Participatory Approaches to Risk Assessment Across One Health Disciplines: A Scoping Review

Abstract

Risk assessments for emerging infectious disease threats are often conducted independently of affected communities. Participatory approaches to risk assessment present an opportunity to integrate community knowledge early in the risk-based decisionmaking process. We conducted a scoping review to understand the breadth of evidence from human, animal, and environmental health disciplines for integrating community participation in steps of the risk assessment process. A systematic literature search in PubMed, Scopus, Ei Compendex, Embase, Web of Science, and Global Health Database identified 4993 articles, of which 138 met inclusion criteria for the review. The types of participatory approaches described in the risk assessment literature varied by degree of community involvement, types of communities engaged, and activities implemented to engage communities. There was substantial evidence from environmental contamination and climate change studies on conducting hazard and exposure assessments within a community-based participatory research model. However, examples of community participation in problem formulation, capacity assessments, data report-back, and pathway mapping were limited. Additionally, the limited examples of community-initiated and community-driven risk assessments suggest a need for improving community involvement from the earliest stages of research priority setting through all phases of data collection, analysis, and interpretation. Further research is also needed on adapting participatory approaches for emerging infectious disease risk assessments.

Keywords

Citizen engagement Environmental detection Epidemic management/response Risk assessment One Health

Introduction

Nearly all of the World Health Organization (WHO)’s disease priority lists for research, medical countermeasure development, prevention, and control programs involve a human–animal interface and are impacted by climate change as a driver of disease.^1,2 Mitigating the risks presented by these diseases to humans and animals while addressing the environmental impacts that exacerbate disease prevalence requires a multidisciplinary One Health approach to risk management.³ Affected communities, including groups within a larger community that share a distinct identity, have long been recognized as indispensable stakeholders in risk management for public health emergencies at the human–animal interface and have been vital in past epidemics to support disease control measures.^4,5

Yet, risk management for emerging infectious disease events often takes a “decide–announce–defend” approach to affected communities, despite lessons learned from past health emergencies on the critical need for community engagement throughout the risk management process.⁶ Approaches that prescribe disease control measures to affected communities, without their participation in designing these measures, can lead to a breakdown in trust between frontline response workers and the community at risk during an epidemic.⁷ Instead, a community-led response, involving the use of participatory approaches at the earliest stages of an outbreak, supports more effective implementation of disease control measures and response operations tailored to the local needs, practices, and beliefs.

Risk assessment is among the first steps in the risk paradigm that then informs risk management and risk communication decisions.^8,9 Stages of human health risk assessment include problem formulation, hazard identification, dose-response assessment, exposure assessment, and risk characterization.¹⁰ In addition to hazard characterization and exposure assessment, formulations used in disaster management also consider dimensions of capacity and vulnerability to determine risk.¹¹ Participatory methods to emerging infectious disease risk assessments support the use of a One Health framework to investigate issues at the intersection of human, animal, and environmental health as they avoid the use of a “one-size-fits-all” approach.¹² Participatory approaches also offer an understanding of animal, human, and environmental phenomena from the perspective of the affected community, unlike community-based surveys and rapid assessments that impose a conceptual framework through the use of a checklist or questionnaire.^12,13 Key et al describe a continuum of community-engaged research activities that highlight the relationship of the researcher relative to the community in which the research is being conducted. The continuum spans from no community involvement in research to increasingly greater levels of engagement, such as community informed, community consultation, community participation, community initiated, community-based participatory research (CBPR), and community driven/led research.^14,15 Participatory approaches are processes that exist along this spectrum of community involvement to engage the public, stakeholder groups, and/or individual members of a defined community, in an effort to bring focus to local priorities and perspectives.¹⁶

Community-centered assessment methods have been applied in rural development and disaster risk reduction contexts since the 1970s.^17,18 Participatory assessment approaches have highlighted the value of “indigenous technical knowledge” since the emergence of Rapid Rural Appraisal and Participatory Rural Appraisal (PRA) methodologies, which were developed to overcome the biases and limitations of questionnaire-based surveys.¹⁷ Though distinct from qualitative research methods, the set of approaches used in PRA drew upon methodologies used in activist participatory research, applied anthropology, and field research on farm systems.¹⁷ The Global Rinderpest Eradication Program, established in 1994, also attributes its successes to adopting participatory epidemiology for rinderpest surveillance efforts and to better understand local perspectives of the disease.¹⁹ Practices were adapted from the international development sector’s participatory rural appraisal methodologies and were first piloted in eastern Africa. The main methods used in participatory epidemiology included semistructured interviews, focus group discussions, prioritization of disease observations, and participatory mapping techniques.²⁰ A combination of these techniques was also used to gain insights on disease prevalence, mortality, and high-risk areas. For example, key informant interviews on disease presence were used to inform qualitative risk maps and sample site selection.²⁰ Field investigators also used interview techniques to identify seasonal cattle migratory practices that spread rinderpest from endemic lowland ecological zones to cattle in highland ecological zones.¹⁹ It was often found that formal surveillance methods were unable to provide adequate disease detection, while the additional use of participatory epidemiology helped to identify additional cases that typically went undetected.^19,21 Lastly, proportional piling, whereby participants were asked to divide piles of counters such as beans across various categories, proved to be a useful method to assess disease risk factors, disease prevalence, and perception of disease impact.²⁰

