Our Voice in a rural community: empowering Colombian adolescents to advocate for school community well-being through citizen science

Currently, there are approximately 1.2 billion adolescents, representing 16% of the world’s population. In the coming year/decades, this number is expected to increase, especially in low and middle-income countries (LMIC) [1]. During adolescence, individuals acquire economic, physical, emotional, cognitive and social resources that will define their future and that of subsequent generations [2]. It stands to reason that empowering adolescents within vulnerable communities in ways that may enhance their health and well-being can provide benefits both to the present and future of the population [2].

Evidence shows that about 1.1 million adolescents die annually [3]. The causes of their deaths are typically preventable and are related to factors that include both the physical and social environment and adolescent behaviors [3]. For adolescents aged 10 to 14 years, these deaths are mainly caused by health risks related to water, hygiene and sanitation [3]. For adolescents aged 15 to 19 years, the leading causes of death are traffic accidents, suicide, and interpersonal violence [3]. In both cases, the school environment is pivotal for maintaining health and well-being [2], as adolescents spend a significant portion of their time in school environments. Schools are safe spaces that provide adolescents with resources to develop their skills, address their mental health problems, and improve their social interactions and civic engagement [4, 5]. Nevertheless, in rural communities, school environments are often deteriorated. This diminishes their capabilities as safe spaces for adolescents. Thus, by engaging in improving school environments, adolescents could participate in increasing those capabilities, their sense of belonging to the school, and benefiting from spending time in a safer space.

Santa Ana is a rural district of around 5000 Afro-descendants located on the Island of Barú, Colombia [6, 7]. Over the years, the island of Barú has become one of the most important tourist centers in Colombia. In 2014 a bridge was built to facilitate the entry to the island, and one of the sectors that benefited the most from the construction of this bridge was tourism. As a result, the tourist trade has brought economic opportunities for the population as a whole, but it also has widened socioeconomic disparities and redefined the community as a semi-rural urban-influenced population [8]. Santa Ana is an example of a population with high levels of multidimensional poverty, different forms of violence (e.g. gender-based violence, sexual violence, familial violence, and street violence), lack of decent housing, precarious working conditions, and education of limited quality [8]. In 2019 the United Nations Population Fund reported that in Latin America young people (10 to 24 years old) usually face obstacles in their transition from childhood to adulthood [9]. At this stage of life, young people are faced with problems such as teen pregnancy, unemployment, and lack of access to higher education [9]. For example, just 59.4% of young people have completed high school, the youth unemployment rate is approximately 20, 25% of deaths in young people are due to homicides and only 56% of young people have connected to the internet in the last 3 months [9]. Santa Ana is an exemplar of this broader phenomenon. By 2019, 95.8% of households in Santa Ana lived in poverty and 54.6% in misery [10]. In terms of education, in 2019 the public school Institución Educativa de Santa Ana reported a dropout rate of 9.6% (above the average 3.68% dropout rate of Cartagena) and was ranked in the lowest category of academic performance among schools in Cartagena [10]. In terms of health, Santa Ana does not have a primary care hospital, and the hospitals on the island of Barú do not operate properly and require priority intervention [10]. Also, Santa Ana does not have a sewage system, which makes it difficult to manage wastewater, and it has only had aqueduct service since 2017 [10]. Regarding housing, 26% of houses are built with precarious or unstable materials, 51% of the houses do not have walls or the walls are made of fabrics, plastic, cardboard or other waste material, and 49% of the houses do not have a paved floor [10]. Officially, one case of teen pregnancy was reported in Santa Ana for 2018 and 19 cases for 2019. However, this number does not include births performed by midwives and therefore this number may be higher [11]. For the district of Cartagena, in 2021 a problem of adolescent pregnancy was reported since there was a high fertility rate in women between 15 and 19 years old; approximately 63 births occur annually for every 1000 women of reproductive age [12]. Prior research in Santa Ana found that adolescents face situations of violence and substance use that are related to both the physical and social environments that surround them (Guerra AM, et al.: Individual attributes and social network predictors of alcohol consumption susceptibility among adolescents in a rural area of Colombia, unpublished), [13], (Rodriguez AL, et al.: Adolescent violence in rural Colombia: a mixed methods social network analysis, unpublished). These situations are not quantified for Santa Ana since, for example, the official annual report of cases of violence in 2018 is lower than what is expected according to qualitative information from other studies: 2 deaths due to theft, 2 cases of sexual abuse, 3 cases of domestic violence, and 13 cases of interpersonal violence [10].

