Abstract

The objective is to identify concepts, experiences, methods, and techniques in Popular Health, Environmental and Occupational Surveillance (VPSAT). This is an integrative review that used the descriptors: Community Participation, Public Health Surveillance, Environmental Health, and Occupational Health, using five databases: Virtual Health Library, EBSCOhost, Embase, Scopus and Web of Science. The review selected 15 studies, based on the inclusion criteria: surveillance experiences with community protagonism; and exclusion criteria: research without primary data and developed only by the health service. The theoretical and methodological bases of the studies were identified as citizen science, popular education, and environmental justice; experiences such as participatory mapping and monitoring; methods such as action research, ‘do-it-yourself’, and community-based research; and techniques such as “Photovoice” and Community Journal. Low-income urban communities, indigenous peoples, young individuals, and workers stand out as the protagonists. The recognition of the VPSAT as an important source of data and intervention by public health systems and academia contributes to making health surveillance more dialogic and effective.

Key words:
Community Participation; Community-Based Participatory Research; Environmental Health; Occupational Health; Public Health Surveillance

Introduction

At the turn of the 21^st century, with the intensification of environmental conflicts, several social movements and populations affected by large enterprises, such as agribusiness and “hydrobusiness”, mining and the polluting industry, carried out territorial experiences to analyze and face the health impacts resulting from the transformations of their territories, degradation, environmental pollution and precarious work. This demonstrates that health is a sensitive dimension in their lives and goes towards the construction of resistance¹1 Rigotto RM, Aguiar ACP, Pontes AGV, Diógenes SS, Bernardo EM. Desvelando as tramas entre saúde, trabalho e ambiente nos conflitos ambientais: aportes epistemológicos, teóricos e metodológicos. In: Rigotto RM, Aguiar ACP, Ribeiro LAD, organizadoras. Tramas para a justiça ambiental: diálogo de saberes e práxis emancipatórias. 1ª ed. Fortaleza: Edições UFC; 2018. p. 163-214..

In response to conflicts, as well as the COVID-19 pandemic, experiences have been developed in popular health surveillance, which house initiatives of knowledges and practices that are born from territories and popular organization in defense of the right to health and life, but which, very often, are still disregarded, silenced and erased by the conceptions and institutional actions of surveillance in the Government health field²2 Corrêa HR, Segall-Corrêa AM. Lockdown ou vigilância participativa em saúde? Lições da Covid-19. Saude Debate 2020; 44(124):5-10.^,33 Carneiro FF, Pessoa VM. Iniciativas de organização comunitária e Covid-19: esboços para uma vigilância popular da saúde e do ambiente. Trab Educ Saude 2020; 18(3):e00298130.. Currently, in the pandemic scenario, the Government’s response followed the same Health Surveillance model that has been practiced since the 19^th century.

This model is mainly related to the control of diseases carried out by Government structures, anchored in the symbolic order of belligerent representations of the war against microbes and guided by the microbiology founded in the last third of the 19^th century⁴4 Sevalho G. Apontamentos críticos para o desenvolvimento da vigilância civil da saúde. Physis 2016; 26(2):611-632.. Terms such as “surveillance”, “control”, “sentinel event” and “campaign” belong to this military-inspired scenario, focused on the surveillance of patients and suspected cases, constituting an authoritarian, persecutory and punitive health policy, as elements that contribute to hinder popular participation in Health Surveillance⁴4 Sevalho G. Apontamentos críticos para o desenvolvimento da vigilância civil da saúde. Physis 2016; 26(2):611-632..

The term “Popular Health, Environmental and Occupational Surveillance” (VPSAT, Vigilância Popular da Saúde, Ambiente e Trabalho) is used by Carneiro and Pessoa³3 Carneiro FF, Pessoa VM. Iniciativas de organização comunitária e Covid-19: esboços para uma vigilância popular da saúde e do ambiente. Trab Educ Saude 2020; 18(3):e00298130. to name surveillance practices that privilege the protagonism of communities and social movements in the setting of public health, the environment and workers’ health. It may involve different degrees of action by the Government, the academia and health workers, as long as they acknowledge the actors and popular knowledges and are involved in the participatory processes of a dialogical nature³3 Carneiro FF, Pessoa VM. Iniciativas de organização comunitária e Covid-19: esboços para uma vigilância popular da saúde e do ambiente. Trab Educ Saude 2020; 18(3):e00298130..

However, according to Rigotto and Aguiar⁵5 Rigotto RM, Aguiar ACP. Invisibilidade ou invisibilização dos efeitos crônicos dos agrotóxicos à saúde? Desafios à ciência e às políticas públicas. In: Nogueira RP, Santana JP, Rodrigues VA, Ramos ZVO. Observatório internacional de capacidades humanas, desenvolvimento e políticas públicas: estudos e análises. Brasília: OPAS; 2015. p. 47-90. in “a scenario of scientific controversy, permeated by conflicts of interest and by strong and powerful economic interests, which actively affect the Government and its public policies”(p.50), a chronic difficulty in the SUS working process regarding surveillance can be identified in the health, environmental and occupational areas.

In this scenario, the need to structure new conceptual and methodological bases for health, environmental and occupational surveillance is reinforced, developing territorialized strategies and participatory methods that facilitate the autonomy of the population and prevent segregation and exclusion in the processes, incorporating different knowledges and dimensions, such as economic, social, cultural, spiritual and ethical ones. In this sense, the Ecology of Knowledge framework developed by Boaventura de Sousa Santos⁶6 Santos BS. Para além do pensamento abissal: das linhas globais a uma ecologia de saberes. Novos Estud CEBRAP 2007; 79:71-94. contributes to the VPSAT, as this concept promotes a dialogue between different types of knowledge that can be considered useful for the advancement of social struggles by those who intervene in them⁷7 Carneiro FF, Krefta NM, Folgado CAR. A Praxis da Ecologia de Saberes: entrevista de Boaventura de Sousa Santos. Tempus Actas Saude Colet 2014; 8(2):331-338..

The VPSAT emerges as a participatory process of alert and call to action related to the guarantee of both universal and constitutional human rights to health, an ecologically balanced environment and the defense of life. The “thinking and doing with” the communities becomes, in the VPSAT processes, a creative and innovative possibility to strengthen the SUS in the defense of life³3 Carneiro FF, Pessoa VM. Iniciativas de organização comunitária e Covid-19: esboços para uma vigilância popular da saúde e do ambiente. Trab Educ Saude 2020; 18(3):e00298130.^,88 Valla VV, Assis M, Carvalho M. Participação Popular e os Serviços de Saúde: O Controle Social como Exercício da Cidadania. Rio de Janeiro: Escola Nacional de Saúde Pública/Fiocruz; 1993.. Therefore, this article aims to identify existing conceptions, experiences, methods and techniques in popular health, environmental and occupational surveillance at national and international levels.

