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LETTER
A previously published case study by Buman et al. (2011) in Translational Behavioral Medicine described the Neighborhood Eating and Activity Advocacy Team (NEAAT) Study, in which an ethnically diverse group of older low-income “citizen scientists” received advocacy and skills training to empower them to collaboratively gather, review, prioritize, and disseminate data about features of their neighborhood environment that help or hinder active living and healthy eating [1]. Although active involvement by the NEAAT Study research team ended in 2011, the older adult citizen scientists have continued to use the team-oriented engagement skills they learned during the initial phases of this study to advocate for improvements in their neighborhood and to partner with key allies, including local policy makers.
The sustained information sharing and problem solving has encouraged officials of this ethnically diverse, lower-income city to more coherently focus on creating an age-friendly community, and resulted in the allocation of significant government dollars for built environment improvements and public health inclusion in the city’s general plan. The voices of the older adults were incorporated in a Senior Advisory Committee resolution adopted in 2012, which identified a range of issues relating to active living, including sidewalk repair, off-leash dogs, parking issues, and open-space concerns. Over the past 2 years, the City's Planning and Engineering Divisions have (a) reviewed the streetscapes and pathways around the senior residents’ US Department of Housing and Urban Development Section 8 funded housing site to create a safer walking environment and improve access to the nearby senior center, (b) received a US$1,000,000 grant from the Strategic Growth Council to update the general plan and zoning code so that public health is targeted in future planning, (c) appropriated US$400,000, through the City Council, to complete the environmental analysis of the aforementioned plans, and (d) implemented a comprehensive community sidewalk inventory and repair program, incorporating shade trees to encourage walking by residents.
Among the challenges that have been described in translating research into practice are the absence of culturally appropriate language and approaches that fully “speak” to residents, community businesses, organizations, and decision makers alike, minimal mechanisms for sustainability within the community setting and structure, and distrustful community/researcher/policymaker relationships [2]. The community-based empowerment approach used in the NEAAT Study was specifically aimed at overcoming these challenges, resulting in the successful implementation of community-driven, researcher-supported methods that translated into funded, comprehensive policy-level changes.
The NEAAT experience underscores the frequently made observation that translational research takes time and persistence among all parties. Yet, it also shows that training and empowering older adults to assess their neighborhoods and engage with local private and public sector decision makers for neighborhood improvements is a viable approach. In this study, this approach resulted in sustained partnerships and meaningful changes that are of benefit not only just to the older adults, but also to all residents of the community. In addition, such programs provide an opportunity for greater civic engagement, agency, and productivity among this growing segment of the population that can help in fulfilling the potential of a long life [3].
References
Buman MP, Winter SJ, Baker C, Hekler EB, Otten JJ, King AC. Neighborhood Eating and Activity Advocacy Teams (NEAAT): engaging older adults in policy activities to improve food and physical environments. Transl Behav Med. 2012; 2(2): 249-253.
Wallerstein N, Duran B. Community-based participatory research contributions to intervention research: the intersection of science and practice to improve health equity. Am J Public Health. 2010; 100(Suppl 1): S40-S46.
King A, Guralnik J. Maximizing the potential of an aging population. J Am Med Assoc. 2010; 34: 1944-1945.
Acknowledgments
This work was supported in part by a Clinical Translational Science Award Seed Grant awarded through the Stanford University Office of Community Health (PI: King). At the time this study was conducted, Drs. Buman and Hekler were supported by US Public Health Service grant 5T32L007034 from the National Heart, Lung and Blood Institute and Dr. Otten was supported by a Nutrilite Training Grant. Drs. Winter and Sheats are currently supported by US Public Health Service grant 5T32L007034 from the National Heart, Lung and Blood Institute. We thank Rhonda McClinton-Brown and Jill Evans from the Stanford University Office of Community Health for their continued support and the residents for their participation.
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Implications
Research: Empowering “citizen scientists” through advocacy and skills training to gather, analyze, and disseminate data can overcome previously identified challenges in translating research into practice and policy.
Practice: Using a citizen scientist approach can help build community capacity and facilitate community support and empowerment, which increases intervention relevance and helps to ensure its suitability to the cultural and contextual needs of the community.
Policy: Using a citizen scientist approach and “voice” can result in the allocation of substantial government dollars for neighborhood improvements that can facilitate active living and greater public health inclusion in municipal processes and activities, even in times of local government financial constraint.
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Winter, S.J., Buman, M.P., Sheats, J.L. et al. Harnessing the potential of older adults to measure and modify their environments: long-term successes of the Neighborhood Eating and Activity Advocacy Team (NEAAT) Study. Behav. Med. Pract. Policy Res. 4, 226–227 (2014). https://doi.org/10.1007/s13142-014-0264-1
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DOI: https://doi.org/10.1007/s13142-014-0264-1