2009 Progress Report: Community Outreach and Translation Core

EPA Grant Number: R833293C004
Subproject: this is subproject number 004 , established and managed by the Center Director under grant R833293
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).

Center: Southern Center on Environmentally Driven Disparities in Birth Outcomes
Center Director: Miranda , Marie Lynn
Title: Community Outreach and Translation Core
Investigators: Keating, Martha H.
Current Investigators: Keating, Martha H. , Maxson, Pamela , Miranda , Marie Lynn
Institution: Duke University
EPA Project Officer: Callan, Richard
Project Period: May 1, 2007 through April 30, 2012 (Extended to April 30, 2014)
Project Period Covered by this Report: May 1, 2009 through April 30,2010
RFA: Centers for Children’s Environmental Health and Disease Prevention Research (2005) RFA Text |  Recipients Lists
Research Category: Children's Health , Health Effects , Health


The central objective of the Community Outreach and Translation Core (COTC) is to create, implement, and assess strategies to translate and apply the findings of the Southern Center on Environmentally-Driven Disparities in Birth Outcomes (SCEDDBO) into relevant information for women of childbearing age, families, community groups, policy makers, and health care professionals. The COTC conducts environmental health outreach and education directed at low income and minority women and their children; enhances the capacity of disadvantaged communities to understand threats posed by environmental contaminants; and provides a bridge between campus research, communities and policy makers. The specific aims of the COTC are:

  1. Support the community-based neighborhood assessment being undertaken as part of Research Projects R833293C001 and R833293C002;
  2. Partner with nursing programs at Duke-affiliated hospitals to develop and present curricula to nursing students on environmental exposures and maternal and child health outcomes;
  3. Develop culturally-appropriate advisory materials on environmental contaminants for low-income expectant or nursing mothers with low English proficiency;
  4. Deliver training to local health department personnel focused on environmental factors related to maternal health and pregnancy outcomes;
  5. Participate in regional, state and federal policy dialogues to provide decision makers with policy-relevant science-based information concerning environmental exposures and health disparities related to maternal and child health and well-being; and
  6. Increase awareness of maternal health and health disparities by facilitating bi-directional exchanges between Center investigators, community members, public health advocacy groups, and policy makers.

Progress Summary:

The goals for COTC in Year 3 were to continue to expand communication and translation efforts to specific audiences. With a communication strategy in place, the COTC utilized various communication tools appropriate to a variety of audiences. Collaboration with researchers and groups external to SCEDDBO continued to evolve and the COTC welcomed and responded to requests for environmental health information from community groups and the general public.

In Year 3, the COTC continued to disseminate the findings of the Community Assessment Project (CAP) which assesses built environment variables for over 17,000 tax parcels, including the home addresses of over 40% of the participants in the Healthy Pregnancy, Healthy Baby Study (SCEDDBO Project R833293C002). During Year 3, the CAP report was distributed to nearly 250 community groups, Durham County and city officials, and community leaders (see (http://cehi.env.duke.edu/cap/ Exit ). This distribution in turn led to numerous requests for COTC staff to present the findings of the study (see below under External Collaborations). In addition, the CAP methodology and findings were presented at the annual American Public Health Association meeting, EPA’s environmental justice meeting, Strengthening Environmental Justice Research and Decision Making: A Symposium on the Science of Disproportionate Environmental Health Impacts, the Region 4 PEHSU Break the Cycle conference, and the 2010 Community Health Assessment Institute (Office of Healthy Carolinians).

Although data collection for CAP has concluded, the project is not static. CAP data are being summarized through the development of Neighborhood Health Indices which describe seven major characteristics of neighborhoods that potentially affect health (e.g., tenure, safety, housing and property damage). Development of the indices will facilitate linking the CAP findings to Projects R833293C001 and R833293C002 pregnancy outcomes.

