Class Outline 2/19/13 Video Presentation - - PowerPoint PPT Presentation

Class Outline

2/19/13

• Video Presentation –

http://www.youtube.com/watch?v=KKgJ2VxxEZw –

(10 minute video – Ohio State University http://www.youtube.com/watch?v=_Mbu8bvKb_U (7.13 mins) http://www.youtube.com/watch?v=HzEsuY2x2Ww (3.20 mins)

• Community Based Participatory Model

– Healthy Public Housing Initiative (HPHI) – Lawrence Projects

Cultural Humility vs Cultural Competence

• Cultural Humility:

– Life Long Learning & Development, Self Reflection – Recognize and Mitigate Power Imbalance – Institutional Accountability

Cultural Humility: People, Principles & Practices. 30 Minute documentary published 8/2/12 Professor Vivian Chavez, San Francisco State http://www.youtube.com/watch?v=SaSHLbS1V4w (complete version)

Healthy Public Housing Initiative: Community Based Participatory Research, using IPM Intervention as a case study

Rhona Julien, ScD

Introduction to Environmental Justice

• Feb. 19, 2013

• Boston Public Housing Facts

– Largest apartment owner in Boston – 15,000 units in 68 developments – 25,000 residents (10,000 children) – Average Income: 17% of Boston-area median

• < $10,000 for a family of four

Boston Public Housing

• Project goals

– Improve home environments of residents. – Empower residents. – Build capacity within city agencies, community

• rganizations and residents.

– Impact national policy on housing and health.

Healthy Public Housing Initiative

HPHI Partners

• Public/Government

– Boston Housing Authority (BHA) – Boston Public Health Commission

• Universities

– Boston University School of Public Health – Harvard University School of Public Health – Tufts University School of Medicine

• Community

– Committee for Boston Public Housing, Inc. – Franklin Hill Tenant Task Force, Inc. – West Broadway Tenant Task Force, Inc. – Public Health Initiative, South Boston Community Health Center – Residents of BHA developments

HPHI Study Group

• 3 Boston Housing Authority (BHA) Developments:

West Broadway Franklin Hill Washington Beech

• Recruited 60 households, pediatric asthmatic (4 to 17 yrs)
• Racial Composition:

Hispanic - 65.8% Black - 31.6% Caucasian - 2.6%

• Health data
• Environmental Measurements
• Interventions

– Clinical – Asthma case management: training, access to peak flow meters, monthly diaries and maintaining an appropriate medication regimen. – Environmental – new mattresses, pillow covers, air purifier, plastic ware, minor home improvements, IPM.

HPHI intervention

Working Definition of IPM

Integrated Pest Management (IPM) is an approach to pest control using multiple strategies that emphasize modification of pest environments with the minimum use of pesticides.

IPM Intervention

Evaluate Effectiveness:

• Pre IPM Measurements (Baseline)

Housing conditions/housekeeping practices, pest problem, pesticide use, IAQ awareness, pesticide residues

• IPM Interventions

Resident Education Professional House Cleaning Professional Pesticide Treatment

• Post IPM Measurements (3 months after baseline)

Measurements (pre/post IPM)

• Home Assessment
• Pesticide inventory
• Assessed roach infestation
• Environmental

Measurements

IPM Interventions

Professional cleaning: Washing of walls, removal of debris; minor repairs (caulking) HPHI pest contractor apply Crack and Crevice Treatments, e.g., gels and boric acid

• Monitor home for pest activity
• Control pest infestation
• Reduce pesticide use
• Minimize occupants’ exposure to

pesticides

• Optimize use of non toxic

alternatives

• Share the results with a friend…

Resident Education

Summary of Findings

• Pre IPM Intervention
• Every home had at least 3 pesticides, some as many as 8

some pesticides were banned, RUP

• RUP, detected in 70% of homes
• Chlorpyrifos found in every home 2 years following withdrawal from sales
• Post IPM Intervention

Resident Education

– Positive association with reduction in cyfluthrin concentrations (active ingredient for Tempo, restricted use pesticide) – Negative association with permethrin reduction, which may be suggestive of pesticide substitution

Professional Cleaning

– Homes with poor housekeeping were higher at baseline and got better reductions

Reduction in cockroach infestation

Community Based Participatory Research (CBPR)

CBPR is research that is conducted as an equal partnership between traditionally trained "experts" and members of a

• community. (Wikipedia)

Community Expert Researcher - Resource

Challenges to IPM

• Language and cultural barriers
• Literacy issues
• Access to homes
• Gaining trust
• Community’s Agenda vs Researchers’ Agenda

(…making a difference is great, quantifying the difference is greater!)

Factors that helped overcome barriers…

Focus Group Meeting

Meetings with residents introduce ourselves, discuss project, to discuss housing hazards…

Community Health Advocates (CHAs)

Hire & Train: data collection/documentation, peer education, home inspections (e.g., id asthma triggers, pest entryways.)

Meeting with Project Partners Check-ins: what’s working, what’s not

Community Meetings to Present Study Findings

Tempo, RUP used by some families

HPHI Team

Theory to practice - findings led to BHA IPM Program, Bodega outreach, pesticide buyback program.

Cultural Humility

• http://www.youtube.com/watch?v=SaSHLbS1V4w

(complete version - 30 mins)