Methodology

Method

The integrative literature review method was used, which, according to Mendes et al.⁹9 Mendes KDS, Silveira RCCP, Galvão CMaria. Revisão Integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Enferm Florianopolis 2008; 17(4):758-764. “allows the synthesis of multiple published studies and overall conclusions regarding a study area”(p.759), in six steps: 1) identification of the research hypotheses or problem; 2) establishment of the inclusion and exclusion criteria for the studies; 3) retrieval of information from the selected studies; 4) evaluation of the studies included in the review; 5) interpretation of results; and 6) presentation of the review¹⁰10 Sousa LMM, Marques-Vieira CMA, Severino SSP, Antunes AV. A metodologia de Revisão Integrativa da Literatura em Enfermagem. Rev Invest Enferm 2017; 2:17-26.. The items present in the checklist for systematic reviews and meta-analyses¹¹11 Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372:n71. were adapted to report this study.

To apply the method, a group of eight researchers with academic and practical experience in the subject of the review was formed to discuss and decide on the creation of the research question, the definition of the search descriptors, the selection and evaluation of the studies, and the analysis and interpretation of results. The group met between August 2021 and June 2022, in which a pair was divided into peers (independent reviewers) to select and evaluate the studies. Peer review is an important step in deciding which publications should or should not be included in review studies.

Research question and data collection

To create the research question, the PICo strategy was used - an acronym for Population (P), Interest (I) and Context (Co)¹²12 Lockwood C, Porrit K, Munn Z, Rittenmeyer L, Salmond S, Bjerrum M, Loveday H, Carrier J, Stannard D. Chapter 2: Systematic reviews of qualitative evidence. In: Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis. JBI; 2020.^,1313 Santos CMR, Crispim MO, Silva TTM, Souza RCR, Frazão CMFQ, Frazão IS. Reiki como cuidado de enfermagem às pessoas em sofrimento psíquico: revisão integrativa. Rev Bras Enferm 2021; 74:e20200458. -, in which: (P) - community participation; (I) - conceptions, experiences, methods and techniques in popular surveillance; and (Co) - health, environmental and occupational surveillance. Thus, the following question was defined: What is there of scientific production, considering community participation, related to conceptions, experiences, methods and techniques associated with popular health, environmental, and occupational surveillance?

In this context, in September 2021, a literature search was carried out in five databases: Virtual Health Library (VHL), EBSCOhost, Embase, Scopus and Web of Science (WOS) without restrictions regarding the year of publication and using the following language filters: Portuguese, English or Spanish. In the case of the VHL and EBSCOhost, full-text filtering was also used. With the exception of the VHL, the databases were accessed through the Journal Portal of the Coordination for the Improvement of Higher Education Personnel (CAPES, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior).

Indexed descriptors were used for the literature search, according to the DeCs/MeSh terms system: “community participation”, “public health surveillance”, “environmental health” and “Occupational Health”, and their respective descriptors in English and Spanish. Chart 1 shows the search strategies adapted for each database. The identified studies, after filtering by language and full text, were exported to, organized and stored in Excel® spreadsheets for identification of duplicates and for the inclusion or exclusion of studies.

Study eligibility and selection

The inclusion criteria comprised studies that addressed community/popular protagonism in an experience of surveillance in workers’ health and/or in health and the environment. The research group established four attributes that were considered as community/popular protagonism: 1) the initiatives arise from communities/territories through popular knowledges, not originating exclusively from health services; 2) the community generates its own data; 3) the surveillance occurs with the population as a protagonist through social technologies/simplified monitoring; 4) the community’s articulation/relationship with the health service and the academia should occur from a participatory perspective (emancipatory and dialogical).

As exclusion criteria, the following were considered: 1) the collection of information was carried out only by the health services; 2) the study does not have primary data; 3) the unavailability of the full text in Portuguese, Spanish or English.

Considering these criteria, the study selection took place in two phases. In phase 1, two independent reviewers selected the studies by reading the titles and abstracts of all studies, according to the eligibility criteria. In case of disagreement, a third reviewer carried out a new reading to select or not the studies.

In phase 2, the reviewers independently read the full texts according to the eligibility criteria. In cases of disagreement, a third reviewer once again analyzed the studies to reach a final decision. The selection of the studies included in the review was carried out independently and “blindly”.

To assist in the analysis, the extraction of data and information from the studies was performed using instruments adapted and proposed by Ursi¹⁴14 Ursi ES. Prevenção de lesões de pele no perioperatório: Revisão Integrativa da Literatura [dissertação]. Ribeirão Preto: Universidade de São Paulo; 2005. and Sousa et al.¹⁰10 Sousa LMM, Marques-Vieira CMA, Severino SSP, Antunes AV. A metodologia de Revisão Integrativa da Literatura em Enfermagem. Rev Invest Enferm 2017; 2:17-26.. Data extractions were carried out by two independent reviewers and were later compared.

Assessment of methodological quality

The studies were evaluated according to the levels of evidence developed by Melnyk¹⁵15 Melnyk BM. Evidence-based practice in nursing & healthcare: a guide to best practice. 4ª ed. Philadelphia: Wolters Kluwer Health; 2019. and Schenkman and Bousquat¹⁶16 Schenkman S, Bousquat AEM. Alteridade ou austeridade: uma revisão acerca do valor da equidade em saúde em tempos de crise econômica internacional. Cien Saude Colet 2019; 24(12):4459-4473., namely: I) high: meta-synthesis (qualitative studies) or meta-analysis (quantitative studies); II) medium-high: evidence from a single qualitative or quantitative study; III) medium: synthesis of descriptive studies; IV) medium-low: evidence from a single descriptive study; and V) low: expert opinions, theoretical studies or essays.

The Joanna Briggs Institute (JBI)¹⁷17 Joanna Briggs Institute (JBI). Critical Appraisal Tools [Internet]. [cited 2021 nov 10]. Available from: https://jbi.global/critical-appraisal-tools.
https://jbi.global/critical-appraisal-to... tools were used for critical assessment of the included studies. Two reviewers independently assessed the methodological quality, using two checklists corresponding to the design of the included studies: for qualitative research and for cross-sectional analytical studies. Disagreements were resolved by consensus and, when necessary, a third review author was consulted.

The selected articles were evaluated against the criteria of their respective checklists and the answers were classified using the parameters “yes”, which corresponded to high quality; “no”, to low quality; and “uncertain” for unknown quality. Based on this evaluation, it was possible to verify the possibility of bias in the study design, conduction and analysis, and the level of bias was classified according to the score obtained in these tools, as follows: A (06 to 10 points) are studies with good methodological quality and reduced bias; and B (up to 05 points) are those with satisfactory methodological quality, but increased potential for bias¹⁸18 Toledo MM, Takahashi RF, De-La-Torre-Ugarte-Guanilo MC. Elementos de vulnerabilidade individual de adolescentes ao HIV/AIDS. Rev Bras Enferm 2010; 64(2):370-375..

