Environmental Engineering Reference
In-Depth Information
species. Cohen et al. (2005) argue that such unintended
changes in consumption behavior could have negative net
impacts on public health. For instance, under the 2004
joint USEPA/USFDA mercury advisory, reproductive-age
women are advised to avoid eating high-mercury fi sh and
to instead eat low-mercury fi sh. Assuming certain benefi ts
from eating fi sh and certain risks from ingesting mercury,
Cohen et al. calculated that women who modify their fi sh
intake in accordance with the advisory would likely ben-
efi t the development of their offspring while experiencing
few negative impacts. However, if they instead decrease
their total fi sh consumption, the risks would substantially
reduce the net benefi ts. Furthermore, Cohen et al. deter-
mined that if adults other than reproductive-age women
reduce their fi sh consumption—that is, even though the
advisory does not apply to them—the net public health
impact would be negative.
Still other studies show that people obtain advisory
information through a variety of sources and that they
instinctively trust some sources more than others. The
mainstream media, the Internet, health care providers,
health fairs, and fi shing guide publications are some of the
avenues through which advisory information is delivered.
A Canadian study found that about one third of fi sh con-
sumers surveyed turned to conventional sources of infor-
mation, such as the media, when deciding whether to eat
their catch; another third depended on unconventional
sources of information, such as bait shop owners and other
interpersonal contacts (IJC, 2004). In Jardine's Canadian
study (2003), many study participants indicated a lack of
trust in their government, which was responsible for issu-
ing advisories.
Jardine (2003) suggests that if a fi sh-consumption advi-
sory is to be effective, fi sh consumers must be aware of the
advisory, understand the advisory, and trust the agency
that issued the advisory. Furthermore, Jardine also sug-
gests that to achieve this, public participation and com-
munication during the advisory development process are
necessary.
health issues and concerns and enabling them to design
interventions that are effective and relevant for that specifi c
community (AHRQ, 2003; Israel et al. 2005). Because they
are directly involved in CBPR, community members are
more likely to trust both the researchers and the research
itself, which in turn increases the likelihood that the com-
munity will accept and comply with a particular interven-
tion (Jardine, 2003). In addition, under the CBPR approach,
the benefi ts of research are often experienced immediately
by the community. This is usually not the case under the
traditional health research approach (AHRQ, 2003).
CBPR is a t y p e of
translational research,
which the National
Institute of Environmental Health Sciences (NIEHS)
defi nes as the conversion of environmental health research
into information, resources, or tools that can be used by
public health and medical professionals and by the pub-
lic to improve overall health and well-being, especially in
vulnerable populations (NIEHS, 2008). Indeed, because of
its community-specifi c focus and ability to build trust, the
CBPR approach can be a particularly effective way to tackle
health problems in communities that are marginalized,
disadvantaged, or otherwise overlooked.
The CBPR approach thus lends itself well to the process
of developing and communicating effective fi sh advisories,
especially for vulnerable populations. In particular, Jardine
(2003) points out that public participation in the fi sh-
advisory process ensures that community information is
being incorporated into the process, that the information
requirements of the community are being met, and that
this information is being communicated to the affected
people.
The following examples from the work of two of this
chapter's authors and/or their collaborators in the Great
Lakes region illustrate how CBPR can be applied to the
development and communication of fi sh-consumption
guidelines for vulnerable populations.
EXAMPLE 1: THE HMONG
Milwaukee, Wisconsin, is home to a relatively large num-
ber of Hmong, an Asian ethnic group that aided the
United States in fi ghting the North Vietnamese during
the Vietnam War and then sought political refuge in the
United States after the country withdrew from Vietnam in
1975. As avid and traditional anglers, Hmong people fre-
quently fi sh in local and regional waters. However, many
Hmong have a limited understanding of the contaminants
present in Wisconsin's waterways and fi sh.
To address this problem, the NIEHS Children's
E nv i r on me nt a l H e a lt h S c ie nc e s C or e C e nte r ( N I E H S C E H S C ),
formerly the NIEHS Marine and Freshwater Biomedical
Sciences Center, at the University of Wisconsin-Milwaukee
partnered with the Sixteenth Street Community Health
Center and the Hmong/American Friendship Association
to develop an outreach program (Thigpen and Petering,
2004). The goal of the program was to communicate the
Community-Based Participatory Research
A relatively new health research approach known as
community-based participatory research,
or CBPR (Agency for
Healthcare Research and Quality [AHRQ], 2003). incorporates
both public participation and communication. CBPR aims to
impact the health of a particular community directly, quickly,
and effectively by actively involving members of the studied
community in all aspects of the research process. In contrast
to the traditional approach to health research, under a CBPR
approach, community members are partners with research-
ers rather than just research subjects, and the community is
involved in the project from beginning to end (AHRQ, 2003).
Under this arrangement, the community's knowledge
and input guide the research, thereby helping researchers
identify and better understand the community's unique
