Place-based health efforts account for the role of the community environment in shaping decisions and circumstances that affect population well-being. Such efforts, rooted as they are in the theory that health is socially determined, mobilize resources for health promotion that are not typically used, and offer a more informed and robust way of promoting health outcomes within a community. Common criticisms of place-based work include the difficulty of replication, since engagement is so specific to a place, and limited sustainability of the work, in the absence of continued institutional structures, both within the community and supporting structures outside the community, to keep these initiatives resilient. This paper describes a place-based initiative, GO! Austin/VAMOS! Austin (GAVA), which was designed to harness the strengths of place-based work—namely, its specificity to place and community. From the start, the project was designed to balance this specificity with a focus on developing and utilizing a standardized set of evidence-informed implementation and evaluation approaches and tools that were flexible enough to be modified for specific settings. This was accompanied by an emphasis on leadership and capacity building within resident leaders, which provided for informed intervention and demand building capacity, but also for longevity as partners, philanthropic, and otherwise, moved in and out of the work.
Background
Go! Austin/Vamos! Austin (GAVA) is a coalition-led health initiative that targets low-income communities with disparities in access to healthy food and physical activity
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The purpose of this initiative was to increase healthy eating and physical activity among residents by facilitating access to food and physical activity opportunities through environmental and policy changes. Although GAVA is ongoing, this paper describes the original GAVA intervention and the 5-year evaluation study (2013–2018), presenting selected baseline data obtained through its cohort sub-study.
Methods
To assess the impact of GAVA, the evaluation plan included multiple sub-studies and involved collection of quantitative, qualitative, and observational data at different levels. The main cohort sub-study followed 313 parent-child dyads over 5 years. Annually, parents completed self-administered surveys regarding awareness and use of community assets/resources as well as their diet and activities. Heights and weights also were measured.
Results
Cohort participants were primarily Hispanic (87%), very low-income (77%), and food insecure (58%), with high overweight/obesity prevalence among both parents (81%) and children (41%). Awareness and use of community physical activity and healthy eating resources were low, and reported barriers to using these resources were many. Engagement in physical activity and healthy eating also was low.
Conclusions
Given the baseline statistics, GAVA resident teams chose and implemented strategies to address the noted barriers and low usage of community resources. This approach built community capacity and governance. Both the GAVA intervention approach and evaluation protocol can serve as models for other community initiatives to be implemented in other locations and contexts.
The growing frequency and intensity of extreme weather events have placed cities at the forefront of the human, social, economic, and ecological impacts of climate change. Extreme heat, extended freeze, excessive precipitation, and/or prolong drought impacts neighborhoods disproportionately across heterogenous urban geographies. Underserved, underrepresented, and marginalized communities are more likely to bear the burden of increased exposure to adverse climate impacts while simultaneously facing power asymmetries in access to the policy and knowledge production process. Knowledge co-production is one framework that seeks to address this convergence of disproportionate climate impact exposure and disenfranchised communities. Co-production is increasingly used in sustainability and resilience research to ask questions and develop solutions with, by, and for those communities that are most impacted. By weaving research, planning, evaluation, and policy in an iterative cycle, knowledge and action can be more closely coupled. However, the practice of co-production often lacks reflexivity in ways that can transform the science and policy of urban resilience to address equity more directly. With this, we ask what kind of co-production mechanism encourage academic and non-academic partners to reflect and scrutinize their underlying assumptions, existing institutional arrangements, and practices? How can these efforts identify and acknowledge the contradictions of co-production to reduce climate impacts in vulnerable communities? This paper presents a framework for reflexive co-production and assesses three modes of co-production for urban resilience in Austin, Texas, USA. These include a multi-hazard risk mapping initiative, a resident-driven community indicator system for adaptive capacity, and a neighborhood household preparedness guide. We establish a set of functional and transformational criteria from which to evaluate co-production and assess each initiative across the criteria. We conclude with some recommendations that can advance reflexive co-production for urban resilience.
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