Interpretation and analysis of bibliographic material

For purposes of the processing and analysis of the articles included in this review, the thematic analysis technique was used, in which each article was submitted to floating and exhaustive reading of the content, which was coded and categorized¹⁹19 Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 14ª ed. São Paulo: Hucitec; 2014.. After this initial stage of processing the bibliographic material, the set of topics, already categorized, were discussed, problematized and interpreted in the light of theoretical references related to the object, defined here, namely: Popular participation⁸8 Valla VV, Assis M, Carvalho M. Participação Popular e os Serviços de Saúde: O Controle Social como Exercício da Cidadania. Rio de Janeiro: Escola Nacional de Saúde Pública/Fiocruz; 1993.^,2020 Valla VV. Sobre a participação popular: uma questão de perspectiva. Cad Saude Publica 1998; 14(Supl. 2):507-518., Popular Education²¹21 Freire P. Pedagogia do oprimido. 50ª ed. Rio de Janeiro: Paz e Terra; 2011., Participatory Monitoring²²22 Breilh J. De la vigilancia convencional al monitoreo participativo. Cien Saude Colet 2003; 8(4):937-951.^,2323 Breilh J. Epidemiologia crítica: ciência emancipadora e interculturalidade. Rio de Janeiro: Fiocruz; 2006. and Ecology of Knowledges⁶6 Santos BS. Para além do pensamento abissal: das linhas globais a uma ecologia de saberes. Novos Estud CEBRAP 2007; 79:71-94.^,2424 Santos BS, Meneses MP, organizadores. Epistemologias do Sul. Lisboa: Biblioteca Nacional de Portugal; 2009.. After critical reading and systematization of the data, two categories were identified: Theoretical bases and concepts in popular surveillance; and Experiences, methods and techniques in VPSAT.

Results and discussion

Study characteristics and synthesis

Initially considering the search by title, abstract and descriptors, 908 publications were identified in the databases, including articles, theses, abstracts, reports and a video, of which 786 were eliminated after the reading of the title and the abstract, because they were duplicates or not related to the topic of interest. The full reading of the 122 pre-selected studies was then carried out, of which 107 were excluded and 15 articles were included in the review, as they met the inclusion criteria and answered the research question. Figure 1 shows the flowchart related to the publication selection process.

The synthesis of the publications included the author, year, level of evidence, place/country where the experience took place, method, theoretical basis, surveillance concepts/ terms, and is depicted in Chart 2.

It can be observed that the first publication was in 2000²⁵25 Quigley D, Handry D, Goble R, Sanchez V, George P. Participatory research strategies in nuclear risk management for native communities. J Health Commun 2000; 5(4):305-331., which demonstrates that it is a recent topic in national and international literature, followed by two (2006)²⁶26 Toledo RF. Educação, saúde e meio ambiente: uma pesquisa-ação no Distrito de Iauaretê do Município de São Gabriel da Cachoeira/AM [tese]. São Paulo: Universidade de São Paulo; 2006.^,2727 Lambert T, Guyn L, Lane S. Development of local knowledge of environmental contamination in Sydney, Nova Scotia: environmental health practice from an environmental justice perspective. Sci Total Environ 2006; 368(2-3):471-484., one (2010)²⁸28 Flum M, Siqueira CE, DeCaro A, Redway S. Photovoice in the Workplace: A Participatory Method to Give Voice to Workers to Identify Health and Safety Hazards and Promote Workplace Change - a study of University Custodians. Am J Ind Med 2010; 53(11):1150-1158., one (2012)²⁹29 Toledo RF, Giatti LL, Pelicioni MCF. Mobilização Social em Saúde e Saneamento em Processo de Pesquisa-ação em uma Comunidade Indígena no Noroeste Amazônico. Saude Soc 2012; 21(1):206-218., one (2015)³⁰30 Wilson SM, Murray RT, Jiang C, Dalemarre L, Burwell-Naney K, Fraser-Rahim H. Environmental Justice Radar: A Tool for Community-Based Mapping to Increase Environmental Awareness and Participatory Decision Making. Prog Community Health Partnersh 2015; 9(3):439-446., two (2017)³¹31 English P, Olmedo L, Bejarano E, Lugo H, Murillo E, Seto E, Wong M, King G, Wilkie A, Meltzer D, Carvlin G, Jerrett M, Northcross A. The Imperial County Community Air Monitoring Network: A Model for Community-based Environmental Monitoring for Public Health Action. Environ Health Perspect 2017; 125(7):074501.^,3232 Musesengwa R, Chimbari MJ. Experiences of community members and researchers on community engagement in an Ecohealth project in South Africa and Zimbabwe. BMC Med Ethics 2017; 18(1):76., two (2018)³³33 Rey-Mazón P, Keysar H, Dosemagen S, Dignazio C, Blair D. Public Lab: Community-Based Approaches to Urban and Environmental Health and Justice. Sci Eng Ethics 2018; 24(3):971-997.^,3434 Barzyk TM, Huang H, Williams R, Kaufman A, Essoka J. Advice and Frequently Asked Questions (FAQs) for Citizen-Science Environmental Health Assessments. Int J Environ Res Public Health 2018; 15(5):960., one (2019)³⁵35 Panikkar B, Lemmond B, Allen L, DiPirro C, Kasper S. Making the invisible visible: results of a community-led health survey following PFAS contamination of drinking water in Merrimack, New Hampshire. Environ Health 2019; 18(1):79., two (2020)³⁶36 Johnston J, Juarez Z, Navarro S, Hernandez A, Gutschow W. Youth Engaged Participatory Air Monitoring: A 'Day in the Life' in Urban Environmental Justice Communities. Int J Environ Res Public Health 2020; 17(1):93.^,3737 Wong M, Wilkie A, Garzón-Galvis C, King G, Olmedo L, Bejarano E, Lugo H, Meltzer D, Madrigal D, Claustro M, English P. Community-Engaged Air Monitoring to Build Resilience Near the US-Mexico Border. Int J Environ Res Public Health 2020; 17(3):1092. and two (2021)³⁸38 Nolan J, Coker E, Ward B, Williamson Y, Harley K. Freedom to Breathe: Youth Participatory Action Research (YPAR) to Investigate Air Pollution Inequities in Richmond, CA. Int J Environ Res Public Health 2021; 18(2):554.^,3939 Prado C; Colectivo Salud y Justicia Ambiental; Red de Ciudadanos para el Mejoramiento de las Comunidades. Border Environmental Justice PPGIS: Community-Based Mapping and Public Participation in Eastern Tijuana, México. Int J Environ Res Public Health 2021; 18(3):1349., increasing after the year 2015, which reflects the fact that it has been an expanding topic in the world’s literature. As for the origin of the studies, eight countries stand out, with most of the studies being from the United States of America (USA), with nine publications, followed by Brazil with two, and other countries with one publication only: Mexico, Canada, Israel/Palestine, Spain and USA and Zimbabwe and South Africa.

It can be observed that, as of 2017, there is a higher number of studies related to VPSAT, with an average of two per year. Another highlight is that of the fifteen selected studies, nine are from the US, while the other countries have an average of one article in this review. This may indicate that the topic has become emergent in recent years, but at the same time, it may have a limited academic visibility, especially on the Global South side, which faces greater research funding difficulties and tensions with the neo-extractivism development model.

Additionally, as shown in Chart 2, the monitoring, participatory mapping and popular communication techniques were some highlights of the review. The innovation, in at least three studies, comprised the use of the “Photovoice” technique. The advancement of technologies developed for mobile phones allows this equipment to be strategic to the registration of social and environmental risk situations and decisively contribute to VPSAT actions and to demand actions by public agencies in the presence of the identified situations.