Specific Aim 2 of the COTC is to partner with nursing programs to develop and present curricula to nursing students on environmental exposures and maternal and child health outcomes. Implementing activities to address this Specific Aim was a focus of COTC efforts in Year 3, and these efforts will continue in Year 4. A comprehensive project was designed to develop environmental health curricula for nursing students, nursing faculty, and practicing nurses. Supplemental funding was sought with a grant submittal to EPA’s Environmental Education Grant Program. Funding determinations have not been announced at this time. The COTC also partnered with the UNC School of Nursing and Healthcare Without Harm to co-sponsor an environmental health symposium for practicing nurses. The symposium, Environmental Considerations in Nursing Practice, attracted nationally-recognized speaker and an audience of 60 practicing nurses. The event was also accredited for Continuing Nursing Education credits. COTC staff participated in all aspects of the planning and execution of this conference. SCEDDBO Director Marie Lynn Miranda presented the keynote address.

Specific Aim 3 of the COTC is to develop culturally-appropriate advisory materials on environmental contaminants for low-income expectant or nursing mothers with low English proficiency. During Year 3 the COTC, guided by the communication strategy, established a number of dissemination efforts to distribute the mercury fish consumption fish advisory materials that were developed in Year 2 for Latino families. Because the materials will be distributed to families primarily by nutritionists in the North Carolina Supplemental Nutrition Program for Women, Infants, and Children (WIC), considerable effort was expended to reach this audience. A series of webinars, accredited for continuing education credits for Registered Dieticians, were held for all WIC staff in North Carolina. The webinars were attended by 109 participants representing 66 out of 88 (80%) of the WIC clinics in North Carolina. A project description and all materials are also available on a newly-developed website (see http://cehi.env.duke.edu/fishadvisory/ Exit ). In addition, the project was presented at two national conferences (American Public Health Association and the National Environmental Public Health Conference) and two program conferences sponsored by the National Institute of Environmental Health Sciences.

Specific Aim 4 of the COTC is to deliver training to state and local health departments focused on environmental factors related to maternal health and pregnancy outcomes. During Year 3, the COTC partnered with SCEDDBO’s Geographic Information Systems and Statistical Analysis Core to offer no-cost training to public health professionals throughout North Carolina. Four all-day sessions of “An Introduction to GIS in Public Health: Tools for Mapping Social Determinants of Health” were held at the Nicholas School of the Environment. This course has broad ranging public health applications including policy guidance, community outreach and education, and program planning. The training was accredited for continuing education credits for Registered Sanitarians (the professional certification common to county health department personnel). The training courses were attended by 65 participants representing 18 NC counties, 18 different program areas of state government, 7 non-profit organizations, and Durham city personnel. The training courses not only build capacity within these organizations, but encourage future collaborations and networking between the COTC and stakeholder audiences.

COTC staff continues to collaborate with a variety of regional, state, and federal advisory groups including the American Lung Association Advisory Group, the Durham County Health Department Community Health Assessment Working Group, and the Obesity and Chronic Disease Committee of the Partnership for a Healthy Durham. In addition, SCEDDBO Director Marie Lynn Miranda was appointed to serve on the EPA's Children's Health Protections Advisory Committee (CHPAC). The CHPAC is a federal advisory committee established in 1998 to provide independent advice to the EPA Administrator on regulations, research, and communications issues relevant to children's environmental health.

Collaborations with other SCEDDBO Components

COTC staff continues to meet monthly with the SCEDDBO investigators to keep apprised of research developments and findings, translation opportunities, and scientific outreach activities (e.g., meetings, presentations and manuscripts) of the SCEDDBO investigators. The COTC staff also provides the investigators with updates on COTC activities and opportunities to participate in outreach activities. During Year 3, as part of the communication strategy, COTC staff received a periodic update from each SCEDDBO investigator detailing any presentations, conferences, or other issues or occasions that might constitute a research translation opportunity. These regular and frequent communications enable COTC staff to keep abreast of research progress, update the website, and plan for translation efforts.

External Collaborations

The COTC has developed a wide and diverse network of collaborators among federal, state and local agencies, universities and community groups. Activities with these diverse partners cover a broad spectrum of children’s environmental health issues, ranging from birth outcomes to lead poisoning prevention, environmental exposures, and obesity.