Given this situation, there is a clear need to improve the well-being of the Santa Ana’s adolescent population in ways that are contextually relevant and sustainable. There are no studies that make it possible to establish the number of adolescents currently in Santa Ana. However, in 2008 a survey was conducted of more than 90% of the population of Santa Ana, which allowed for a determination that the adolescent population represents 14% of the total population of Santa Ana [14]. Currently, Santa Ana is an isolated community that receives little attention from state agencies. There is a noticeable lack of coordination between the entities at the regional and local levels [6], making it difficult to develop and implement stable policies and planning at the local level [6]. As a result, many citizens have lost interest in becoming involved in local processes and dynamics that could positively impact the well-being of the community [6]. Such a circumstance has been conceptualized as being compromised by limited “social capital,” wherein community stakeholders have lost the capacity for cooperation, trust, and coordination [15].

In the above context, citizen science “by the people,” as exemplified by the Our Voice citizen science research method, allows residents the unique opportunity of participating directly in collecting meaningful information about their local contexts, collectively analyzing and prioritizing their information, and then developing and collaborating to enact relevant actions based on their results [16].

The use of mobile technology among adolescents is increasing. Currently, approximately 80% of adolescents in the United States have a mobile phone and use it frequently [17]. In Colombia, it is estimated that 5 out of 10 adolescents have a mobile phone [18]. Previous studies have shown that the use of mobile technology may provide a way to engage adolescents in projects where they express their perspectives and advocate for issues that affect them [19‐23]. Our Voice uses mobile technology as a way of engaging adolescents and other groups in the process of identifying local barriers to and facilitators of health and well-being. The web-based Our Voice data platform then allows for the creation of community reports that enable citizen scientists to draw on their own data in collaborating to promote changes in their local environments.

One of the main objectives of Our Voice is to provide populations that traditionally have not had the opportunity to be heard with the means for collectively participating in community decision-making [16]. This model has been applied in over 20 countries spanning 6 continents and has been utilized by different age groups in varying contexts and circumstances to address local problems that influence the well-being of the community [16, 24]. However, it has never been applied in a rural area with a Latin American population–particularly one of African descent. This article documents the application of Our Voice in Santa Ana, Barú. The purpose of this study was to evaluate the impacts of this type of community-engaged citizen science method among the adolescents of Santa Ana, particularly with respect to the school environment, and to explore how students might use their group data to advocate for change with school stakeholders. The results were aimed at informing decision-makers about possible interventions for improving the well-being of the adolescent population of Santa Ana as well as similar populations.

The Our Voice in Barú study is, as far as we are aware, the first citizen science project in a rural Latin American context focused on supporting members of a school community to advocate for data-informed changes in their local environment to increase well-being. During this study, the adolescents identified and presented to decision-makers what they perceived to be the most relevant barriers and facilitators of the built-environment for well-being in their school. The main barriers reported were the poor or insufficient condition of the school infrastructure and the lack of surveillance of risks to students, all of which impacted the low sense of student belonging. In the community meeting, citizen scientists explained that these barriers were related to their well-being, as adolescents are exposed to injuries, fights, and at risk of school dropout. At the same time, there is a reinforcement loop because school facilities are often damaged during fights, and as violent behavior continues to be normalized, school facilities continue to be damaged. As mentioned above, Santa Ana is a place where there is a presence of different forms of violence (e.g. gender-based violence, sexual violence, familial violence, and street violence) [8]. Another reinforcement loop occurs between the lack of risk surveillance for student injuries and school dropout. The problem reported about the school wall through which students escape reveals the concern that students want to leave the school to carry out other activities. According to the latest report on quality of life on the Barú peninsula, the dropout rate at the Institución Educativa Santa Ana was 9.6% in 2018, 2.5 percentage points more than in 2017 [10]. In addition, the average time of school study in Santa Ana is 5.45 years, and is expected to be at least 10 years old to complete the school stage [10]. So, if there are incentives outside the school for adolescents not to want to study, and there is a lack of surveillance of risks to students, they will try to escape more from the school and will be at greater risk of harming themselves in the attempt. Furthermore, as more students drop out, others are implicitly encouraged to do so. Adolescents in Santa Ana usually often stop studying to go to work and provide income for their homes. This may be related to the fact that the average study time in Santa Ana is much shorter than in Cartagena. Thus, the findings of citizen scientists about barriers in the built environment reveal problems related to the well-being of adolescents in Santa Ana that need to be addressed. Interestingly, the solutions and action agreements reached in the community meeting with stakeholders are focused not only on fixing the built environment, but also on dealing with the underlying problems that were mentioned above (i.e. school dropout, risks for students, violence). The citizen scientists also identified facilitators of well-being related to the presence of green areas and spaces supportive of studying. These facilitators are again related to the well-being of adolescents to the extent that they could be considered safe spaces for them. These are physical spaces where adolescents can meet without being exposed to the difficult challenges that generally affect them in their environment, such as violence, substance use, discrimination, and teen pregnancy, among others [8, 10]. In addition, the spaces supportive of studying reveal the willingness of adolescents to study and the need to address the problem of school dropout that is evident in Santa Ana. Through the Our Voice process, the citizen scientists had the opportunity to have their perspectives on these issues be directly heard by the decision-makers at their school. This positive dynamic helped to close the communication and support gap for students who reported at the beginning of the project that they felt little to no support among people in the community and did not feel that they could influence the decisions that affect them. As elicited in the follow-up with the school principal, this exercise allowed the students to realize that this is not always true, and that they can empower themselves to advocate for changes by establishing mechanisms of participation. Concerning this, it is useful to note that Santa Ana is a community characterized by having strong, largely hierarchical power relations and having few participatory mechanisms due to the low attention of the state [8]. In this respect, it is useful to highlight the activity of participatory mapping, reported in the social sciences to be an exercise that can transform power relations so that they could be inclusive and community-based [28]. Projects such as this have the potential to shorten distances between decision makers and communities.