All studies are similar regarding the use of participatory research methodologies in the face of complex environmental problems, highlighting those related to air quality. This may indicate that even in the face of large-scale problems it is possible for the community to contribute with protagonism to the surveillance. It is noteworthy that vulnerable populations, especially those at environmental risk, such as urban communities, indigenous people, poor young individuals and workers, are the social groups that stand out in the research.

Assessment of methodological quality of the included studies

Chart 3, available in the Open Science Framework platform repository (https://osf.io/5PTWJ), under identification DOI 10.17605/OSF.IO/6JB7V, shows that all publications had bias level classification: A (06 to 10 points), which are the studies with good methodological quality and reduced bias. Of these, five studies²⁵25 Quigley D, Handry D, Goble R, Sanchez V, George P. Participatory research strategies in nuclear risk management for native communities. J Health Commun 2000; 5(4):305-331.^,2626 Toledo RF. Educação, saúde e meio ambiente: uma pesquisa-ação no Distrito de Iauaretê do Município de São Gabriel da Cachoeira/AM [tese]. São Paulo: Universidade de São Paulo; 2006.^,2929 Toledo RF, Giatti LL, Pelicioni MCF. Mobilização Social em Saúde e Saneamento em Processo de Pesquisa-ação em uma Comunidade Indígena no Noroeste Amazônico. Saude Soc 2012; 21(1):206-218.^,3232 Musesengwa R, Chimbari MJ. Experiences of community members and researchers on community engagement in an Ecohealth project in South Africa and Zimbabwe. BMC Med Ethics 2017; 18(1):76.^,3838 Nolan J, Coker E, Ward B, Williamson Y, Harley K. Freedom to Breathe: Youth Participatory Action Research (YPAR) to Investigate Air Pollution Inequities in Richmond, CA. Int J Environ Res Public Health 2021; 18(2):554. (33.3%) reached the maximum score, meeting all the criteria of critical and methodological evaluation.

In the case of the publications that were evaluated with the qualitative checklist, Chart 3 shows that the Criteria of Ethical Approval (Q9) was absent in five studies³³33 Rey-Mazón P, Keysar H, Dosemagen S, Dignazio C, Blair D. Public Lab: Community-Based Approaches to Urban and Environmental Health and Justice. Sci Eng Ethics 2018; 24(3):971-997.^,3434 Barzyk TM, Huang H, Williams R, Kaufman A, Essoka J. Advice and Frequently Asked Questions (FAQs) for Citizen-Science Environmental Health Assessments. Int J Environ Res Public Health 2018; 15(5):960.^,3636 Johnston J, Juarez Z, Navarro S, Hernandez A, Gutschow W. Youth Engaged Participatory Air Monitoring: A 'Day in the Life' in Urban Environmental Justice Communities. Int J Environ Res Public Health 2020; 17(1):93.^,3737 Wong M, Wilkie A, Garzón-Galvis C, King G, Olmedo L, Bejarano E, Lugo H, Meltzer D, Madrigal D, Claustro M, English P. Community-Engaged Air Monitoring to Build Resilience Near the US-Mexico Border. Int J Environ Res Public Health 2020; 17(3):1092.^,3939 Prado C; Colectivo Salud y Justicia Ambiental; Red de Ciudadanos para el Mejoramiento de las Comunidades. Border Environmental Justice PPGIS: Community-Based Mapping and Public Participation in Eastern Tijuana, México. Int J Environ Res Public Health 2021; 18(3):1349. and was not clear in two publications³⁰30 Wilson SM, Murray RT, Jiang C, Dalemarre L, Burwell-Naney K, Fraser-Rahim H. Environmental Justice Radar: A Tool for Community-Based Mapping to Increase Environmental Awareness and Participatory Decision Making. Prog Community Health Partnersh 2015; 9(3):439-446.^,3131 English P, Olmedo L, Bejarano E, Lugo H, Murillo E, Seto E, Wong M, King G, Wilkie A, Meltzer D, Carvlin G, Jerrett M, Northcross A. The Imperial County Community Air Monitoring Network: A Model for Community-based Environmental Monitoring for Public Health Action. Environ Health Perspect 2017; 125(7):074501.; that is, of 13 publications that were evaluated with this instrument, seven (54%) did not state their process of ethical approval. Additionally, Chart 3 clearly shows that in two studies³⁷37 Wong M, Wilkie A, Garzón-Galvis C, King G, Olmedo L, Bejarano E, Lugo H, Meltzer D, Madrigal D, Claustro M, English P. Community-Engaged Air Monitoring to Build Resilience Near the US-Mexico Border. Int J Environ Res Public Health 2020; 17(3):1092.^,3939 Prado C; Colectivo Salud y Justicia Ambiental; Red de Ciudadanos para el Mejoramiento de las Comunidades. Border Environmental Justice PPGIS: Community-Based Mapping and Public Participation in Eastern Tijuana, México. Int J Environ Res Public Health 2021; 18(3):1349. the relationship between the researcher and the participants was not addressed and in another two³¹31 English P, Olmedo L, Bejarano E, Lugo H, Murillo E, Seto E, Wong M, King G, Wilkie A, Meltzer D, Carvlin G, Jerrett M, Northcross A. The Imperial County Community Air Monitoring Network: A Model for Community-based Environmental Monitoring for Public Health Action. Environ Health Perspect 2017; 125(7):074501.^,3636 Johnston J, Juarez Z, Navarro S, Hernandez A, Gutschow W. Youth Engaged Participatory Air Monitoring: A 'Day in the Life' in Urban Environmental Justice Communities. Int J Environ Res Public Health 2020; 17(1):93. it was not clear (Q7).

Regarding the assessment of the methodological quality instrument for cross-sectional analytical studies, two studies was evaluated. In both²⁷27 Lambert T, Guyn L, Lane S. Development of local knowledge of environmental contamination in Sydney, Nova Scotia: environmental health practice from an environmental justice perspective. Sci Total Environ 2006; 368(2-3):471-484.^,3636 Johnston J, Juarez Z, Navarro S, Hernandez A, Gutschow W. Youth Engaged Participatory Air Monitoring: A 'Day in the Life' in Urban Environmental Justice Communities. Int J Environ Res Public Health 2020; 17(1):93., of the eight answered questions, it was not possible to identify the confounding factors (Q5) or whether strategies were established to deal with these factors (Q6). One confounding factor is the difference between comparison groups and it might influence the direction of study results¹⁷17 Joanna Briggs Institute (JBI). Critical Appraisal Tools [Internet]. [cited 2021 nov 10]. Available from: https://jbi.global/critical-appraisal-tools.
https://jbi.global/critical-appraisal-to... .

Theoretical bases and conceptions in popular surveillance

This category seeks to dialogue with the concepts, foundations and principles that support the studies included in this review and which are closely related to VPSAT. Prado et al.³⁹39 Prado C; Colectivo Salud y Justicia Ambiental; Red de Ciudadanos para el Mejoramiento de las Comunidades. Border Environmental Justice PPGIS: Community-Based Mapping and Public Participation in Eastern Tijuana, México. Int J Environ Res Public Health 2021; 18(3):1349. highlight the importance of participatory mapping for decision-making on the uses of soil and development processes. A community engaged in the mapping of Environmental Justice produces local knowledge that generate environmental indicators of territory evaluation and identify cases of environmental injustice, key elements for the surveillance process³⁹39 Prado C; Colectivo Salud y Justicia Ambiental; Red de Ciudadanos para el Mejoramiento de las Comunidades. Border Environmental Justice PPGIS: Community-Based Mapping and Public Participation in Eastern Tijuana, México. Int J Environ Res Public Health 2021; 18(3):1349..

