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Resumo Este ensaio explora as convergências e singularidades do diálogo entre a educação popular (EP) e a educação alimentar e nutricional (EAN) a partir de fragmentos biográficos do percurso formativo da graduação em Nutrição de três docentes universitários que constituíram as suas trajetórias acadêmico-profissional mediados pela Educação Popular. Inspirando-se na autobiografia, as narrativas revelaram que as indignações iniciais com as desigualdades sociais foram mobilizadoras do percurso formativo, possibilitando a compreensão dos fenômenos da fome, do sofrimento e do cuidado humano. Assim, o exercício de buscarem espaços e oportunidades na qual pudessem conhecer e experienciar o trabalho social em contextos de vulnerabilidades mostrou-se decisivo nas construções pessoais e profissionais, revelando as contradições dos modelos tradicionais de formação e foram o ponto de partida para a gênese do pensamento crítico. Assim, pretende-se oferecer pistas para compreender as interfaces entre EP e EAN, na convergência de ações em torno da luta contra a fome e pelo Direito à Alimentação, sem, entretanto, reduzir-se uma à outra, quando a alimentação e nutrição se projetam no horizonte das práticas.
Abstract This essay explores the convergences and singularities of popular education and Food and Nutrition Education based on biographical fragments of the undergraduate training program in Nutrition of three university professors who established their academic and professional trajectories at these crossroads of knowledge and actions mediated by popular education. Inspired by the autobiographical method, the narratives revealed that the initial indignations with social inequalities were mobilizing the routes in the formative path toward understanding hunger, suffering, and human care. To this end, seeking spaces and opportunities to learn about and experience social work in contexts of vulnerabilities was a decisive factor in their personal and professional constructions, revealing the contradictions of traditional training models and the starting point for the genesis of critical thinking. Thus, clues are offered to understand the interfaces of Popular Education (PE) and Food and Nutrition Education (FNE) in the converging actions around the fight against hunger and the right to food without, however, reducing one to the other when food and Nutrition are projected on the horizon of practices.
ABSTRACT
Resumo Paulo Freire pensava a Educação Popular (EP) como um processo emancipatório, por meio da problematização e agir crítico como dimensões da existência humana. A partir de suas contribuições aos campos da Educação e da Saúde, este texto tem como objetivo realizar uma revisão narrativa de literatura sobre as articulações das ideias de Paulo Freire com as ações de Vigilância Popular em Saúde (VPS). O texto apresenta como a contribuição de Paulo Freire e da Educação Popular em Saúde inspirou a construção de uma Vigilância Popular em Saúde, que busca promover a transformação da realidade local frente às situações de violações de direitos e na defesa da vida. Dessa maneira, experiências dos territórios e das populações em situação de vulnerabilidade, na maioria das vezes, lançam mão de estratégias pedagógicas da Educação Popular para se constituírem como práticas de VPS. É no território que a Educação Popular em Saúde se torna fundamental para o estímulo à transformação da percepção dos indivíduos, problematizando sua realidade. A promoção de uma práxis acerca da "situação limite" no cotidiano dos atores sociais permite um diagnóstico da realidade, baseado na informação científica em diálogo com a cultura e a organização popular, como possibilidade de construção de "inéditos viáveis".
Abstract Paulo Freire considered Popular Education (PE) as an emancipatory process, through debate and critical action, as a dimension of human existence. This text aims to conduct a narrative literature review on the articulations of Paulo Freire's ideas with Popular Health Surveillance (PHS) actions based on his contributions to Education and Health. The text presents how the contributions of Paulo Freire and Popular Health Education inspired the construction of Popular Health Surveillance, which seeks to promote the transformation of local reality in the face of rights violations and advocate for life. Thus, experiences from vulnerable territories and populations often use Popular Education pedagogical strategies to establish PHS practices. Popular Health Education becomes crucial in the territory to stimulate the transformation of individual perception and discuss their reality. Promoting a praxis about the "critical situation" in the daily lives of social stakeholders allows diagnosing reality based on scientific information in dialogue with culture and popular organization as a possibility of building the "viable unprecedented".
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Resumo O texto desenvolve-se a partir de uma mesa redonda realizada na Faculdade de Educação (FE) da Universidade Estadual de Campinas (Unicamp), como uma das atividades de comemorações do Centenário de Paulo Freire (2021). Objetiva registrar parte da sua passagem por essa universidade, nos anos de 1980 a 1991, a partir do trabalho realizado com a FE e Faculdade de Ciências Médicas (FCM) por meio de atividades de formação e extensão no Centro de Saúde Escola de Paulínia-SP. Descreve e analisa as pautas do processo de redemocratização do país, os embates em torno das políticas públicas na Assembleia Nacional Constituinte e o processo de constituição de um sistema integrado e universal de educação e saúde pública coletiva a partir de uma perspectiva participativa.
