Preparing for the health impacts of climate change in Indigenous communities: The role of community-based adaptation

Climate change presents substantial risks to the health of Indigenous peoples. Research is needed to inform health policy and practice for managing risks, with community based adaptation (CBA) emerging as one approach to conducting research to support such efforts. Few, if any, studies however, have critically examined the application of CBA in a health or Indigenous peoples context. We examine the strengths, challenges, and opportunities of health-related CBA research in Indigenous community settings, drawing on the experiences of the multi-nation interdisciplinary Indigenous Health Adaptation to Climate Change (IHACC) project. Data collection was guided by a framework developed to evaluate CBA projects. Semi-structured interviews (n = 114) and focus groups (n = 23, 177 participants) were conducted with faculty-based researchers, institutional partners, community members, students, and trainees involved in the IHACC project in Canada, Uganda, and Peru. Results illustrate the importance of CBA in co-generating knowledge on climate-health vulnerability and adaptation options, capacity building, and informing decision choices. There are also significant challenges of conducting CBA which can have unintended negative consequences, with results emphasizing the importance of managing the tension between health research and tangible and immediate benefits; developing a working architecture for collective impact, including team building, identification of common goals, and meaningful engagement of knowledge users; and the need to continuously monitor and evaluate progress. CBA holds significant promise in a health adaptation context, but only in the ‘right’ circumstances, where considerable time is spent developing the work with partners

Vulnerability and adaptive capacity of community food systems in the Peruvian Amazon: a case study from Panaillo

Rainfall variability and related hydrological disasters are serious threats to agricultural production in developing countries according to the Intergovernmental Panel on Climate Change (IPCC). Since projections of climate change indicate an increase in the frequency and intensity of climatic hazards like flooding and droughts, it is increasingly important to understand communities’ adaptive capacity to extreme hydrological events. This research uses a case-study approach to characterize the current vulnerability and adaptive capacity of the food system to a climatic hazard in Panaillo, a flood-prone indigenous community in the Peruvian Amazon. Participatory methods were utilized to examine how biophysical and socioeconomic factors constrain or enable local adaptive capacity to climatic hazards over time. Seasonal flooding was shown to strongly influence agriculture and fishing cycles. Panaillo residents have developed several adaptive strategies to adjust to hydrological extremes, such as food preservation and the cultivation of fast-growing crops on riverbeds. However, Panaillo residents generally lack the necessary human, physical, social and natural resources to effectively employ their adaptive mechanisms as a result of major social and environmental changes in the area. The temporal analogue of the extreme 2010-2011 floods highlighted the multiple drivers of vulnerability that exist at different spatial and temporal scales. Economic development, low institutional capacity, climate variability, and the assimilation social model in Peru all have profound effects on the food system and health by affecting the ways in which adaptive strategies and livelihoods are practiced. Climate change has the potential to exacerbate these socioeconomic and biophysical drivers and further compromise community food systems in the Peruvian Amazon in the future.La variabilité des précipitations, et les désastres hydrologiques qui y sont reliés, sont des menaces sérieuses à la production agricole dans les pays en voie de développement, selon le Groupe d’experts intergouvernemental sur l’évolution du climat (GEIC). Comme les projections des changements climatiques prévoient une augmentation de la fréquence et de l’intensité des risques climatiques tels que les inondations et les sécheresses, il devient de plus en plus important de comprendre la capacité d’adaptation des communautés aux évènements hydrologiques extrêmes. Ce projet utilise l’approche d’étude de cas dans le but de caractériser la vulnérabilité actuelle et la capacité d’adaptation du système alimentaire aux risques climatiques à Panaillo, une communauté indigène localisée dans une région prône aux inondations dans l’Amazonie Péruvienne. Des méthodes participatives sont utilise afin d’examiner la façon dont les facteurs biophysiques et socioéconomiques peuvent contraindre ou faciliter la capacité d’adaptation locale aux risques climatiques au fils du temps. Les résultats démontrent que les inondations saisonnières ont une forte influence sur les cycles agricoles et de pêche. Les résidents de Panaillo ont développés plusieurs stratégies d’adaptations pour s’ajuster aux extrêmes hydrologiques, tels que la préservation des aliments et la culture de plantes à croissance rapide sur les lits des rivières. Par contre, les résidents de Panaillo en général manquent de capital human, physique, et social, ainsi que de ressources naturelles pour déployer effectivement leurs mécanismes d’adaptation compte tenu des changements sociaux et environnementaux majeurs qui ont eu lieu dans la région. L’analogue temporel des inondations extrêmes de 2010-2011 surlignent les causes multiples de la vulnérabilité qui existe à différentes échelles spatiales et temporelles. Le développement économique, la faible capacité institutionnelle, la variabilité climatique, et le modèle d’assimilation sociale au Pérou ont tous des effets profonds sur le système alimentaire et la santé en affectant les façons dont les stratégies d’adaptation et les moyens d’existence sont pratiqués. Les changements climatiques ont le potentiel d’exacerber ces effets socio-économiques et biophysiques, compromettant d’avantage les systèmes alimentaires communautaires de l’Amazonie Péruvienne dans le futur

