporting Results of a Community-Based In-Home Exposure Monitoring Study: Developing Methods and Materials.

BACKGROUND: Reporting exposure results to study participants provides information that can ideally be used to decrease harmful exposures, improve health, and prevent disease. In reality, we often do not fully understand how an environmental exposure contributes to disease. This is the case when reporting back indoor air exposures in the absence of regulations. OBJECTIVES: We reported nitrogen dioxide (NO2) and fine particulate matter (PM2.5) results back to individual participants of an in-home study in Chelsea, Massachusetts. We aimed to provide participants with information on the pollutant concentrations in their homes and in their community and to suggest strategies for decreasing in-home exposures. Our goals were to improve environmental health literacy and empower residents to take action on air quality issues in their community. The main objective of this paper is to describe how we developed our report back process and materials. METHODS: Our team of academic and community partners developed a two-part report back process. The first part included a mailing tailored to every home containing daily indoor and outdoor NO2 and PM2.5 concentrations, community averages, outdoor standards and guidelines, and results from other indoor air quality studies for comparison. The second part included a community meeting for participants. CONCLUSIONS: Our report back process and materials benefitted from the contributions of multiple diverse stakeholders. We recommend at least a two-part strategy for facilitating communication within the community and between community and academic researchers. The materials and methods can be easily adapted by other researchers to report back exposure results in other community-specific contexts.

A Mixed Methods Evaluation of Sharing Air Pollution Results with Study Participants via Report-Back Communication.

We implemented a concurrent triangulation mixed-methods evaluation of an air pollution data report-back to study participants in Chelsea, Massachusetts. We aimed to determine whether the report-back was effective in the following three ways: engagement, understandability, and actionability for the participants. We also evaluated participants' valuation of the report-back information and process. The evaluation involved both qualitative components, such as ethnographic observation, and quantitative components, such as closed-ended questionnaires and demographic data. The participants who engaged in the report-back process were significantly different from those who did not engage both in terms of their demographics, and in their indoor air pollutant concentrations. Participant understanding generally corresponded with the intended meaning of the research team, suggesting successful data communication. Additionally, many of the participants reported that they were inspired to take action in order to reduce their indoor air pollutant exposure as a result of the report-back process and information provided. These results identify areas of improvement for engagement, particularly regarding populations that may have higher exposures. This work outlines a framework with which to contextualize and evaluate the success of engagement with report-back efforts. Such evaluations can allow research teams to assess whether they are providing information that is equitably useful and actionable for all participants.

Community change and resident needs: Designing a Participatory Action Research study in Metropolitan Boston.

The health implications of urban development, particularly in rapidly changing, low-income urban neighborhoods, are poorly understood. We describe the Healthy Neighborhoods Study (HNS), a Participatory Action Research study examining the relationship between neighborhood change and population health in nine Massachusetts neighborhoods. Baseline data from the HNS survey show that social factors, specifically income insecurity, food insecurity, social support, experiencing discrimination, expecting to move, connectedness to the neighborhood, and local housing construction that participants believed would improve their lives, identified by a network of 45 Resident Researchers exhibited robust associations with self-rated and mental health. Resident-derived insights into relationships between neighborhoods and health may provide a powerful mechanism for residents to drive change in their communities.

A Walk in the Park: The Influence of Urban Parks and Community Violence on Physical Activity in Chelsea, MA.

Proximity to a park does not necessarily imply access or use, and the social environment may positively or negatively influence the positive intentions of the built environment. To investigate parks, park use and physical activity, and their associations with exposure to community violence, we interviewed residents (n = 354) of a densely populated urban community. Our findings indicate that proximity to any park is not associated with physical activity. However, proximity to the preferred park reported by residents to be conducive for physical activity (with walking paths, large fields, playgrounds for children and tennis courts) was associated with physical activity. Conversely, knowledge of sexual assault or rape in the neighborhood is inversely associated with every type of physical activity (park-based, outdoor, and indoor). Our findings suggest that improvements to the built environment (parks, green spaces) may be hindered by adverse social environments and both are necessary for consideration in the design of public health interventions.

Engaging Communities in Research on Cumulative Risk and Social Stress-Environment Interactions: Lessons Learned from EPA's STAR Program.

Studies have documented cumulative health effects of chemical and nonchemical exposures, particularly chronic environmental and social stressors. Environmental justice groups have advocated for community participation in research that assesses how these interactions contribute to health disparities experienced by low-income and communities of color. In 2009, the U.S. Environmental Protection Agency issued a request for research applications (RFA), "Understanding the Role of Nonchemical Stressors and Developing Analytic Methods for Cumulative Risk Assessments." Seven research projects were funded to help address this knowledge gap. Each engaged with communities in different ways. We describe the community engagement approaches of the seven research projects, which ranged from outreach through shared leadership/participatory. We then assess the experiences of these programs with respect to the community engagement goals of the RFA. We present insights from these community engagement efforts, including how the grants helped to build or enhance the capacity of community organizations in addition to contributing to the research projects. Our analysis of project proposals, annual grantee reports, and participant observation of these seven projects suggests guidelines for the development of future funding mechanisms and for conducting community-engaged research on cumulative risk involving environmental and social stressors including: 1) providing for flexibility in the mode of community engagement; 2) addressing conflict between research timing and engagement needs, 3) developing approaches for communicating about the uniquely sensitive issues of nonchemical stressors and social risks; and 4) encouraging the evaluation of community engagement efforts.