Abstract The text is based on a round table held at the Faculty of Education (FE) of the State University of Campinas (Unicamp) as one of the activities to commemorate Paulo Freire's Centenary (2021). It aims to record part of his time at the university, from 1980 to 1991, based on the work conducted with FE and the Faculty of Medical Sciences (FCM) through training and extension activities at the Paulínia-SP School Health Center. It also describes and analyses the agendas of the country's re-democratization process, the clashes over public policies in the National Constituent Assembly, and the process of setting up an integrated and universal system of education and collective public health from a participatory perspective.
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Objective: Latino day labourers (LDLs) in the USA are at increased risk for non-fatal and fatal occupational injuries, which are compounded by stressors that include wage theft, job insecurity and discrimination. This paper describes the development and refinement of Vales+Tú (You are Worthy of More), an injury prevention programme currently being evaluated as part of a cluster randomised trial in which health promotion is taken directly to the 'corners' (e.g. street corners, home improvement store parking lots, and public parks) where workers gather to seek employment. Design: Vales+Tú comprises two corner-based intervention approaches, group problem-solving (small group discussions) and brief motivational interviewing (one-on-one dialogue), that aim to activate LDL agency to control their safety and that of their peers. Setting: Corners in Houston, Texas, where LDLs seek employment. Method: Intervention Mapping informed the refinement of Vales+Tú for the current trial. We provide a narrative review of the development process based on needs assessment and formative development activities (surveys, focus group discussions and pilot tests). Results: In addition to documenting the need for LDL injury prevention, with 20.2%-41.6% of Houston-based LDLs surveyed between 2013-2014 and 2019 reporting a severe work-related injury in the past year, we describe key facets of the Vales+Tú corner-based intervention approaches - including their theoretical basis and LDL-centred activities, as well as enhancements made informed by formative evaluation. Conclusion: The community-engaged development process of Vales+Tú resulted in two practical intervention approaches that can be adopted by worker centres and other organisations to promote LDL worker safety.
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Structural competency is used to train health professionals on how social, political, and economic dynamics create conditions that negatively impact a population's health. In the Global South, this approach has historical roots in social movements, popular education, social medicine, and human rights. In 1982, during a time of extreme poverty, inequality, and violence under the Chilean military dictatorship, Educación Popular en Salud (EPES), developed a programme for training community health promoters to address common illnesses and analyse the underlying causes of poor health. In 2010, EPES began using the same model to train international and Chilean health professionals. The approach advanced four competencies. Evaluations show that training contributes to transforming health professionals' mindsets and leads them to question their practices. However, educating practitioners does not change the underlying structures that generate poor health. This article examines the intersection between EPES' competencies and the structural competency framework, highlighting two major contributions of EPES to structural competency: a methodology that narrows the gap between a theoretical analysis of social determinants of health and implementing action plans; and organic long-term links with social movements that strengthen collective action in poor neighbourhoods to advance social justice.
Subject(s)
Poverty , Humans , Chile , Educational StatusABSTRACT
Resumo Objetivo de promover reflexão sobre a palhaçaria, à luz da Educação Popular em Saúde. Descreve e analisa intervenções realizadas entre outubro de 2020 e dezembro de 2021, com usuários e servidores públicos no Sertão Central. A palhaça abriu alas para a territorialização e se mostrou potente tecnologia para uma atuação humanizada da enfermeira residente. Como interlocutora entre o saber científico e o popular, em sua corporalidade cenopoética, lidava de forma criativa e leve com assuntos tabus para a saúde comunitária, promovendo uma educação problematizadora e dialógica com seu público. A experiência fez-nos refletir nas lacunas de investimentos para viabilizar projetos como esse, fortalecendo a institucionalização da Educação Popular em Saúde. Assim, defendemos a implementação de formações e oficinas sobre conceitos, desafios e potencialidades da Educação Popular em Saúde. A palhaçaria, como proposta de atuação, é tecnologia transformadora que inspira o protagonismo à comunidade por meio de conhecimento, cuidado amoroso e arte.
