Coco Alarcon, MLA, PhDc
Nominated From: University of Washington
Research Site: Centro de Investigaciones Tecnológicas Biomédicas y Medioambientales (CITBM)
Research Area: One Health, Environmental Health
Primary Mentor: Dr. Joseph Zunt
Research Project
Preliminary Impacts and Implementation Outcomes of Environmental Actions for “One Health” in the Urban Amazon Region: Iquitos, Peru
Iquitos, a rapidly expanding city in the Peruvian Amazon, faces significant challenges due to its lack of green spaces, with only 1.48 square meters per inhabitant, far below the WHO’s recommended 9 square meters. This deficiency is linked to critical public health and ecological issues, including vector-borne diseases such as dengue and Zika viral infections, leptospirosis, poor mental health, and emerging environmental threats causes and impacts. Despite efforts by local authorities to reforest the city, land scarcity, poor interinstitutional collaboration, lack of participatory approaches, and unplanned urban growth have hindered progress. Residential backyards represent a key opportunity to increase green spaces and improve public health. The Healthy Amazonian Green Cities (HAGC) program aims to address these issues by promoting healthy backyard gardening practices to improve public health, One Health, and environmental resilience. The program provides educational materials, technical support, and economic incentives for households to design and maintain these green spaces. Proof-of-concept trials in a few households have shown promising results, and this study will evaluate the program’s broader impact in 30 households. The first aim of this project is to assess the preliminary impact of HAGC on One Health and resilience to emerging environmental threats. Core indicators include mental health, food security, dengue and leptospirosis risk, biodiversity of local species, temperature, and environmental conditions. The second aim is to assess the implementation outcomes of HAGC, focusing on program acceptability, feasibility, fidelity, and sustainability through surveys, interviews, and focus groups. The study will use a pre-post-controlled design, randomly assigning 60 households to intervention or control groups. Health impacts will be measured using tools such as the GAD-7, PHQ-8, and entomological indicators for dengue risk. Ecological and environmental variables, including biodiversity and CO2 sequestration, will be documented using on-site equipment. To assess the effect size of variables of interest we will use a difference in difference analysis. The implementation outcomes will be evaluated using both quantitative and qualitative methods.
Research Significance
Significance The program will test one of the first models for implementing environmental actions for One Health and resilience to emerging environmental threats in the country, with the potential for integration into government services. Specifically, it aims to become a multisectoral strategy addressing local efforts in dengue epidemic control, urban reforestation, and social development. Results from this program could advance the field of implementation science by providing new frameworks for integrating the built environment and One Health into practice. Moreover, many urban areas in the Amazon region share historical processes and conditions with Iquitos. As such, the program has the potential to serve as a model for Amazonian cities across nine countries in South America, representing a combined population of 33 million inhabitants. Additionally, the HAGC program could be adapted to diverse contexts worldwide, including the USA. The complexity of this multidisciplinary approach has brought hundreds of professionals, researchers, and students from the U.S. and Peru to Iquitos over the past decade. This project will continue to serve as a platform for training, research, and advancing the careers of emerging designers and researchers with an interest in the advancement of the built environment, One Health, and resilience to emerging environmental threats. Significance and Relevance to the United States The implementation of environmental programs for One Health and resilience to emerging environmental threats is an ongoing global effort. Few major cities have large-scale examples, and even fewer prioritize the necessary implementation variables for replicability and scalability. This proposal offers a new, adaptable framework for major cities worldwide, including the US. Additionally, the program aims to serve as a platform for international trainees and fellows to experience tools and frameworks for the novel ‘One Health’ approach. During recent years, previous stages of this project have hosted over a hundred US professionals, professors, and students who used these experiences to advance their careers and research in the US.
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