Superfund Research Program
Community Engagement Core
Project Leaders: Phil Brown, Carmen Milagros Velez Vega (University of Puerto Rico Medical Sciences Campus)
Co-Investigator: Julia Green Brody (Silent Spring Institute)
Grant Number: P42ES017198
Funding Period: 2014-2025
Project Summary (2020-2025)
Established in 2010, the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) Superfund Research Center (SRC) uses a holistic system of research, training, and stakeholder engagement to study the fate, transport, exposure, health impact, and remediation of contaminant mixtures, aimed at reducing preterm birth (PTB) and other adverse pregnancy outcomes (APOs). Rates of PTB and infant mortality in Puerto Rico are among the highest in all U.S. states and territories. After reaching 20 percent in 2008, the PTB rate in Puerto Rico has decreased to 11.4 percent in 2017 yet continues to be among the highest globally. Evidence exists that exposure to Superfund chemicals contributes to APOs. Contamination is extensive in Puerto Rico: there are 18 Superfund sites, and evidence of contamination of the drinking water is extensive. There are also extreme events (hurricanes, flooding) that may result in elevated exposures to environmental pollution. The Community Engagement Core (CEC), working closely with the Human Subjects and Sampling Core (HSSC), the Research Translation Coordinator, and the research projects, is the main vehicle for interaction with community stakeholders in Puerto Rico. PROTECT's approach emphasizes bidirectional engagement with two groups of stakeholders: (1) women participating in the PROTECT study cohort (1,457 participants with 1,280 completed pregnancies as of October 2018, with the goal of adding another 1,000) and (2) the broader group of residents in the areas where PROTECT's groundwater study is being conducted, including collaborators at the community health centers (CHCs) and clinics that serve as study sites. The CEC's continual connection with the HSSC has produced strong relationships with study participants, staff, and clinicians at CHCs and private clinics, health educators, social work and nursing staff, and community groups. Building on this foundation, the CEC is continuing its strong bidirectional communication strategy, which includes meetings and focus groups with participants and clinical staff, distribution of extensive educational materials on reproductive and child health, and report-back of research findings to stakeholders, informed by stakeholder priorities, needs, and concerns. Inspired by participant feedback, the CEC continues to implement a new interactive smartphone-based app that allows individualized report-back to participants. This innovation more fully includes participants in the research process, improves study recruitment/retention, provides individual exposure reduction information, and lays the groundwork for community-based participatory research projects. The CEC works extensively on exposure reduction by providing detailed suggested actions in the app and by working with the Portable, Self-Cleaning Advanced Electro-Oxidation Systems for Distributed and Point-of-Use Water Treatment project to test its water filters. The CEC's central role in providing post-hurricane water filters and emergency supplies has made PROTECT even more trusted, and the Core plans to continue providing emergency preparedness training/support. The CEC continues working on capacity building for participants, health care providers, and their organizations, as well as developing resources for maternal and child health.