Engaging Public Health Critical Race Praxis in Local Social Determinants of Health Research: The Youth Health Equity and Action Research Training Program in Portland, OR—yHEARTPDX
Abstract
:1. Introduction
2. yHEARTPDX: Conceptual Roots and Theoretical Groundings
3. yHEARTPDX Vol.I: Youth Participatory Research on Local Social Determinants of Health
3.1. yHEARTPDX Overview
- Create opportunities for youth to influence local public health practice and policy
- Assess community SDH through democratized community health assessment processes
- Provide training opportunities for youth to gain public health skills for future educational opportunities
- Pilot a curriculum for training local youth on health equity, SDH, and participatory research
- Guide youth through a participatory research project to identify and map local SDH concerns
- Use youth research data to generate a series of research and creative arts products that can be used to inform and guide LHD and city planning practices/strategies related to SDH
3.2. yHEARTPDX Training + Research Process
yHEARTPDX Participatory Research Method | Description |
---|---|
Photovoice | A participatory action research method designed to facilitate the empowerment of youth and adults through photography [61,62]. Participants used photography to visually document their daily/weekly experiences (and perceptions thereof) of place-based SDH. The visual representations they generated provided the focus for group discussions and documentation of stories and themes examining/uncovering their lived local SDH experiences in NE Portland. Participants used their smartphones for this method. Activities for this method included 1 training session covering method conceptual roots and ethical concerns, 3 photo review sessions, and 3 participatory photo analysis sessions. For these analysis sessions, youth were trained to complete their own qualitative coding and theming analysis using a process similar to that detailed in Petteway and colleagues [63]. |
Activity SpaceMapping | A process by which a participants’ daily activity locations and patterns are mapped out [64,65,66]. In this project, we used a participatory approach. Participants documented their daily activity spaces in a two-fold process. First, they used web-based maps to indicate locations of photovoice photos and other important daily places not captured via Photovoice. Second, they completed Activity Space Mapping worksheets for each photovoice photo location. These worksheets included a series of short descriptive questions and a “Rate Your Place” activity for youth to assign a star-rating to each place (see Figure 2 below). Activities for this method included 1 training session and 1 mapping session. |
X-ray Mapping | A cognitive mapping method to understand how participants perceive their daily experiences with place-based SDH and how those experiences affect their bodies/health [29,67]. Essentially, a participatory method to capture subjective notions of embodiment. Participants used “X-ray Map” worksheets containing a basic body outline with ventral and dorsal representation on the front side of the paper and were instructed to locate their perceived place-embodiment effects for each SDH photovoice location (see Figure 3 below). They used color-coded stickers, with green representing a perceived positive body effect, red representing a negative effect, and yellow representing both a positive and negative effect. Participants used the back of their X-ray Map worksheets (and often the front) to write a brief description/narrative explaining their SDH place-embodiment representations. Activities for this method included 1 training session covering notions of embodiment, allostatic load, and weathering, as well as method details, and 1 mapping session. |
Participatory GIS | A method by which participants actively define and spatially locate places and share power in creating mapped realities [68,69]. Here, participants integrated Photovoice, Activity Space Mapping, and X-ray Mapping findings for the creation of web-based maps with photos and narratives embedded into each SDH location they identified. Activities for this method included 2 mapping sessions. |
3.3. Illustrative Examples of yHEARTPDX Vol.1 Research
3.3.1. Photovoice
3.3.2. Activity Space Mapping
3.3.3. X-ray Mapping
3.3.4. Participatory GIS
3.4. Creative Arts Products and Dissemination
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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yHEARTPDX Training Module | Description |
---|---|
Public Health 101 | Introduced youth to public health systems and processes in both practice and academic/research contexts. Discussed core aspects of public health laws and regulations, including basic structure of public health powers across legislative, judicial (e.g., case law), and executive branches (e.g., administrative law) of federal, state, and local government. Example discussion topics included aspects of public health law, policy, and practice related to inspections, nuisance abatement, health monitoring and surveillance, quarantine, and environmental regulation. Discussed role of governmental (e.g., CDC, EPA) and non-governmental public health organizations (e.g., NACCHO). Provided a basic overview of core public health subfields of Epidemiology, Health Education/Health Promotion, Environmental Health, Health Systems and Policy, and Biostatistics. |