Abstract The scope of this paper is to elicit reflection on therapy clowns in the realm of Popular Education in Health. It describes and analyzes interventions conducted between October 2020 and December 2021 between civil service workers and patients in the Sertão Central hinterlands. Therapy clowning paved the way as a potent technology for humanized care treatment by the resident nurse. As an intermediary between scientific and popular knowledge, in its scenopoetic approach, it dealt creatively and humorously with taboo subjects for community health, promoting a light-hearted interaction experience with its audience. The experience revealed some points about the scarcity of investment to make projects like this viable, thereby empowering the institutionalization of Popular Education in Health. For this reason, we advocate the implementation of training sessions and workshops on concepts, challenges, and potentialities in Popular Education in Health. Therapy clowning, as a proposed action, is a transformative technology that inspires a proactive approach in the community through knowledge, loving care, and art.
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Long-term research has identified significant water contamination and associated poor health outcomes in the indigenous community of Alpuyeca, located in south-central Mexico. We set out to develop a popular education initiative in this community to improve water, sanitation and hygiene (WaSH) knowledge and practices. In order to avoid recreating hierarchical power dynamics in this vulnerable community, a participatory action research (PAR) design was used, wherein the community took leadership and facilitation roles in each stage of the research process. In qualitative interviews and design sessions, community members identified unsatisfied WaSH needs in households and community institutions and articulated a clear worldview of the spiritual role of water, which guided the development of a series of popular education-based workshops and discussions. The popular education initiative process was documented with a mixed methods framework, using before-and-after surveys, semi-structured interviews and participatory observation. Increases in knowledge and practices related to water purification, water consumption and hand hygiene were noted in the community. The community identified locally installed and managed ecotechnologies as a key opportunity for sustainable development, community participation and the adoption of water and sanitation systems, compatible with public imaginaries of the role of water.
Subject(s)
Hygiene , Water Quality , Humans , Mexico , Sanitation , Educational Status , Water SupplyABSTRACT
Spatial and temporal scales are essential components of geological sciences; both are almost always imbricated in complex ways, challenging geoscientific knowledge among nonspecialists and students. The present paper focuses on the efforts made by the French naturalist Simon-Suzanne Nérée Boubée (1806-62) regarding popular education on geology. Though Boubée is poorly known nowadays, he experienced some prestige during his lifetime. He worked as an independent teacher, offering private as well as free public courses. Boubée, as a nineteenth-century science popularizer, repeatedly insisted on his disposition for "spreading science for all." He extensively published books and journals on geology, all aimed at popularizing geological scientific knowledge, considered to be of paramount relevance. This paper analyzes three visual examples extracted from his works: the Tableau Mnémonique des Terrains Primitifs, destiné au géologue voyageur, avec son explication (1831), the Tableau de l'État du Globe à ses différents âges (1832), and the Tableau figuratif de la structure minérale du globe, ou résumé synoptique du Cours de géognosie de M. N. Boubée (1839), supplemented with images from the travel guide Deux Promenades au Mont Doré (1834). Our goal is to understand Boubée's efforts to synthesize information, scaling down geologic time and space into foldable materials that made geological knowledge cognitively and materially accessible to laypeople.
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Earth, Planet , Geology , Geology/educationABSTRACT
Este trabalho relata a experiência de um projeto de pesquisa e extensão no âmbito da participação social e da educação popular em saúde, realizado na comunidade de Roda de Fogo, Recife, PE, entre 2019 e 2021. Tem como objetivo descrever como se deu essa experiência, apontar seus resultados e identificar suas potencialidades e desafios. Para a sistematização dos dados, utilizamos gravações, cadernos de campo e atas de reunião do projeto. Ao revisitar todo o material, foi possível ratificar o importante trabalho realizado pela ouvidoria coletiva no âmbito da formação dos estudantes, da participação dos moradores e da interlocução com diversos setores da máquina pública, que, juntos, visaram uma maior compreensão dos inúmeros desafios enfrentados pelos territórios mais empobrecidos. Entretanto, verificamos que as discussões no âmbito do projeto tenderam a se encaminhar para necessidades imediatas, o que comprometeu o sentido político da participação social.(AU)
This article recounts the experiences of a research and extension project in the area of public participation and popular health education developed between 2019 and 2021 in a community called Roda de Fogo in Recife, the capital of the state of Pernambuco, Brazil. We describe the experiences, outline the main results and identify strengths and challenges. The data were collected using recordings, field diaries and project meeting minutes. The findings reveal the importance of the work carried out by the collective ombudsman for student training, community participation and engagement with various sectors of the public sector apparatus, which together aimed to promote better understanding of the numerous challenges faced in poor areas. However, we found that project discussions tended to focus on immediate need, compromising the political meaning of public participation.(AU)