Interestingly, comparisons with other Our Voice studies conducted in schools in both urban Colombia and the US point to similarities in the facilitators and barriers identified. In a school study carried out in Bogotá, Colombia, for example, green areas were also identified as facilitators for a healthy life and similar barriers emerged such as low maintenance of bathrooms and classrooms and lack of a culture/norms to keep the school environment in good condition [24]. In Barú, one of the barriers that emerged in the conversation between stakeholders and citizen scientists was car traffic on the school’s main road. This finding has been reported in other school-based studies in different countries and contexts that have focused on identifying facilitators and barriers to having safe routes for students to travel to school [27, 31, 32]. For example, in a safe routes to school study in the US, some of the barriers that emerged were also related to traffic and speed on the streets near the school [31]. To address this issue in Barú, an agreement was reached with the police to facilitate targeted driver education programs. To date, however, this has not happened. In the US study, the solutions to improve school traffic were not pursued because the key municipal transportation stakeholder for the area left his/her position [31]. This suggests that it is important that agreements do not depend on specific actors but, rather, should occur at the organizational level and formalized, whenever possible, within each entity. An example of organization-level action occurred in a study occurring in Bogotá, Colombia where the citizen scientists were trained by members of a nearby law school in culturally relevant advocacy skills to help advance their change efforts [24].

Ripple effects identified after the project ended indicate that the Our Voice project in Barú has the potential to facilitate changes at a systems level in the broader Santa Ana community, and has generated emergent phenomena such as cohesion, cooperation, and coordination among students, directors, teachers, and external community members. As the principal of the school noted 6–12 months after project completion, following the Our Voice intervention students began to more fully and frequently engage in collective action with important groups in the community such as fishermen, the major hotels in the area, and the Santa Ana community board, where the results of the study were presented. Of note, an Our Voice study in Bogotá, Colombia aimed at enhancing local parks for physical activity and well-being also showed similar ripple effects [33]. In that study, the citizen scientists’ results were presented to additional groups that were not involved initially, and the Our Voice approach helped to promote dialogue among different community actors [33].

The presence and actions of local organizations such as the Amor por Barú Foundation were important factors that promoted these changes at a systems level. An actor like the Foundation has the power to create synergies across different community organizations and entities by acting as a bridge and closing communication gaps. Findings from Our Voice in Baru are also consistent with the health-related citizen science literature more generally. A recent review of this literature suggests that this type of citizen science approach can be helpful in addressing both physical and social environmental determinants that affect well-being by empowering people to identify and change the community-level factors that affect their well-being [34].

This study has several limitations. First, while the citizen scientists were randomly selected from the student pool comprising the science club of the school, which can help to reduce bias related to self-selection, the club itself represents a select group of students who may not be representative of the larger school population. Although this could bias the results of the study, a previous study suggested that having a greater number of individuals who are leaders could enable a better advocacy phase as they are agents of change [24]. In addition, the pool of students was composed of students of different sex and age groups, so the selection process helped to preserve student diversity for these categories. Second, we were unable to fully monitor the progress made around the project action plan that was developed, as the school’s activities were suspended due to the pandemic caused by the COVID-19 virus. It was not possible at that point to organize interviews with students and teachers to get their perspectives, as flight suspensions across the country made it impossible to travel. Further, we were unable to organize virtual interviews due to the lack of internet access within the Barú population. However, we were able to speak with the principal, and the Amor por Barú Foundation sent us a report of the subsequent citizen science-inspired activities occurring in the school. Also, we remain in contact with the school and continue to develop different projects in Santa Ana that are aimed at improving the well-being of the population and its built environment. In particular, in 2022 we will finish a Our Voice project with walks outside the school and this allows us to continue monitoring the improvement of the school environment. These methods provided us with valuable information concerning the school’s progress in responding to student concerns and enhancing the school environment in support of well-being. Finally, due to the current political milieu in Santa Ana, we could not bring the findings to a local governmental audience. The political conditions in Santa Ana are complex as its governance is divided and it is a territory where there is still widespread violence. These issues notwithstanding, we received strong support a strong commitment from the school authorities to promote student-identified changes within the school environment.