In this sense, health research gains power with community involvement/engagement, including several activities such as consultation, information dissemination, collaboration in decision-making, creation of partnerships with interested parties and seeking guidance from community leaders. This engagement must guarantee to the communities and researchers the respect to the sociocultural, political and economic context of the territory where it is conducted³²32 Musesengwa R, Chimbari MJ. Experiences of community members and researchers on community engagement in an Ecohealth project in South Africa and Zimbabwe. BMC Med Ethics 2017; 18(1):76..

Community engagement and the use of the citizen science approach have been crucial for public health practices, such as establishing independent air quality monitoring networks. The big challenge remains the long-term funding of these initiatives³¹31 English P, Olmedo L, Bejarano E, Lugo H, Murillo E, Seto E, Wong M, King G, Wilkie A, Meltzer D, Carvlin G, Jerrett M, Northcross A. The Imperial County Community Air Monitoring Network: A Model for Community-based Environmental Monitoring for Public Health Action. Environ Health Perspect 2017; 125(7):074501..

Positivist science based on the “biomedical model” and “hard science” considers community knowledge as “data contamination” during the investigation process. The limitations of methods for evaluating exposure to risks in environmental health of positivist science fail to provide satisfactory subsidies for community-based studies. Moreover, quantitative studies are not enough to account for the complexity of the impact assessment of health contaminants. From this perspective, some studies discuss that it is necessary to dialogue in the sense of effective risk communication, to meet the community of each territory that is affected by risk and is not restricted only to the academic sphere as a transfer of information to peers, but inaccessible to the community field²⁵25 Quigley D, Handry D, Goble R, Sanchez V, George P. Participatory research strategies in nuclear risk management for native communities. J Health Commun 2000; 5(4):305-331..

According to Nolan et al.³⁸38 Nolan J, Coker E, Ward B, Williamson Y, Harley K. Freedom to Breathe: Youth Participatory Action Research (YPAR) to Investigate Air Pollution Inequities in Richmond, CA. Int J Environ Res Public Health 2021; 18(2):554. the approach to structural violence and participatory research illuminate studies on the iniquities of exposures and refine the mitigation strategies. Promoting a more equitable relationship between communities and researchers in these types of studies is not simple and requires: the guarantee of community participation in all stages of the research process; the recognition of popular knowledges, so they are not treated as anecdotic or subjective; and the training of community members for conducting community-based research³⁸38 Nolan J, Coker E, Ward B, Williamson Y, Harley K. Freedom to Breathe: Youth Participatory Action Research (YPAR) to Investigate Air Pollution Inequities in Richmond, CA. Int J Environ Res Public Health 2021; 18(2):554.. In this sense, popular education and the ecology of knowledges are important reference concepts that strengthen this path towards a more dialogical research²¹21 Freire P. Pedagogia do oprimido. 50ª ed. Rio de Janeiro: Paz e Terra; 2011.^,2424 Santos BS, Meneses MP, organizadores. Epistemologias do Sul. Lisboa: Biblioteca Nacional de Portugal; 2009..

The work by Lambert et al.²⁷27 Lambert T, Guyn L, Lane S. Development of local knowledge of environmental contamination in Sydney, Nova Scotia: environmental health practice from an environmental justice perspective. Sci Total Environ 2006; 368(2-3):471-484. about industrial contamination, gives rise to the concept of environmental justice. In contrast to a traditional science that makes the community an “object” of research, environmental justice seeks to engage the population in actions, combining the methodological rigor of research with the action for community claim. Popular protagonism is necessary for the construction of a participatory science focusing on facing environmental injustices and their impact on human health.

The experiences of popular education inspired by Paulo Freire²¹21 Freire P. Pedagogia do oprimido. 50ª ed. Rio de Janeiro: Paz e Terra; 2011. constitute influences in the process of interaction between traditional and scientific knowledges in the construction of VPSAT processes. For Gil Sevalho⁴4 Sevalho G. Apontamentos críticos para o desenvolvimento da vigilância civil da saúde. Physis 2016; 26(2):611-632., Civil Health Surveillance is founded in local culture and popular education, becoming a health surveillance aspect that embodies popular participation and contributes to social transformation, complementing the traditional epidemiological surveillance. Paulo Freire sought to build a liberating education, in a dialogical proposal between leaderships and the population, in which the subjects meet to transform the world while collaborating²¹21 Freire P. Pedagogia do oprimido. 50ª ed. Rio de Janeiro: Paz e Terra; 2011..

Among the studies analyzed in this review, it is clear how close they are to the thinking of Paulo Freire and Boaventura Santos, along with the methodological paths implicated with dialogue, based on the different knowledges and permeated with the experienced reality. Popular education is used as a methodological inspiration²⁸28 Flum M, Siqueira CE, DeCaro A, Redway S. Photovoice in the Workplace: A Participatory Method to Give Voice to Workers to Identify Health and Safety Hazards and Promote Workplace Change - a study of University Custodians. Am J Ind Med 2010; 53(11):1150-1158.^,2929 Toledo RF, Giatti LL, Pelicioni MCF. Mobilização Social em Saúde e Saneamento em Processo de Pesquisa-ação em uma Comunidade Indígena no Noroeste Amazônico. Saude Soc 2012; 21(1):206-218.^,3636 Johnston J, Juarez Z, Navarro S, Hernandez A, Gutschow W. Youth Engaged Participatory Air Monitoring: A 'Day in the Life' in Urban Environmental Justice Communities. Int J Environ Res Public Health 2020; 17(1):93.^,3939 Prado C; Colectivo Salud y Justicia Ambiental; Red de Ciudadanos para el Mejoramiento de las Comunidades. Border Environmental Justice PPGIS: Community-Based Mapping and Public Participation in Eastern Tijuana, México. Int J Environ Res Public Health 2021; 18(3):1349., being a useful instrument to analyze the local context through the knowledges and previous experiences to better understand the determinants of problem situations and the creation of proposals for solutions and actions²⁹29 Toledo RF, Giatti LL, Pelicioni MCF. Mobilização Social em Saúde e Saneamento em Processo de Pesquisa-ação em uma Comunidade Indígena no Noroeste Amazônico. Saude Soc 2012; 21(1):206-218.^,3636 Johnston J, Juarez Z, Navarro S, Hernandez A, Gutschow W. Youth Engaged Participatory Air Monitoring: A 'Day in the Life' in Urban Environmental Justice Communities. Int J Environ Res Public Health 2020; 17(1):93.. It is a process of materialization of the popular protagonism of communities, in which participatory means of sharing knowledge are provided for the construction of more effective public policies to promote and protect the health of these communities²⁸28 Flum M, Siqueira CE, DeCaro A, Redway S. Photovoice in the Workplace: A Participatory Method to Give Voice to Workers to Identify Health and Safety Hazards and Promote Workplace Change - a study of University Custodians. Am J Ind Med 2010; 53(11):1150-1158.. Other studies have addressed the implementation of community education or education in health without mentioning the influence of the Freire method²⁵25 Quigley D, Handry D, Goble R, Sanchez V, George P. Participatory research strategies in nuclear risk management for native communities. J Health Commun 2000; 5(4):305-331.^,3333 Rey-Mazón P, Keysar H, Dosemagen S, Dignazio C, Blair D. Public Lab: Community-Based Approaches to Urban and Environmental Health and Justice. Sci Eng Ethics 2018; 24(3):971-997.^,3737 Wong M, Wilkie A, Garzón-Galvis C, King G, Olmedo L, Bejarano E, Lugo H, Meltzer D, Madrigal D, Claustro M, English P. Community-Engaged Air Monitoring to Build Resilience Near the US-Mexico Border. Int J Environ Res Public Health 2020; 17(3):1092..