COTC staff has developed working relationships with scientists at the U.S. EPA representing a wide variety of disciplines. These relationships have allowed for exchange of research findings and data in a number of areas including distance-to-roadway analyses, air pollution impacts on birth outcomes, community engagement, and using GIS for environmental justice analysis. In terms of formal meetings, Dr. Marie Lynn Miranda was invited to present the keynote address at the joint NIEHS EPA meeting of the Gene and Environment Initiative's Exposure Biology Program. The meeting was held in August 2009 at the U.S. Environmental Protection Agency's campus in Research Triangle Park, North Carolina. Her talk entitled "Combining Population, Clinical, and Animal Models to Assess Exposure and Effects" described the research efforts currently underway at the Southern Center on Environmentally Driven Disparities in Birth Outcomes (SCEDDBO).

Activities with multiple state and local agencies continue to cover a wide variety of topics including the impact of the built environment on obesity and pregnancy outcomes, mapping environmental exposures and built environment variables, as well as other topics related to school-aged children. The COTC is actively working with staff at numerous state and local offices. At the state government level these offices include the Senior Advisor for Healthy Schools, the Women’s Health Branch, the Nutrition Services Branch, and the Office of Healthy Carolinians. Activities with county health departments and non-profit organizations ranged from GIS training and fulfilling mapping requests to serving on advisory groups (for example Durham County’s Community Health Assessment Working Group).

For the 2nd consecutive year COTC investigators mentored a student in the “Break the Cycle.” project sponsored by the Region 4 of the U.S. EPA, Emory University and the Southeast Pediatric Environmental Health Specialty Unit. The selected student used data from SCEDDBO’s Healthy Pregnancy Healthy Baby research project to describe the effects of maternal depression on pregnancy outcomes. These findings were presented at the 4th Break the Cycle in September 2009. Also in year 3, the next round of “Break the Cycle” was underway. The selected student for this round explored the relationship between the built environment and low birthweight. These findings will be presented May 6, 2010 (year 4) at Emory University in Atlanta.

A major focus of the COTC continues to be dissemination of the findings of the Community Assessment Project. Outreach meetings were held with various and diverse community and neighborhood groups and other interested parties, ranging from the Southwest Central Durham Quality of Life Project in southwest Durham to singer Jackson Browne. In addition, COTC staff have participated in and provided GIS and other support to a range of other community stakeholders including the Durham Police Department, NC Legal Aid, Clean Energy Durham and Durham Congregations, Associations and Neighborhoods, among others.

Finally, the COTC continues to respond with detailed information to numerous requests from private citizens about a variety of environmental health concerns. These requests were received through both the CEHI toll-free number and via the CEHI website.

Future Activities:

During year 4, the COTC will continue to expand communication and translation efforts to specific audiences. By participating in the design, planning, and execution of the Durham County Community Health Assessment, we hope to gain additional insight into community health and information needs. We will also continue our efforts to incorporate environmental health topics into continuing nursing education and sustain established collaborations with researchers within and external to SCEDDBO.

Journal Articles:

No journal articles submitted with this report: View all 31 publications for this subproject

Supplemental Keywords:

Risk communication, outreach, translation, participatory research, built environment,

Progress and Final Reports:

Original Abstract
  • 2007
  • 2008
  • 2010
  • 2011
  • 2012
  • Final Report

  • Main Center Abstract and Reports:

    R833293    Southern Center on Environmentally Driven Disparities in Birth Outcomes

    Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
    R833293C001 Research Project A: Mapping Disparities in Birth Outcomes
    R833293C002 Research Project B: Healthy Pregnancy, Healthy Baby: Studying Racial Disparities in Birth Outcomes
    R833293C003 Research Project C: Perinatal Environmental Exposure Disparity and Neonatal Respiratory Health
    R833293C004 Community Outreach and Translation Core
    R833293C005 Geographic Information System and Statistical Analysis Core