Despite widespread recognition by public health organizations on the critical role of communities, community involvement across global health preparedness activities remained “grossly insufficient” according to a 2019 report on the state of public health emergency preparedness by the Global Preparedness Monitoring Board (GPMB).²² This report, developed prior to the COVID-19 pandemic, called for “long-term, sustained community engagement” and highlighted that community needs must be understood and incorporated systematically into accountability and planning mechanisms.²² The subsequent GPMB annual report considered the global response to the COVID-19 pandemic and stated an urgent call to action for engaged citizenship, due to the lack of community involvement and community empowerment observed in multiple countries.²²

In March 2021, WHO also convened an ad-hoc consultation on “community-centered approaches to health emergencies,” which recognized the need for methodological innovation and “research to strengthen community-centered initiatives” in order to advance evidence-based practice.²³ The importance of community participation is also acknowledged in numerous high-level frameworks and policies across the sustainable development and disaster disciplines.²³ Notably, the Sendai Framework (2015) highlights that reducing disaster risk and building resilience requires meaningful community and stakeholder participation.¹¹ The Health Emergencies and Disaster Risk Management Framework (EDRM), which integrates emergency and disaster management, epidemic preparedness and response, and health systems strengthening, also emphasizes that community participation in risk assessments can identify hazards, vulnerabilities, and actions in ways that reduce health risks prior to the onset of a public health emergency.²⁴ Although the Sendai Framework and Health EDRM Framework emphasize community participation in risk assessment during preparedness phases, as seen in other areas of health systems strengthening, reinforcing the need for community participation during a public health emergency remains a critical gap.²⁵

The purpose of this study is to identify and characterize participatory approaches used in risk assessment through a scoping review of literature from the human, environmental, and animal health evidence base.

Methods

The scoping review followed the PRISMA Extension for Scoping Reviews Cochrane Rapid Reviews Methods Group interim guidance.²⁶ This study design was selected to as it provides an opportunity to understand the breadth of literature on conducting risk assessments through participatory approaches from a heterogeneous evidence base.^26,27 We used an adapted Population, Intervention, Comparator, Outcome (PICO) criteria framework for risk assessment tools to conduct a systematic literature search in PubMed, Scopus, Ei Compendex, Embase, Web of Science, and Global Health Database with the assistance of an information specialist.²⁸ The PICO criteria were: (1) studies with populations affected by a threat or hazard being assessed for risk in any geographical context; (2) studies using participatory methodologies as the intervention to assess hazards, risks, capacities, exposures, vulnerabilities, resilience, impacts, context, or a related formulation of risk; (3) studies that review comparative participatory methods for risk assessment; and (4) studies describing outcomes of interest including conceptual frameworks, assessment methods, hazard prioritization methods, sampling and analysis strategies, and impacts on programs, policies, or projects. We determined studies for inclusion or exclusion based on the criteria outlined in the Table and tested the screening protocol against a subset of records with a second screener, and screening then proceeded with a single screener.²⁹

Table.

Inclusion and Exclusion Criteria for Scoping Review

Category	Inclusion Criteria	Exclusion Criteria
Date	• Studies from 2000 to 2024	• Studies before 2000
Language	• Sources in English	• Sources not in English
Topics	• Studies from public health emergencies, disaster preparedness, and response, environmental health, animal health, health systems, or related disciplines • Studies describing events due to any cause (eg, natural, deliberate, accidental) • Studies describing risk assessments conducted in any country	• Studies from nonhealth-related topics
Method	• Studies with qualitative, quantitative, mixed-method, systematic review, and case study research designs • Studies using a participatory method to assess components of risk including vulnerability, hazard, threat, exposure, coping capacity, context, or resilience assessments	• Studies that do not include a description of methods and details on the application of the methods • Studies that do not use or describe a participatory method as a data collection or analysis strategy • Studies that do not include information on sampling strategy, how participants were identified or recruited for participation
Publication types	• Peer-reviewed journal articles, reports, book chapters, and conference papers	• Websites, news articles, webinars