Este trabajo relata la experiencia de un proyecto de investigación y extensión en el ámbito de la participación social y de la educación popular en salud, realizado en la comunidad Roda de Fogo/Recife/Estado de Pernambuco, entre 2019 y 2021. Su objetivo es describir cómo se realizó esa experiencia, señalar sus resultados e identificar sus potencialidades y desafíos. Para la sistematización de los datos utilizamos grabaciones, cuadernos de campo y actas de reunión del proyecto. Al revisitar todo el material, fue posible ratificar el importante trabajo realizado por la defensoría colectiva en el ámbito de la formación de los estudiantes, de la participación de los moradores y de la interlocución con diversos sectores de la máquina pública que, en conjunto, tuvieron como objetivo una mayor comprensión de los innumerables desafíos enfrentados por los territorios más empobrecidos. No obstante, verificamos que las discusiones en el ámbito del proyecto tendieron a dirigirse hacia necesidades inmediatas, lo que comprometió el sentido político de la participación social.(AU)
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Resumen (analítico) El artículo analiza las modalidades de resistencia y re-existencia producidas en el contexto del levantamiento popular de 2021, en sus relaciones con el juvenicidio. Metodológicamente, se optó por el análisis de narrativas de experiencias de jóvenes de tres ciudades, así como el análisis de un corpus de imágenes relacionado con estos acontecimientos. En resultados, la categoría salir del cerco evidenció que el levantamiento está imbricado con el juvenicidio, desde la precarización y la violencia estatal en pandemia y la existencia de opresiones cruzadas. En la categoría subvertir, se observó la presencia de estrategias de confrontación y deslegitimación simbólica al sistema dominante. En la categoría estéticas populares sobresalen la autorrepresentación y la curación simbólica. La categoría educación popular evidenció la implementación de prácticas fomentadoras del interaprendizaje y la cocreación para buenos vivires.
Abstract (analytical) This article analyzes the modalities of resistance and re-existence that occurred in the context of the Colombian popular uprising in 2021 and relates them with the practice of youthcide. At a methodological level, the article analyses narratives of experiences of young people from three cities, as well as a corpus of images related to the popular uprising. The results identify a category of getting off the fence, which shows that the uprising is related to acts of youthcide. The protests were a response to precariousness and state violence during pandemic, as well as the existence of multiple forms of oppression of the youth population. In the subversion category, confrontation strategies and symbolic delegitimization of the dominant system were observed. In the popular aesthetic category, self-representation and symbolic healing were evident. In the popular education category, the implementation of practices that promote mutual learning and co-creation for good living were identified.
Resumo (analítico) O artigo analisa as modalidades de resistência e reexistência ocorridas durante a revolta popular de 2021, em suas relações com a juvenilicídio. Metodologicamente, utilizou-se a análise de narrativas de experiências de jovens de três cidades, bem como a análise de imagens relacionadas a esses eventos. Nos resultados, a categoria de sair da cerca mostrou que a revolta está entrelaçada com a juvenilicídio, a partir do aprofundamento da precariedade e da violência estatal e para-estatal. Na categoria subverter, observou-se a implementação de estratégias de enfrentamento e deslegitimação simbólica do sistema dominante. Na categoria estética popular, destacam-se a autorrepresentação e a cura simbólica. E na categoria educação popular foram desveladas práticas que promovem o aprendizado mútuo para o bem viver.
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RESUMO Em meados dos anos 1990, Victor Valla propôs a incorporação da participação da população à prática da vigilância em saúde, por meio da educação popular de Paulo Freire. Esse contraponto às práticas tradicionais da vigilância, nomeadas vigilância civil da saúde, somam-se à concepção ampliada de saúde, e possuem forte ligação com a perspectiva crítica da epidemiologia enquanto meio de compreender a relação dialética entre classes sociais e seus espaços vividos. A prática da vigilância civil pretende superar lacunas importantes deixadas pelos métodos tradicionais de investigação em saúde pública, como falta de atenção aos contextos socioculturais, construção do risco localizada somente no indivíduo e representação de agendas de saúde pública que privilegiam e patologizam certos comportamentos. Nesse sentido, o presente trabalho debate o conceito de vigilância civil da saúde, o locus de discussão dos estudos de população na reificação do papel do efeito contextual para a explicação da produção social da saúde e a incorporação da participação popular à vigilância em saúde como elemento de transformação social. O aprofundamento dessa discussão, no limite, permite uma construção participativa de novos modelos de saúde concentrados na redução efetiva das iniquidades em saúde e, consequentemente, universalização efetiva do direito à saúde.