Therefore, the aspects of theoretical approaches identified in this review can be used as a theoretical basis of support for the structuring of the VPSAT concept that is being developed in Brazil. It has been observed, in participatory research processes, an interest by Brazilian popular movements in using this term to establish life promotion actions against the current Brazilian development model. The concept of Ecology of Knowledges is more contemporary compared to popular education, and has contributed, in epistemological terms, to justify this choice in research processes and VPSAT.

VPSAT experiences, methods and techniques

Popular participation comprises the multiple actions of different social forces to focus on the creation, performance, supervision and evaluation of public policies and/or services intended for the community²⁰20 Valla VV. Sobre a participação popular: uma questão de perspectiva. Cad Saude Publica 1998; 14(Supl. 2):507-518.. Thus, this concept houses the conception of “involvement of the community members in the tasks of this community”, that is, to do it by and for themselves, which leads to the idea of community protagonism.

According to Santos²⁴24 Santos BS, Meneses MP, organizadores. Epistemologias do Sul. Lisboa: Biblioteca Nacional de Portugal; 2009., the combination of popular knowledge and community practices associated to surveillance techniques can be used as guidance for health care models and bring actions closer to the real needs and the reorganization of the relationship between subjects, professionals, users and the environment. In this context, VPSAT emerges, which, for Carneiro and Pessoa³3 Carneiro FF, Pessoa VM. Iniciativas de organização comunitária e Covid-19: esboços para uma vigilância popular da saúde e do ambiente. Trab Educ Saude 2020; 18(3):e00298130. “is not intended to replace the role of the Government, but to be the expression of the need for greater community participation in surveillance, as highlighted in the National Health Surveillance Policy”(p.5).

Among the experiences in popular surveillance depicted in this review, it is observed that community mapping has been a practice adopted by the communities³⁰30 Wilson SM, Murray RT, Jiang C, Dalemarre L, Burwell-Naney K, Fraser-Rahim H. Environmental Justice Radar: A Tool for Community-Based Mapping to Increase Environmental Awareness and Participatory Decision Making. Prog Community Health Partnersh 2015; 9(3):439-446.^,3939 Prado C; Colectivo Salud y Justicia Ambiental; Red de Ciudadanos para el Mejoramiento de las Comunidades. Border Environmental Justice PPGIS: Community-Based Mapping and Public Participation in Eastern Tijuana, México. Int J Environ Res Public Health 2021; 18(3):1349.. Based on a Public Participation Geographic Information Systems (PPGIS), these mappings are ways that community members found to independently identify problems and solutions to participate and focus on decisions about their territories. These are techniques that allow the mapping of priorities related to indicators, such as radioactive waste²⁸28 Flum M, Siqueira CE, DeCaro A, Redway S. Photovoice in the Workplace: A Participatory Method to Give Voice to Workers to Identify Health and Safety Hazards and Promote Workplace Change - a study of University Custodians. Am J Ind Med 2010; 53(11):1150-1158.; sewage disposal^26.29; diseases such as schistosomiasis and malaria³²32 Musesengwa R, Chimbari MJ. Experiences of community members and researchers on community engagement in an Ecohealth project in South Africa and Zimbabwe. BMC Med Ethics 2017; 18(1):76.; particulate materials, particularly the inhalable ones such as MP10³¹31 English P, Olmedo L, Bejarano E, Lugo H, Murillo E, Seto E, Wong M, King G, Wilkie A, Meltzer D, Carvlin G, Jerrett M, Northcross A. The Imperial County Community Air Monitoring Network: A Model for Community-based Environmental Monitoring for Public Health Action. Environ Health Perspect 2017; 125(7):074501.^,3737 Wong M, Wilkie A, Garzón-Galvis C, King G, Olmedo L, Bejarano E, Lugo H, Meltzer D, Madrigal D, Claustro M, English P. Community-Engaged Air Monitoring to Build Resilience Near the US-Mexico Border. Int J Environ Res Public Health 2020; 17(3):1092. and MP2.5³⁶36 Johnston J, Juarez Z, Navarro S, Hernandez A, Gutschow W. Youth Engaged Participatory Air Monitoring: A 'Day in the Life' in Urban Environmental Justice Communities. Int J Environ Res Public Health 2020; 17(1):93.; global warming gases, such as nitrogen dioxide (NO₂), ozone (O₃), sulfur dioxide (SO₂)³⁰30 Wilson SM, Murray RT, Jiang C, Dalemarre L, Burwell-Naney K, Fraser-Rahim H. Environmental Justice Radar: A Tool for Community-Based Mapping to Increase Environmental Awareness and Participatory Decision Making. Prog Community Health Partnersh 2015; 9(3):439-446.^,3838 Nolan J, Coker E, Ward B, Williamson Y, Harley K. Freedom to Breathe: Youth Participatory Action Research (YPAR) to Investigate Air Pollution Inequities in Richmond, CA. Int J Environ Res Public Health 2021; 18(2):554.; noise³⁸38 Nolan J, Coker E, Ward B, Williamson Y, Harley K. Freedom to Breathe: Youth Participatory Action Research (YPAR) to Investigate Air Pollution Inequities in Richmond, CA. Int J Environ Res Public Health 2021; 18(2):554.; risk areas, for instance, abandoned places and clandestine dumps³⁰30 Wilson SM, Murray RT, Jiang C, Dalemarre L, Burwell-Naney K, Fraser-Rahim H. Environmental Justice Radar: A Tool for Community-Based Mapping to Increase Environmental Awareness and Participatory Decision Making. Prog Community Health Partnersh 2015; 9(3):439-446.^,3939 Prado C; Colectivo Salud y Justicia Ambiental; Red de Ciudadanos para el Mejoramiento de las Comunidades. Border Environmental Justice PPGIS: Community-Based Mapping and Public Participation in Eastern Tijuana, México. Int J Environ Res Public Health 2021; 18(3):1349..

Rey-Mazon et al.³³33 Rey-Mazón P, Keysar H, Dosemagen S, Dignazio C, Blair D. Public Lab: Community-Based Approaches to Urban and Environmental Health and Justice. Sci Eng Ethics 2018; 24(3):971-997. conducted a study involving three case studies on “citizen surveillance” based on the “Do-It-Yourself” (DIY) method, open source technologies developed by Public Laboratory of Open Technology and Science (PUBLICLAB). They presented ways to perform community monitoring using simple, easily accessible and low-cost techniques and materials, such as aerial mapping of risk areas using kites or balloons for photographic registration, exercising aerial surveillance with safety and ways to easily identify evidence of poor water quality through a monitor device designed by students, indicated, for instance, by the color of the fluid.

