Using community-engaged research to inform development of an environmental health survey

Purpose: Studies have demonstrated an association between chronic illnesses and exposure to toxic environmental conditions. We used Photovoice to document community members' perceptions of environmental factors that influence health and contribute to health disparities. We conducted a formative assessment of community risks to inform the development of an environmental health survey on cancer and environmental risk perceptions. Methods: Homogenous and convenience sampling were used to recruit community members (n=14) across North Charleston, South Carolina. Participants documented positive and negative environmental features of their neighborhoods using Photovoice. Group consensus was employed to identify and confirm photo themes. Results: Research staff identified 10 emergent themes from the photos. They included: housing/dwellings, industrial, hazards/pollution, beautification, places of worship, human and social services, businesses/schools, construction, natural environment, and other. Photovoice resulted in the generation and/or revision of questions on perceived cancer risk, environmental health risks, and social factors that influence health and identification of three to five factors perceived as paramount to addressing risk perceptions. Conclusions: Our findings demonstrated that Photovoice is a useful method of ascertaining community input, engaging community members in research, and documenting perceptions of environmental challenges in underserved communities. Results from this study will inform development of an environmental health survey and future health promotion interventions. Understanding social beliefs and general perspectives on environmental risks may provide a partial explanation for racial/ethnic differences in environmental and cancer health disparities.