Culture circles on social and environmental determinants: action research with community health agents of Paraisópolis, SP

Santos, Francisco Nilson Paiva dos; Toledo, Renata Ferraz de

doi:10.1590/1983-1447.2020.20190353

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Original Article • Rev. Gaúcha Enferm. 41 • 2020 • https://doi.org/10.1590/1983-1447.2020.20190353 copy

Culture circles on social and environmental determinants: action research with community health agents of Paraisópolis, SP

Círculos culturales acerca de determinantes sociales y ambientales: investigación-acción con agentes de salud comunitarios de Paraisópolis, SP

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

To identify social and environmental determinants of health in the perception of community health agents, and to develop a health education process to contribute to the improvement of health promotion.

Methods:

A qualitative action research based on Freire's Research Itinerary (Culture Circles), using talking maps and integrated panels, with 29 community health agents of the Paraisópolis II Basic Health Unit, in the community of Paraisópolis, Sao Paulo. The analysis of the results was carried out by the Method of Triangulation.

Results:

Sanitation, housing, behaviors, health services, and other social facilities were identified, which, along with the representation of blaming, were codified and decoded by the integration of technical and traditional knowledge.

Conclusions:

Knowledge, values and abilities related to social and environmental determinants and their applicability in the Family Health Strategy, as well as the importance of community strengthening for health promotion and for coping with health vulnerabilities and inequities, were critically unveiled.

Keywords:
Community health workers; Social determinants of health; Health education; Family health strategy; Health vulnerability

Categories of generating themes	Negative social and environmental factors represented and/or mentioned
Inefficient sanitation	Garbage in inappropriate places; open sewage; creeks with waste and sewage; clogged storm drains; bad smell.
Animals	Abandoned animals; animals inside homes; disease vectors in animals (rats, cockroaches, flies, mosquitoes).
Housing and other facilities	Wooden shacks; houses very close to each other; humidity inside homes; electric “cats” (electricity theft); wooden bridge; junkyard.
Social issues/violence	Drugs (consumption and trafficking); bars; sexual abuse.
Behavioral factors	Neglect of the community; people's “ignorance” (little knowledge and/or difficulty in learning); cars parked on the sidewalks; loud car sounds late at night; people accumulating garbage.
Categories of generating themes	Positive social and environmental factors represented and/or mentioned
Trade	Butchery; bakery; pizzeria; restaurants; stores; market; drugstore; fuel station; bar; bank.
Health services	Basic Health Unit - BHU; Specialty Outpatient Clinic - SOC; dentist; CHA; Outpatient Medical Assistance - OMA; Psychosocial Care Center - CAPS.
NGOs/Social projects	Bom Prato (“Good Plate”); Reference Center for Social Assistance (CRAS), and Casa da Mulher(“The Woman’s Place”); Recycling Center.
Sports and leisure	Ballet school; sports court; soccer field; gym.
Green areas	Houses' gardens; trees.
Education	School; “mãe crecheira” (“nursery mother”); language school.
Behavioral factors	Receptive patients
Animals	The pleasant company of pets.
Churches	Space to socialize and “spiritual food”.

Group	What we learn
1	Together we learned the importance of listening, of respect, ethics, confidentiality, continuous learning, so that we can improve our community and work environment.
2	Together we can make the population aware, so that everyone can do their part, taking care of the environment.
3	Despite all the needs, we know that we cannot do it alone, and together with the community we are stronger to fight for improvement.
4	We learned to observe and guide according to the specific economic and cultural reality and to the belief of each person. With listening and an enlarged look with empathy.
5	We learned that as individuals we can make a difference or change things around us and, in addition, we learned where to start those changes, and how to continue them. We learned to respect each other's time and especially the “no” answer from people around us.

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

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[1] Corresponding author:
Francisco Nilson Paiva dos Santos E-mail: franpaivasantos1975@gmail.com