Plested, Edwards, Jumper-Thurman, 2006; Wang, C. and M.A. Burris, Photovoice: concept, methodology, and use for participatory needs assessment. Health ...
Using A Community-based Participatory Approach To Design Changes To The Food Environment In A Central American Immigrant Community Colón-Ramos U, Edberg M, Cleary S, Evans WD, Andrade E Department of Global Health and Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University
INTRODUCTION
Arising from youth’s concern about lack of access to healthful foods in their neighborhood, we formed a community coalition to design interventions to improve access to healthier food options. These are the results from the first year, where we focused on the design of strategies to improve the food environment. CBPR APPROACH
We facilitated monthly meetings with the coalition and trained members to assist in conducting formative work to identify barriers, facilitators to behaviors, and potential strategies.
RESULTS FORMATIVE WORK
Mission statement:“ Working together to create an informed community that has the capacity and structure to act on nutrition and its implications, to improve the wellbeing of all, and to take physical and cultural care of the families.”
Observations in neighborhood: • Supermarkets and stores display sodas from the US and from Latin American countries. • Restaurants offer water placed in bottom shelf • Promotion of sugary drinks (tamarindo, horchata, jamaica, etc) Interviews with parents: • Providing water for their children emerged as a theme of what parents want to feed their children. • Parents often purchase bottled water for use at home. • Tap water in the US is perceived as less safe and clean than in their home countries. CHOOSING A FOCUS FOR OUR COALITION WORK
• Promote behaviors to drink water instead of sugary drinks. • Improve access to drinking water in : early care centers, schools, stores, restaurants and informal food vendors, and the community at large. EARLY DESIGN OF STRATEGIES (RESUTLS FROM MORE FORMATIVE WORK) This collaborative formative work included : • Food environment observations (academic staff) • 10 focus group discussions (led by community partner) • 15 interviews with mothers (led by community partner) • 9 key informant interviews with school staff (joint effort academic staff and community partner) • 6 key informant interviews to assess community readiness to act on drinking water promotion (adapted with community partners, and academic staff trained community partners to lead) • Development and pilot of a youth advocacy curriculum around disparities in access to drinking water (academic staff)
1. Raise awareness about access to safe, palatable drinking water in the community: Among stakeholders (clinicians, school district, representatives) there is awareness about the importance of drinking water and but vague awareness access to drinking water in the neighborhood and efforts to improve it. 2. Improve access to safe palatable drinking water in schools and early care centers • In schools, youth reported that they rarely drink bottled water and never drink tap or fountain water. • School staff drank bottled water brought from home, or soda and other drinks bought from vending machines at school. • School staff would support initiatives to promote drinking water, reusable water bottles in schools, and improved sources of drinking water in schools. 3. Promote drinking water Youth would respond to a promotional campaign that includes local celebrities/role models and messages related to energy, beauty/health of drinking water.
Funding: Racial and Ethnic Approaches to Community Health (REACH) from Centers for Disease Control and Prevention. References: Andrade E et al. Where PYD meets CBPR: a photovoice program for Latino immigrant youth. APHA 2015) Plested, Edwards, Jumper-Thurman, 2006; Wang, C. and M.A. Burris, Photovoice: concept, methodology, and use for participatory needs assessment. Health Educ Behav, 1997. 24(3): p. 369-87.