Data Extraction and Analysis

Data was captured on the study population, risk assessment step (intervention), degree of participation (outcome),¹⁴ primary participatory approach (outcome), participatory methods used for risk assessment (outcome), and sampling strategy (outcome) described in each article. We developed initial categories using deductive coding, based on the main research questions, and used inductive coding as a secondary strategy to capture specific approaches in more detail (eg, methods used for risk assessment, sampling strategy). We also coded degree of community participation according to Key’s continuum of community engagement (eg, community informed, community consultation, community participation, community initiated, CBPR, community driven/led).¹⁴

Quantitative summaries were compiled to describe the breadth of articles according to the risk assessment components studied and participatory approaches that were applied. In addition, we compiled narrative summaries to detail themes in the literature according to the risk assessment stage. Due to a predominance of qualitative articles and research aims to detail all possible approaches, we determined it was appropriate to forgo a risk of bias assessment for this scoping review.²⁹

Positionality Statement

As a researcher with a background in community engagement and experience working with community-based organizations, the primary author and scoping review analyst recognizes that their perspectives are shaped by a commitment to participatory approaches and a belief in the value of grassroots knowledge. This orientation may introduce bias in interpreting and analyzing the scoping review literature in ways that emphasize narratives that describe greater community involvement or overlook those where community involvement is limited. To avoid bias, notes were taken to bracket existing assumptions during data collection and analysis.³⁰

Results

The literature search resulted in a total of 4,993 records, of which 138 were included in the review (Figure 1). Nearly two-thirds of the studies were published between 2010 to 2019, and most were conducted in the United States (50 out of 138). Risk assessments conducted in the African and Asia regions were described in 53 out of 138 articles (Figure 2).

Figure 1.

PRISMA diagram for scoping review.

Figure 2.

Summary of select characteristics for included studies (N=138). Studies conducted in Caribbean countries (ie, Grenada, Saint Lucia) were summarized as part of the North American region (i); Other hazard types include fishing bycatch, obesity, invasive species, occupational hazards, genetic modification, engineered nanomaterials, and nonchemical stressors (ii); 35 out of 138 studies engaged 2 or more groups, 13 studies engaged 3 or more groups (iii); 15 out of 138 studies used 2 or more sampling strategies (iv).

Types of Community Participation

For most risk assessments, the specific community engaged was from the affected population (106 out of 138 studies). Additional segments of the affected population included stakeholders; academia; civil society; national, state, regional, and local officials; and subject matter experts. Industry representatives and vendors participated in risk assessments for some studies (8 out of 138).³¹ All studies involved members of the nonresearch community to some degree, as articles without any community involvement were excluded from this scoping review. However, some articles (9 out of 138) described methods that had limited community participation where the community was informed or consulted about research activities but did not have a defined and continued role for their participation throughout the risk assessment. For other studies, community members had a defined role typically as study participants and informants (76 out of 138) or within a CBPR model (27 out of 138).

Community Participation Across Multiple Risk Assessment Steps

Participatory approaches implemented across multiple risk assessment stages that were community-initiated or community-driven (27 out of 138 articles) included Comprehensive Environmental Assessment, participatory risk assessment, and ecological risk assessment.^32-34 Comprehensive Environmental Assessment was applied to identify research priorities and research questions across a diverse set of stakeholders (ie, subject matter experts, industry representatives, academia, local officials) that could be studied by the broader scientific community. Through multiple workshops, participants developed and prioritized research areas using nominal group technique. While this approach engaged a large group of stakeholders and consolidated their diverse perspectives to identify priorities, study authors noted participant attrition in subsequent workshops.³² Multiple studies also conducted cumulative risk assessments through within a CBPR framework to assess environmental contamination risk^35,36 and nonchemical stressors.³⁷ Approaches that incorporated community participation as study participants included community-based disaster risk assessment, participatory risk assessment, ecological risk assessment, rapid participatory assessment, qualitative risk assessment, and participatory modelling.^31,38-43 However, how these approaches were implemented varied by the types of communities engaged and methods used to gather information (eg, site visits, workshops, storytelling, interviews, etc.). For example, participatory risk assessment approach was implemented by Oguttu et al to engage industry representatives and conduct focus group discussions, interviews, and food sampling to understand infection risks in the food value chain;³¹ whereas, other applications of participatory risk assessment involved engaging broad groups of stakeholders, affected populations, or civil society in workshops and participatory mapping.^33,43-45