ABSTRACT In the mid-1990s, Victor Valla proposed to incorporate the population participation in the practice of health surveillance, through Paulo Freire's popular education. This counterpoint to traditional surveillance practices, called civil health surveillance, added to the expanded concept of health, and has a strong connection with the critical perspective of Epidemiology as a means to understand the dialectical relationship between social classes and their lived spaces. The practice of civil surveillance aims to overcome essential gaps left by traditional methods of public health investigation. It includes a lack of attention to socio-cultural contexts, the construction of risk located only in the individual, and the representation of public health agendas that privilege and pathologize certain behaviors. This paper discusses the concept of civil health surveillance, the locus of discussion of population studies in the reification of the role of the contextual effect in explaining the social production of health and the incorporation of popular participation in health surveillance as an element of social transformation. The deepening of this discussion allows a participatory construction of new health models focused on the effective reduction of health inequities and, consequently, the effective universalization of the right to health.
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This case study brings results of qualitative research whose objective was to analyze the meaning of the experience of training the Community Health Workers (CHW) in the Qualification Program in Popular Education in Health (EdPopSUS), one of the priority strategies of the operational plan of the National Policy of Popular Education for the Unified Health System. The production of information included document analysis (didactic material of the Program, letter of expectations and final letter of CHW) and semi-structured interviews with CHW (n=17), health and course managers (n=4). The textual material produced was interpreted by content analysis, in light of the theoretical framework of Popular Education. The results showed that EdPopSUS encouraged reflection, dialogue and affection, enhancing the creativity and autonomy of CHW, in an educational space of self-knowledge and interaction with their experienced world. The CHW 's personal and professional experiences were valued, qualifying their communication with the team-community-families, listening skills and conducting collective educational activities. Field trips and conversation circles were highlighted as potentialities of this training. Challenges were identified in the implementation of the principles of Popular Education in the work of Primary Health Care. The experience strengthened the role of CHW as a change agent and popular educator. In this sense, Popular Health Education was reinforced in this research as a pedagogical-social practice that strengthens people, movements, teams, care practices and the health system. Educational processes based on Popular Education are recommended in the permanent education of health teams.
Este estudio de caso cualitativo analiza el significado de la experiencia de formación de agentes de salud comunitarios (ASC) en el Programa de Calificación de la Educación Popular en Salud (EdPopSUS), una de las estrategias prioritarias del plan operativo de la Política Nacional de Educación Popular para el Sistema Único de Salud. La producción de información incluyó análisis de documentos (material didáctico del Programa, carta de expectativas/final de ASC) y entrevistas semiestructuradas con ASC (n=17), gestores de salud y de curso (n=4). El material textual producido fue interpretado por análisis de contenido, a la luz del marco teórico de la Educación Popular. Los resultados mostraron que EdPopSUS alentó la reflexión, diálogo y afectividad, potenciando la creatividad y la autonomía de la ASC, en un espacio educativo de autoconocimiento e interacción con su mundo experimentado. Se valoraron las experiencias personales y profesionales de los ASC, calificando su comunicación con el equipo-comunidad-familias, la capacidad de escucha y la realización de actividades educativas colectivas. Las salidas de campo y las ruedas de conversación fueron destacadas como potencialidades de esta formación. Se identificaron desafíos en la implementación de los principios de la Educación Popular en el trabajo de la Atención Primaria de Salud. La experiencia fortaleció el rol de ASC como agente de cambio y educadora popular y reforzó la Educación Popular en Salud como práctica pedagógico-social que fortalece a las personas-movimientos-equipos-prácticas de cuidado-sistema de salud. En la educación continua de los equipos de salud se recomiendan procesos educativos basados en la Educación Popular.