The authors remember that by using beautiful and flashy materials, such as a large red balloon in the air or a beautiful kite coupled to simple cameras, in addition to attracting the attention of those involved, generally young people, also demystifies the use of technology and stimulates participants to make suggestions and even assemble their own monitoring devices, which would be unlikely to happen if drones or other specialized technology resources were used, for example³³33 Rey-Mazón P, Keysar H, Dosemagen S, Dignazio C, Blair D. Public Lab: Community-Based Approaches to Urban and Environmental Health and Justice. Sci Eng Ethics 2018; 24(3):971-997.. In the specific case of the study conducted in Israel/Palestine, special attention was paid to the type of device that would be used, given the constant military surveillance in the airspace that endangered the physical integrity of the local participants. The choice of kites allowed the greater engagement of young people and the exchange of knowledges with researchers who had no experience with the activity of flying kites in the region³³33 Rey-Mazón P, Keysar H, Dosemagen S, Dignazio C, Blair D. Public Lab: Community-Based Approaches to Urban and Environmental Health and Justice. Sci Eng Ethics 2018; 24(3):971-997..

As for the mapping activities, the local knowledge of the community gave meaning to the photos, in addition to allowing the empowerment and problematization of the uses of urban space in Castellón, Spain, and the “surveillance of the surveilled” in the case of Israel/Palestine. The companies that perform these services charge for these data, and the possibility that the communities can autonomously generate their own aerial mapping data with an adequate resolution is an innovative one. Having a view beyond the walls and limits imposed by the Government and the private sector allowed the stimulation of what the authors called “civic imagination”, favoring the collective construction of more viable solutions that better meet the demands of the community. Another relevant issue concerns the safety of making data that can expose communities public, given that the areas of study are often areas of intense conflicts, which should be discussed, agreed on and respected by those involved³³33 Rey-Mazón P, Keysar H, Dosemagen S, Dignazio C, Blair D. Public Lab: Community-Based Approaches to Urban and Environmental Health and Justice. Sci Eng Ethics 2018; 24(3):971-997..

In Tijuana, Mexico, the community monitoring results pointed to specific environmental challenges in this border town, including clandestine dumps. The results achieved from the surveillance of these areas contributed to the creation of the urban planning for the entire city by the identification of problems and land verification by the residents³⁹39 Prado C; Colectivo Salud y Justicia Ambiental; Red de Ciudadanos para el Mejoramiento de las Comunidades. Border Environmental Justice PPGIS: Community-Based Mapping and Public Participation in Eastern Tijuana, México. Int J Environ Res Public Health 2021; 18(3):1349..

In Charleston, South Carolina, USA, from a mapping tool developed by community leaders in a community-university-government partnership, it was possible to address environmental risks in places where the communities were in danger through research, community training, and action plans. From this partnership, an “Environmental Justice” (EJ) radar was designed to help community members learn more about local environmental dangers and share information, using a website that acts as an online portal where the interested parties can visualize the areas of concern or environmental risks to the communities³⁰30 Wilson SM, Murray RT, Jiang C, Dalemarre L, Burwell-Naney K, Fraser-Rahim H. Environmental Justice Radar: A Tool for Community-Based Mapping to Increase Environmental Awareness and Participatory Decision Making. Prog Community Health Partnersh 2015; 9(3):439-446..

Moreover, the use of the photovoice technique in two studies involving community mapping and one on participatory ergonomics was observed. For Flum et al.²⁸28 Flum M, Siqueira CE, DeCaro A, Redway S. Photovoice in the Workplace: A Participatory Method to Give Voice to Workers to Identify Health and Safety Hazards and Promote Workplace Change - a study of University Custodians. Am J Ind Med 2010; 53(11):1150-1158. this technique is an important tool, as it is an effective way for workers to identify occupational risks and other dangerous or inadequate situations not recognized or valued by the leadership, allowing them to be more active in relation to health and safety. In addition, according to Wilson et al.³⁰30 Wilson SM, Murray RT, Jiang C, Dalemarre L, Burwell-Naney K, Fraser-Rahim H. Environmental Justice Radar: A Tool for Community-Based Mapping to Increase Environmental Awareness and Participatory Decision Making. Prog Community Health Partnersh 2015; 9(3):439-446., in addition to the workers, the residents and community organizations have also used this technique to identify and act on environmental risks not registered in their territories or that have consequences for other environmental health issues.

Similar to the Photovoice, in Brazil, Renata de Toledo²⁶26 Toledo RF. Educação, saúde e meio ambiente: uma pesquisa-ação no Distrito de Iauaretê do Município de São Gabriel da Cachoeira/AM [tese]. São Paulo: Universidade de São Paulo; 2006. produced a community journal that aimed to socialize and discuss health and environmental issues with the participation of all (those who created it and other readers) in the construction of knowledges and skills aimed at empowerment. That is, here is an example of articulation/relationship of the community with the health service and academia from an emancipatory and dialogical perspective. The journal was a technique used to broadcast the wishes of the community for changes, as well as the work that had been developed by the students of a course, as well as being an opportunity to “translate” information previously made available in a technical report of that study, started in 2005, using a more accessible format and content to the entire local population²⁹29 Toledo RF, Giatti LL, Pelicioni MCF. Mobilização Social em Saúde e Saneamento em Processo de Pesquisa-ação em uma Comunidade Indígena no Noroeste Amazônico. Saude Soc 2012; 21(1):206-218..

In this sense, the authors dialogue with the proposal of “intercultural translation” of Santos⁶6 Santos BS. Para além do pensamento abissal: das linhas globais a uma ecologia de saberes. Novos Estud CEBRAP 2007; 79:71-94., which allows meeting the abyssal thinking, and results in epistemicide, embracing the ecology of knowledges, valuing and recognizing the existence of a multitude of types of knowledge beyond the scientific type, because “preference should be given to the types of knowledge that guarantee the greater participation of the social groups involved in the conception, performance, control and enjoyment of intervention”⁶6 Santos BS. Para além do pensamento abissal: das linhas globais a uma ecologia de saberes. Novos Estud CEBRAP 2007; 79:71-94.(p.51).

From the perspective of building knowledge and skills focused on popular empowerment, the Nuclear Risk Management for Native Communities (NRMNC) project in Nevada, Utah, and southern California, has developed over a four-year period, several educational materials about nuclear risk issues: basic books on radiation, radionuclide data sheets, data sheets on health risk methodologies and visual guides on specific local contamination; in addition to several extensive toxicological profiles on contaminants²⁵25 Quigley D, Handry D, Goble R, Sanchez V, George P. Participatory research strategies in nuclear risk management for native communities. J Health Commun 2000; 5(4):305-331..

