Advancing Translational Research in Environmental Science: The Role and Impact of Social Sciences.

Increasing recognition of the complexity of environmental problems and the need to understand social processes and human values is leading environmental management agencies in many nations, including the USA, to integrate more research from the social sciences through the inclusion of social scientists on interdisciplinary teams. For this study we conducted focus groups at three research laboratories within the U.S. Environmental Protection Agency's Office of Research and Development to better understand how inclusion of social sciences influenced the research process and outcomes, and the barriers to and facilitators of integration. The focus groups identified effects on the research process including improved problem framing, the introduction of new methodologies, and greater stakeholder and public inclusion, while research outcomes included the inclusion or refinement of social and environmental perspectives and systems thinking, increased translatability of research, and new partnerships. Barriers identified included lack of familiarity with social sciences which affected perceptions of social sciences and organizational capacity to absorb and apply social science expertise. Facilitators included receptivity of team members, intentional communication strategies, and project structures and organizational commitment that support interdisciplinary work. Finding a key barrier to be lack of clarity about the different roles social sciences play in translational research, we present a conceptual model defining the roles and contributions of social scientists that clarifies the distinction between "integration" of social sciences in research and "application" of skills and knowledge from the social sciences which play distinct but equally important roles in translational research approaches and solutions-driven research. These insights on the ways social sciences contribute to translational research efforts advance integration of social and natural sciences in environmental science research, particularly in applied contexts.

Scaling Up: Citizen Science Engagement and Impacts Beyond the Individual.

As the application of citizen science expands to address increasingly complex social problems (e.g., community health), there is opportunity to consider higher-order engagement beyond that of individual members of a community. The US Environmental Protection Agency (EPA) is working to foster public engagement in science through Smoke Sense, which is a citizen science research project that aims to reduce the public health burden of wildland fire smoke. Smoke Sense is facilitated by a mobile app that shares information on air quality, smoke, and health, and collects individual reports of smoke exposure and concurrent health symptoms. However, Smoke Sense is also generating interest among organizations that are working in this problem domain at the local, state, national, and tribal levels. The interest in the citizen science project at the organizational level led us to ask: What would motivate members of organizations to engage in a citizen science project like Smoke Sense, and how do they envision that engagement could improve public health? To explore these questions, we collected data through interviews with individuals who were engaged in Smoke Sense through their work at local, state, and tribal environmental and health agencies in the western US. An inductive, thematic analysis suggests that individuals' motivations stem from their experiences and challenges with smoke in their different roles (e.g., personal, professional, and community member). Respondents envisioned leveraging both the app itself and the data generated by individuals in their region to enhance and support their existing outreach and communication efforts related to smoke. Citizen science projects that aim to address issues in complex problem domains should be designed to complement the work of partner organizations.

Knowing Your Audience: A Typology of Smoke Sense Participants to Inform Wildfire Smoke Health Risk Communication.

Central to public health risk communication is understanding the perspectives and shared values among individuals who need the information. Using the responses from a Smoke Sense citizen science project, we examined perspectives on the issue of wildfire smoke as a health risk in relation to an individual's preparedness to adopt recommended health behaviors. The Smoke Sense smartphone application provides wildfire-related health risk resources and invites participants to record their perspectives on the issue of wildfire smoke. Within the app, participants can explore current and forecasted daily air quality, maps of fire locations, satellite images of smoke plumes, and learn about health consequences of wildfire smoke. We used cluster analysis to identify perspective trait-clusters based on health status, experience with fire smoke, risk perception, self-efficacy, access to exposure-reducing resources, health information needs, and openness to health risk messaging. Differences between traits were examined based on demographics, health status, activity level and engagement with the app. We mapped these traits to the Precaution Adoption Process Model (PAPM) to indicate where each trait lies in adopting recommended health behaviors. Finally, we suggest messaging strategies that may be suitable for each trait. We determined five distinct perspective traits which included individuals who were Protectors and have decided to engage on the issue by adopting new behaviors to protect their health; Cautious, Proactive, and Susceptible individuals who were at a Deciding stage but differed based on risk perceptions and information needs; and the Unengaged who did not perceive smoke as a health issue and were unlikely to change behavior in response to messaging. Across all five traits, the level of engagement and information needs differed substantially, but were not defined by demographics. Individuals in the Susceptible trait had the highest level of engagement and the highest information needs. Messaging that emphasizes self-efficacy and benefits of reducing exposure may be effective in motivating individuals from the deciding stage to taking health protective action. Shared perspectives define an individual's propensity for acting on recommended health behaviors, therefore, health risk message content should be tailored based on these perspectives.