Este estudo de caso traz resultados de pesquisa qualitativa cujo objetivo foi analisar o significado da experiência de formação do Agente Comunitário de Saúde (ACS) no Programa de Qualificação em Educação Popular em Saúde (EdPopSUS), uma das estratégias prioritárias do plano operativo da Política Nacional de Educação Popular para o Sistema Único de Saúde. A produção de informações incluiu a análise documental (material didático do Programa, carta de expectativas e carta final dos ACS) e entrevistas semiestruturadas com ACS (n=17), gestores da saúde e do curso (n=4). O material textual produzido foi interpretado pela análise de conteúdo, à luz do referencial teórico da Educação Popular. Os resultados evidenciaram que o EdPopSUS incentivou a reflexão, o diálogo e a afetividade, potencializando a criatividade e autonomia dos ACS, em um espaço educativo de autoconhecimento e interação com seu mundo experenciado. Vivências pessoais e profissionais dos ACS foram valorizadas, qualificando sua comunicação com equipe-comunidade-famílias, habilidade de escuta e a condução de atividades educativas coletivas. Saídas de campo e as rodas de conversa foram destacadas como potencialidades desta formação. Desafios foram identificados na implementação dos princípios da Educação Popular no trabalho da Atenção Primária à Saúde. A experiência fortaleceu o papel do ACS como agente de mudanças e educador popular. Nesse sentido, a Educação Popular em Saúde foi reforçada nesta pesquisa como prática pedagógica-social que fortalece pessoas, movimentos, equipes, práticas de cuidado e o sistema de saúde. Processos educativos fundamentados na Educação Popular são recomendados na educação permanente das equipes de saúde.
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Resumen. A finales del año 2018 se recordaron 50 años de la fundación del Departamento Universitario Obrero Campesino -DUOC- en la Pontificia Universidad Católica de Chile, organización surgida a partir de la acción decidida de tres dirigentes estudiantiles del Instituto Pedagógico, alumnos de Pedagogía en Filosofía, de esa universidad. La labor inicial del DUOC iba en favor de los más desposeídos y que se deseaba entregarles herramientas para su crecimiento personal y laboral. Esta acción obedecía a la Reforma Universitaria iniciada el 11 de agosto de 1967 en esa organización perteneciente a la Iglesia Católica. Aún hoy subsiste esta institución, aunque ha variado en su objetivo inicial.
Abstract. At the end of 2018, 50 years were remembered since the founding of the Departamento Universitario Obrero Campesino -DUOC- at the Pontificia Universidad Católica de Chile, an organization that arose from the determined action of three student leaders of the Instituto Pedagógico, students of Philosophy Pedagogy, of that university. DUOC's initial work was in favor of the most disadvantaged students, who wanted to provide them with tools for their personal and professional growth. This action obeyed the University Reform initiated on August 11, 1967 in this organization belonging to the Catholic Church. This institution still exists today, although its initial objective has changed.
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Introduction: The exposome concept provides a framework to better incorporate the environment into the study of health and disease and has been defined by academics to encompass all lifetime exposures including toxicants, diet, and lifestyle choices. However, initial applications of the exposome concept have been less apt at measuring social determinants of health, focusing primarily on conventional environmental exposures and lifestyle choices that do not reflect the complex lived experience of many communities. To bring community voice into the exposome concept, the HERCULES Exposome Research Center and its Stakeholder Advisory Board co-developed the Exposome Roadshow. We present and discuss the resulting community-exposome definition to inform and improve exposome research. Materials and Methods: Four communities from distinct areas across metro-Atlanta participated in separate 2-day Exposome Roadshow workshops with concept mapping. Aligned with a popular education approach in which community knowledge is used to work collectively for change, concept mapping provided a systematic method to collect and visualize community members' knowledge and create a shared understanding to take action. Community members brainstormed, sorted, and rated their responses to the prompt: "What in your environment is affecting your and your community's health?" Responses were analyzed and visually depicted by concept maps consisting of separate but interrelated clusters of ideas. Community members discussed and validated the maps, selecting a final map illustrating their community's exposome. Results: A total of 118 community members completed concept mapping. On average communities identified 7 clusters to define their exposome. The resulting concept maps offer a community definition of the exposome. Five major themes arose across all four communities: conventional environmental concerns, built environment, social relationships, crime and safety, and individual health and behaviors. Discussion: The resulting community-exposome definition demonstrates the importance of expanding the scope of exposures beyond traditional environmental influences to include the lived experience of individuals and communities. While newer exposome definitions align more closely with this community definition, traditional exposome methods do not routinely include these factors. To truly capture the totality of lifetime exposures and improve human health, researchers should incorporate community perspectives into exposome research.