The construction of these materials occurred with community engagement, in which community residents affected by nuclear contamination participated and applied interviews to develop a community exposure profile, constructed community maps, as well as attended workshops over a four-year period to construct educational materials. A pointed out risk management method is community-based research, which is a way to create knowledge that involves learning from research and applying what is learned to collective problems through social action²⁵25 Quigley D, Handry D, Goble R, Sanchez V, George P. Participatory research strategies in nuclear risk management for native communities. J Health Commun 2000; 5(4):305-331..

High-quality studies on the consequences of environmental exposure for health are expensive and time-consuming, creating a situation of “undone science”, that is, one that perpetuates the lack of information on these impacts³⁵35 Panikkar B, Lemmond B, Allen L, DiPirro C, Kasper S. Making the invisible visible: results of a community-led health survey following PFAS contamination of drinking water in Merrimack, New Hampshire. Environ Health 2019; 18(1):79.. Considering this context, the community itself sometimes assumes the task of trying to prove their suspicions that harmful exposures can lead to diseases, by producing studies in a timely manner. In Merrimack, USA, a project assessed the local response to the contamination of the public water systems and water from local wells by per- and polyfluoroalkyl substances (PFAS), through a health research led and managed by a local defense group. The community-based health research aimed to define the risks and dangers faced by the residents, documenting the potential impacts of contaminants to reduce the risks to which they are exposed³⁵35 Panikkar B, Lemmond B, Allen L, DiPirro C, Kasper S. Making the invisible visible: results of a community-led health survey following PFAS contamination of drinking water in Merrimack, New Hampshire. Environ Health 2019; 18(1):79..

Community air monitoring in which community members play important roles in determining the study design, location and implementation of monitors and data collection was another technique adopted in surveillance research. In a study conducted at Imperial County, California, USA, young individuals were decisive actors in characterizing spatial variability of air pollutant concentrations and using technologies for data collection³⁸38 Nolan J, Coker E, Ward B, Williamson Y, Harley K. Freedom to Breathe: Youth Participatory Action Research (YPAR) to Investigate Air Pollution Inequities in Richmond, CA. Int J Environ Res Public Health 2021; 18(2):554.. They selected priority locations for monitoring and produced information on air quality in real time at community level by establishing a community air monitoring network (CAMN), which started having its information stored, processed, displayed and disseminated by the community itself in the virtual space called “Identifying violations that affect neighborhoods” (IVAN), which was used to denounce these violations on the internet³⁸38 Nolan J, Coker E, Ward B, Williamson Y, Harley K. Freedom to Breathe: Youth Participatory Action Research (YPAR) to Investigate Air Pollution Inequities in Richmond, CA. Int J Environ Res Public Health 2021; 18(2):554..

Young individuals worked in the monitoring of air quality employing the Youth Participatory Action Research (YPAR) method, which emphasizes strength-based engagement, an equitable inclusion of the community in all aspects of the research, co-learning between researchers and members of the community, equitable distribution of resources, local training, research and action, addressing local priorities and sustained engagement³⁸38 Nolan J, Coker E, Ward B, Williamson Y, Harley K. Freedom to Breathe: Youth Participatory Action Research (YPAR) to Investigate Air Pollution Inequities in Richmond, CA. Int J Environ Res Public Health 2021; 18(2):554.. Through YPAR, young individuals bring perspectives and new hopes, often marginalized ones, helping researchers and communities to transform their reality based on deeper understandings of how structural violence and eco-apartheid interact to probabilistically determine social and constructed environments that profoundly affect the health of the community members³⁸38 Nolan J, Coker E, Ward B, Williamson Y, Harley K. Freedom to Breathe: Youth Participatory Action Research (YPAR) to Investigate Air Pollution Inequities in Richmond, CA. Int J Environ Res Public Health 2021; 18(2):554..

According to Wong et al.³⁷37 Wong M, Wilkie A, Garzón-Galvis C, King G, Olmedo L, Bejarano E, Lugo H, Meltzer D, Madrigal D, Claustro M, English P. Community-Engaged Air Monitoring to Build Resilience Near the US-Mexico Border. Int J Environ Res Public Health 2020; 17(3):1092., although air monitoring projects with community involvement may require substantial funding, time and diversified experience of the team, they can result in better project results and strengthen the community’s capacity, sustainability and resilience to deal with environmental and health conditions.

English et al.³¹31 English P, Olmedo L, Bejarano E, Lugo H, Murillo E, Seto E, Wong M, King G, Wilkie A, Meltzer D, Carvlin G, Jerrett M, Northcross A. The Imperial County Community Air Monitoring Network: A Model for Community-based Environmental Monitoring for Public Health Action. Environ Health Perspect 2017; 125(7):074501. have shown that, with the community monitoring, there is increased knowledge and capacity by the community to organize and maintain monitors, and the community partners are now allowed to start and collect air data by themselves. For Wong et al.³⁷37 Wong M, Wilkie A, Garzón-Galvis C, King G, Olmedo L, Bejarano E, Lugo H, Meltzer D, Madrigal D, Claustro M, English P. Community-Engaged Air Monitoring to Build Resilience Near the US-Mexico Border. Int J Environ Res Public Health 2020; 17(3):1092. these practices demonstrate that communities have experience and resources to substantially contribute to air monitoring projects when they have equitable leadership roles and several mechanisms for significant involvement.

Chart 4 shows a brief description of the main experiences, methods and techniques of VPSAT, identified in this integrative review.

Limitations

The review was performed according to the DeCs/MeSh terms system. However, because it does not contain the “Popular Surveillance” descriptor, some studies that employed this keyword, but did not use the descriptors that were selected for this review, may not have been selected. Thus, it is recommended to create some descriptors in the scope of surveillance, such as: “Popular Surveillance”, “Civil Surveillance”, “Citizens’ Surveillance” and “Community Surveillance”, as it will contribute to the visibility of studies in the area.

Moreover, the study used only the descriptor “Community Participation” for the literature search, not appropriating other common terminologies such as “social participation” and “action research”, “empowerment” and “social control”, which may have limited the number of identified articles that were included in this review.

Finally, no search for study publications was applied that used other methods, for instance, on websites, organizations, quotations and gray literature, using only the databases that are described in the methodology of this research. It is noteworthy that 11 studies selected for full-text reading were not recovered, as they were included in paid databases that cannot be accessed through the Capes Journal Portal.

Final considerations

This review identified theoretical and methodological bases (citizen science, environmental justice, popular education and community surveillance), experiences (community mapping and monitoring), methods (action research, “do it yourself”-DIY- and community-based research) and techniques (“photovoice” and community journal) that can be used as references for the VPSAT practices.

The research results suggest that this strong involvement of communities in popular surveillance projects generated greater awareness, knowledge, capacity to confront challenges, infrastructure and influence from a partnership between the community, health services and research institutions.

Moreover, the main findings of this study indicate the importance of the adopted experiences and methodologies in which the community is a protagonist in data generation from the collection and systematic production of information based on participatory and simplified monitoring strategies. This is considered one of the main characteristics of VPSAT proposed herein.

Therefore, the recognition of VPSAT as an important source of data and intervention by health systems and academia can contribute for the surveillance of institutional health to become more dialogical and effective. Overall, these studies reinforce the importance of popular participation as a way of enhancing the field of health surveillance in the defense of life.

References

Publication Dates

History