Illuminating Stakeholder Perspectives at the Intersection of Air Quality Health Risk Communication and Cardiac Rehabilitation.

There is ample evidence of adverse cardiovascular health outcomes associated with exposure to air pollution and cardiac rehabilitation patients are at increased risk for future adverse health events related to air quality. Risk communication and health messaging about recommended behaviors to reduce exposure to air pollution can be integrated into existing care routines and structures. How this can be achieved most appropriately and effectively is not well understood. A focus group design is used to investigate cardiovascular patient and provider experiences, attitudes and beliefs about the risks of air pollution, related health risk messaging and factors that may influence integrating that topic into patient care and communication. Three discussions were hosted, one with cardiac patients, a second with non-physician cardiac rehabilitation providers and a third with physicians who treat cardiac patients. A within-case thematic inductive analysis of each discussion is used to understand the nature of communication, logistics, guidance and overall substance of the cardiac rehabilitation educational experience. Results suggest that air pollution may be an unrecognized risk factor for cardiac patients and cardiac rehabilitation is a prime setting for communicating air pollution health risk messaging. However, to effectively integrate air quality health risk messaging into cardiac rehabilitation, it is critical to account for the existing knowledge-base and behaviors of both providers and patients.

Project SUCCESS' effects on the substance use of alternative high school students.

Project SUCCESS is a selective and indicated substance use prevention program that targets high risk students in secondary school settings. We evaluated the effects of Project SUCCESS on adolescents' substance use immediately following program implementation, and again one year later. Two successive cohorts of alternative high schools were randomly assigned to an intervention or control group, yielding seven schools per condition. Main outcomes included 30-day use of alcohol, marijuana, and illegal drugs excluding marijuana, and drinking to intoxication. We conducted exploratory analyses on 30-day cigarette use. Using Hierarchical Linear Modeling, we found that students in the control schools reported significantly less use of illegal drugs excluding marijuana than those in the intervention group at the first posttest; however, this effect did not persist one year later. There were no other outcome effects of even a marginal nature. While results of this study do not provide evidence of Project SUCCESS' effectiveness, students' program exposure was low. It is possible that Project SUCCESS would perform better in schools with higher and more regular rates of attendance.

Advancing health and environmental disease tracking: a 5-year follow-up study.

OBJECTIVES: Our goal was to gain an understanding of the extent to which environmental public health tracking (EPHT) has progressed since the release of the 2000 Pew Environmental Health Commission report examining the nation's EPHT infrastructure. METHODS: As a follow-up to the Pew Commission report, we conducted a telephone survey of state practitioners in an effort to assess EPHT trends and changes in state-level capacities and activities over the past several years. RESULTS: We found that new and enhanced federal-state partnerships; improved surveillance, data analysis, and communication capacities; and enhanced support of tracking personnel have provided a foundation for progress in the area of EPHT. Also, the Centers for Disease Control and Prevention's support of EPHT has strengthened the national environmental public health infrastructure and capacity to track environmental hazards, exposures, and health. CONCLUSIONS: Improved funding, data access, and translation of data to prevention activities are critical to sustaining progress in EPHT and developing the evidence base necessary for assessing the longer-term impacts and efficacy of EPHT and related environmental health improvements.