Epidemiology 101 | Explored historical foundations and evolution of epidemiology, including core elements of modern practice, goals, and tools/approaches. Introduced youth to various areas of epidemiology, including Infections Disease, Chronic Disease, Behavioral, Environmental, and Injury. Discussed the roles, responsibilities, and functions of epidemiology in LHDs. Covered basic definitions for key terms (e.g., “incidence”, “prevalence”, “exposures”, “outcomes”). This session made use of local epidemiology data (e.g., mortality data) to discuss aspects of local health surveillance and monitoring. |
SDH + Social Epi 101 | Developed youth knowledge and understanding of SDH and introduced socioecological models and health equity frameworks. This session made use of local SDH and health data and maps to discuss the impact and role of SDH locally. Discussed basic foundations of social epidemiology (in contrast to traditional epidemiology), including political economy, ecosocial theory, and the notion of embodiment. Highlighted role of structural forms of oppression and exclusion (e.g., racism, class inequality, sexism) in shaping health. Highlighted the “place” and health subfield as an area important for addressing SDH. |
Health Equity 101 | Introduced conceptual foundations and frameworks related to health equity and social justice within public health, and presented basic definitions for critical concepts (e.g., “disparities” vs. “inequities”, health in all policies). Highlighted the role of SDH and population-focused approaches to public health. |
Public Health Research + Research Ethics 101 | Introduced youth to basic elements of public health research, research methods (e.g., quantitative, qualitative, mixed), functions/roles of public health research (e.g., community assessment, accountability, implications for policy), and goals (e.g., addressing health inequities). Additionally, discussed historical foundations and considerations related to research ethics (e.g., Belmont Report, Tuskegee “study”), specifically in relation to human subjects research and research involving vulnerable populations. |
CBPR + YPAR 101 | Introduced core principles of CBPR and YPAR and provided an overview of the potential benefits of participatory research in comparison to traditional research. Highlighted importance of power relations and building community capacity. Additionally, introduced critical concepts of decolonizing research and methods, as well as feminist and Black feminist notions of situated knowledge(s) and centering the margins. Session also covered Freire’s notion of critical consciousness, Gramsci’s notion of “organic intellectual”, and general discussion of popular epidemiology, citizen science, and co-production of knowledge. |
Place, Placemaking, & Health 101 | Developed youth knowledge and understanding of the significance of “place” in shaping health, including notions and mechanisms of “placemaking”. This included introduction to historic and current forces that shape neighborhood built, natural, and social environments, including discussion of core racialized placemaking processes as follows: Indian Removal Act of 1830, Homestead Act of 1862, Oregon Donation Lands Claim Act of 1850, redlining, racially restrictive covenants, the GI Bill, Federal Highway Act of 1956, Gentrification, Serial Forced Displacement, Blockbusting, and exclusionary zoning. This session also discussed general aspects of city planning, land use, and community development. Session was connected to local/regional social determinants of health, making use of local health data and maps to discuss the impact of placemaking processes on SDH locally. |
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Petteway, R.J.; González, L.A. Engaging Public Health Critical Race Praxis in Local Social Determinants of Health Research: The Youth Health Equity and Action Research Training Program in Portland, OR—yHEARTPDX. Int. J. Environ. Res. Public Health 2022, 19, 8187. https://doi.org/10.3390/ijerph19138187
Petteway RJ, González LA. Engaging Public Health Critical Race Praxis in Local Social Determinants of Health Research: The Youth Health Equity and Action Research Training Program in Portland, OR—yHEARTPDX. International Journal of Environmental Research and Public Health. 2022; 19(13):8187. https://doi.org/10.3390/ijerph19138187
Chicago/Turabian StylePetteway, Ryan J., and Lourdes A. González. 2022. "Engaging Public Health Critical Race Praxis in Local Social Determinants of Health Research: The Youth Health Equity and Action Research Training Program in Portland, OR—yHEARTPDX" International Journal of Environmental Research and Public Health 19, no. 13: 8187. https://doi.org/10.3390/ijerph19138187