Subject(s)
Exposome , Educational Status , Environmental Exposure , Georgia , HumansABSTRACT
RESUMO O artigo objetivou discutir os aprendizados com as Comunidades Ampliadas de Pesquisa-Ação (CAP) em favelas do Rio de Janeiro, como contribuição às discussões conceituais e metodológicas no campo da saúde coletiva, na perspectiva da Promoção Emancipatória da Saúde e da Educação Popular. Com as CAP, como foi sintetizada esta metodologia, buscou-se responder a um dos principais desafios de pesquisas qualitativas em favelas: uma construção metodológica que possibilite a compreensão da forma por meio da qual os moradores desses territórios experimentam e respondem às situações de saúde. O território, como categoria integrativa de análise para compreender os processos de determinação social da saúde, impõe à CAP se configurar como uma rede de diálogos interdisciplinares e entre diferentes agentes sociais. A análise da base material documental produzida no período 2003-2020, utilizando a sistematização de experiência como metodologia de pesquisa, resultou na identificação de três eixos que estruturam o método CAP, metodologia assim denominada: 1) o cotidiano como engrenagem da dinâmica da CAP; 2) o território e os agentes sociais do diálogo; e 3) as ferramentas artesanais de co-laboração com o território. A partir desses eixos, conclui-se ser o método CAP uma rede de produção de conhecimentos e interlocução entre pessoas-lugares-territórios.
ABSTRACT The article aims to discuss the lessons learned from the Extended Action-Research Community (CAP) in favelas in Rio de Janeiro, as a contribution to conceptual and methodological discussions in the field of Public Health, from the perspective of Emancipatory Health Promotion and Popular Education. With the CAPs, we seek to respond to one of the main challenges of qualitative research in favelas: a methodological construction that makes it possible to understand the way the residents of these territories experience and respond to health situations. The territory, as an integrative category of analysis to understand the processes of social determination of health, requires CAP to configure itself with a network of interdisciplinary dialogues and between different social agents. The analysis of the documentary material base produced in the period 2003-2020, using the systematization of experience as a research methodology, resulted in the identification of three axes that structure the CAP method: 1) everyday life as the dynamics gear of CAP; 2) territory and the social agents of dialogue; and 3) artisanal tools to collaborate with the territory. Based on these axes, we conclude that the CAP method is a network for knowledge production and dialogue between people-places-territories.
ABSTRACT
RESUMO Este ensaio se propõe à análise crítica do agronegócio, buscando construir um modelo teórico compreensivo, tendo como referência o conceito de biopoder de Foucault. Pretende ainda contribuir para as discussões de alternativas sustentáveis e de combate às ações que promovem e flexibilizam o uso de agrotóxicos. Argumenta-se que o agronegócio, apesar de ter tido sua imagem construída por discursos que ressaltam sua eficiência e produtividade, impõe barreiras que impedem a garantia da segurança alimentar e nutricional. Pelo uso intensivo de agrotóxicos, também não disponibiliza alimentos seguros e de qualidade, ao mesmo tempo que impacta o meio ambiente e compromete a saúde da população, somado aos seus impactos políticos, econômicos, sociais e culturais. A análise sob a ótica do biopoder destaca que a atuação das indústrias agrícola, agroquímica e de alimentos, enquanto normatizadoras e geradoras de consumo, desconsideram princípios morais e éticos, infringem direitos humanos e a autonomia dos sujeitos. Paralelamente, propõe-se que, por meio da educação popular e a educação alimentar e nutricional, consegue-se, em longo prazo, construir sujeitos e coletividades autônomos e críticos, capazes de transformar as estruturas de poder vigentes e de agir em prol de políticas públicas que fomentem práticas justas, saudáveis, sustentáveis e éticas.
ABSTRACT This essay proposes a critical analysis of agribusiness, seeking to build a comprehensive theoretical model based on Foucault's concept of biopower. It also proposes to contribute to the discussions of sustainable alternatives and to combat actions that promote and make the use of pesticides more flexible. It is argued that agribusiness, despite having its image built by speeches that emphasize its efficiency and productivity, imposes barriers that prevent the guarantee of food and nutritional security. Due to the intensive use of pesticides, it also does not provide safe and quality food, while it impacts the environment and compromises the health of the population, added to its political, economic, social, and cultural impacts. The analysis from the perspective of biopower highlights the performance of the agrochemical and food industries, as standards and generators of consumption, disregards moral and ethical principles, infringes human rights and the autonomy of the subjects. At the same time, it is proposed that, through long term popular education and food and nutrition education, it is possible to build autonomous and critical subjects and collectives, capable of transforming the existing power structures and acting in favor of public policies that promote practices that are fair, healthy, sustainable, and ethical.