Prioritizing Climate Change Adaptations in Canadian Arctic Communities

Arctic regions are experiencing the most rapid climate change globally and adaptation has been identified as a priority across scales. Anticipatory planning to adapt to the impacts of climate change usually follows a number of steps: assess current and future vulnerability, identify potential adaptations, prioritize options, implement prioritized options, and monitor and evaluate implementation. While most of these steps are well documented, there has been limited examination of the process of adaptation prioritization in Arctic communities. In this paper, we build upon existing tools and propose a framework for prioritizing adaptation options and guiding decision-making for implementation in Arctic regions. Using four adaptation performance criteria (timescale, equity, sustainability and total costs) to evaluate options through a multi-criteria decision analysis coupled with a network centric approach, our Adaptation Prioritization Framework promotes a participatory approach for adaptation prioritization and planning. We illustrate application of the framework using a hypothetical example from the territory of Nunavut in the Canadian Arctic.929

Balancing indigenous principles and institutional research guidelines for informed consent : a case study from the Peruvian Amazon

Background: Current literature emphasizes the need to implement informed consent according to indigenous principles and worldviews. However, few studies explicitly address how informed consent can be effectively and appropriately obtained in indigenous communities in accordance with research ethics guidelines. Methods: This article uses participatory rural appraisal methods to identify and characterize community preferences for informed consent in two indigenous communities in the Peruvian Amazon, using Canadian federal research regulations and McGill University's Research Ethics Board as a case study to examine where institutional ethics guidelines constrain or support culturally appropriate notions of informed consent. Results: The study emphasizes the importance of tailoring informed consent procedures to community circumstances. Although both communities in this case study are located in the Peruvian Amazon, there were important distinctions between them, such as gender dynamics and social structure, which profoundly affected informed consent procedures. It is also important to consider the balance of collectivism and individualism at a community level in order to determine the role of individual and community consent. Conclusion: Research ethics guidelines generally allow for this contextualized approach. However, regulations still have the potential to constrain indigenous informed consent due to content requirements for informed consent forms, limited flexibility for modifications in the field, and requirements for individual consent

Advancing Environmental Health Literacy: Validated Scales of General Environmental Health and Environmental Media-Specific Knowledge, Attitudes and Behaviors

Environmental health literacy (EHL) involves understanding and using environmental information to make decisions about health. This study developed a validated survey instrument with four scales for assessing media-specific (i.e., air, food, water) and general EHL. The four scales were created as follows: 1) item generation: environmental health scientists and statisticians developed an initial set of items in three domains: knowledge, attitudes, and behaviors; 2) item review: items were reviewed for face validity; 3) validation: 174 public health students, the exploratory sample, and 98 community members, the test sample, validated the scales. The scales’ factor structure was based on exploratory factor analysis (EFA) and model fit was assessed through confirmatory factor analysis (CFA). For each scale, the final EFA resulted in an independent three-factor solution for knowledge, attitudes, and behaviors. Good fit for the three-factor structure was observed. Model fit for CFA was generally confirmed with fit indices. The scales showed internal consistency with Cronbach’s alpha from 0.63 to 0.70. The 42-item instrument represents an important contribution towards assessing EHL and is designed to enable meaningful engagement between researchers and community members about environmental health. The intended outcome is sustained community–academic partnerships benefiting research design, implementation, translation, dissemination, and community action

Enterprise Evaluation: A New Opportunity for Public Health Policy

Standard evaluation practice in public health remains limited to evaluative measures linked to individual projects, even if multiple interrelated projects are working toward a common impact. Enterprise evaluation seeks to fill this policy gap by focusing on cross-sector coordination and ongoing reflection in evaluation. We provide an overview of the enterprise evaluation framework and its 3 stages: collective creation, individual data collection, and collective analysis. We illustrate the application of enterprise evaluation to the Gulf Region Health Outreach Program, 4 integrated projects that aimed to strengthen health care in Louisiana, Mississippi, Alabama, and the Florida Panhandle after the Deepwater Horizon oil spill. Shared commitment to sustainability and strong leadership were critical to Gulf Region Health Outreach Program\u27s success in enterprise evaluation. Enterprise evaluation provides an important opportunity for funding agencies and public health initiatives to evaluate the impact of interrelated projects in a more holistic and multiscalar manner than traditional siloed approaches to evaluation