ABSTRACT
Many barriers impede the defense of health equity, especially those that hinder social participation in health. In the mid-1990s, Victor Valla proposed incorporating the population's participation into health surveillance through Paulo Freire's popular education. This counterpoint to traditional surveillance practices, then called civil health surveillance, is added to the expanded concept of health, and has a strong connection with the critical perspective of epidemiology to understand the dialectical relationship between social classes and their lived spaces. The practice of civil surveillance aims to overcome essential gaps left by traditional methods of public health investigation. It includes a lack of attention to socio-cultural contexts, the construction of risk located only in the individual, and the representation of public health agendas that privilege and pathologize certain behaviors. In this sense, this paper discusses concept of civil health surveillance, the locus of discussion of population studies in the reification of the role of the contextual effect in explaining the social production of health and the incorporation of popular participation in health surveillance as an element of social transformation. The deepening of this discussion allows a participatory construction of new health models focused on the effective reduction of health inequities and, consequently, the effective universalization of the right to health.
Muitas barreiras impedem a defesa da equidade na saúde, especialmente aquelas que dificultam a participação popular. Em meados dos anos 90, Victor Valla propõe a incorporação da participação da população à prática da vigilância em saúde, por meio da educação popular de Paulo Freire. Este contraponto às práticas tradicionais da vigilância, nomeadas vigilância civil da saúde, se somam à concepção ampliada de saúde, e possuem forte ligação com a perspectiva crítica da epidemiologia enquanto meio de compreender a relação dialética entre classes sociais e seus espaços vividos. A prática da vigilância civil pretende superar lacunas importantes deixadas pelos métodos tradicionais de investigação em saúde pública, como falta de atenção aos contextos socioculturais, a construção do risco localizada somente no indivíduo e a representação de agendas de saúde pública que privilegiam e patologizam certos comportamentos. Neste sentido, o presente trabalho debate o conceito de vigilância civil da saúde, o locus de discussão dos estudos de população na reificação do papel do efeito contextual para a explicação da produção social da saúde e a incorporação da participação popular à vigilância em saúde como elemento de transformação social. O aprofundamento desta discussão, no limite, permite uma construção participativa de novos modelos de saúde focados na redução efetiva das iniquidades em saúde e, consequentemente, universalização efetiva do direito à saúde.
ABSTRACT
To improve health equity, as well as equity in research, community-engaged research and participatory research needs to be inclusive. Equity in health research refers to the principle that anyone affected by research or who can benefit from its outcomes should have equal opportunities to contribute to it. Many researchers advocate the importance of promoting equity in research and engage in processes that foster the research involvement of lay persons, patients, and community members who are otherwise "absent" or "silent". Still, people with limited literacy skills who experience unwarranted structural barriers to healthcare access have little involvement in research. Low literacy is a major barrier to equity in health research. Yet there exist approaches and methods that promote the engagement in research of people with literacy challenges. Building on our previous research projects conducted with community members using participatory visual and sound methods (participatory mapping, photovoice, digital storytelling, etc.), we embarked on the co-creation of a digital platform in 2017. Our aim in this commentary is to report on this co-creation experience that was based on a social justice-oriented partnership. The development of the online platform was overseen by a steering committee made up of workers from community organizations involved with people with limited literacy skills, students, and researchers. In the development process, the co-creation steps included a literature review, informal interviews with key informants, and discussion and writing sessions about format and content. After numerous challenges raised and addressed during co-creation, the Engage digital platform for engagement in research went live in the winter of 2020. This platform presents, on an equal footing, approaches and methods from academic research as well as from the literacy education community engaged with people with limited literacy skills.
People with limited literacy skills are often excluded from health research. Engaging patients and community members with limited literacy in research requires tailored approaches and methods that have been tried and tested with them. In 2017, building on an existing partnership between researchers well-versed in using participatory visual and sound methods and community partners, we undertook the co-creation of a digital platform. Our aim was to empower both academic researchers and community researchers and partners (lay persons, clinicians, stakeholders, community organizations) to engage in research projects with people with limited literacy skills. The result was a digital platform ( https://www.engageplus.org ) comprising several modules and resources available in French and English and accessible on the Web. In this commentary, we share our experience in co-creating this digital platform and discuss the facilitators and challenges encountered.
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Despite progress in documenting the outcomes of Community Health Worker interventions, the lack of standardized measures to assess CHW practice has made it difficult for programs to conduct reliable evaluations, and impossible to aggregate data across programs and regions, impeding commitment to sustainable, long-term financing of CHW programs. In addition, while CHWs have sometimes been involved as data collectors, they have seldom been engaged as full partners in all stages of evaluation and research. This manuscript details the current work being done by the CI Project, demonstrating how CHWs are able to contribute to the integrity, sustainability, and viability of CHW programs through the collaborative development and adoption of a set of common process and outcome constructs and indicators for CHW practice and CHW program implementation.