Community Participation in Needs Assessments

Two examples of participatory needs assessments were found in this scoping review. Little et. al, conducted meetings and interviews in an interactive stakeholder-involvement approach to better understand the needs of emergency response managers for a decision support platform.⁴⁶ Muzaffar et al conducted a needs assessment within a community-based participatory research program to understand nutritional needs and risk of obesity in children. This approach included collecting quantitative anthropometric measures and conducting a survey of demographic measures, dietary intake, and physical activity.⁴⁷

Community Participation in Problem Formulation

The scoping review identified 2 examples of community involvement in the problem formulation stage of risk assessment. These publications described engaging groups in the United States in the problem formulation stage to understand environmental contamination and food safety risks.^48,49 Judd et al followed an analytic-deliberative risk process to engage local vendors and tribal communities in identifying environmental health concerns that shaped risk characterization, exposure evaluations, and research funding proposals.⁴⁸ Similarly, Burger et al involved affected indigenous communities in problem formulation and codesign of a research plan, as well as in data collection, analysis, and dissemination steps.⁴⁹

Community Participation in Hazard Assessments and Hazard Prioritization

We identified 34 publications that described community participation in hazard assessment and prioritization stages. Several approaches to hazard assessments involving community participation were semiquantitative in nature and sought engagement from the affected community. Approaches such as environmental sampling, participatory mapping, and citizen science paired with workshops, transect walks, and interviews provided greater clarity on the geospatial distribution of hazards affected a particular community.^50-61 Nine studies described prioritization steps on topics related to anthrax,⁶² climate change,^63,64 fire,³⁸ environmental toxicants,⁶⁵ genetic modification,³⁹ invasive species,⁶⁶ and engineered nanomaterials.⁶⁷ Methods used to prioritize hazards included gathering information through interviews, stakeholder meetings, or focus group discussions as part of an Analytic Hierarchy Process, followed by multicriteria decision analysis for prioritization.^65,66 Risk prioritization was also conducted as part of a comprehensive environmental assessment by following nominal group technique.⁶⁷

Community Participation in Exposure Assessments

Examples of participatory approaches to exposure assessments, or combined exposure and hazard assessments, largely derived from literature on environmental contamination and air pollution (23 out of 138 studies). Participatory approaches to personal exposure monitoring or environmental sampling were typically conducted through community-based participatory research activities.^68-76 Models for community initiated and community driven approaches to risk assessment included participatory action research and activist-initiated research.^77,78 Other approaches that engaged communities as study participants in exposure assessment included citizen science, comparative risk assessment, environmental health risk assessment, and multibarrier approach to understand exposure along the pathogen transmission chain.^79-82 Participatory approaches to understanding geographic distribution of areas with greater exposure risks, like participatory mapping, transect walks, and interviews, were also used in fishing bycatch and sanitation system related studies.^82-84

Community Participation in Data-Report Back

Community involvement in report back of exposure results was described in 11 out of 138 articles and exclusively in the context of US-based environmental contamination studies, published between 2004 and 2019. Most commonly, study teams conducted data report-back as part of a community-based participatory research study.^85-91 Among studies that involved environmental sampling or specimen testing to understand exposures, investigators often conducted interviews with study participants or community leaders first to determine how best to share exposure results.^86-88,91 Results were then shared in person or through mailed packets in conjunction with an opportunity to discuss results and concerns with the study team at a house visit or community meeting.^86,92 While researchers found report-back to be time-consuming and challenging, the process strengthened their relationships with study participants.⁹¹ Participants also found report-back beneficial and were motivated to take exposure reduction measures, identify new research questions, and communicate study results with their healthcare providers to access medical or governmental assistance.^87,91-94

Community Participation in Vulnerability and Hazard Assessments

We identified 9 articles that described approaches to integrate community involvement for vulnerability and hazards assessments, including community-based disaster risk assessment, CBPR, participatory action research, participatory risk assessment, and rapid rural appraisal.^76,95-100 These examples were found primarily in the environmental contamination, disaster risk, and climate change literature. Masri et al described leveraging an academic CBPR partnership to map quantitative vulnerability scores, derived from demographic indicators, and soil sampling results to locate areas of cumulative risk.⁷⁶ Comparatively, all other studies assessed vulnerability and hazard by combining approaches including workshops, transect walks, focus group discussions, site visits, and participatory mapping.^95-101 Additionally, Fleming et al supplemented stakeholder engagement by establishing a partner advisory committee that was involved from conceptualization stage and consulted throughout the assessment process.¹⁰¹

Community Participation in Capacity and Vulnerability Assessments

In total, 23 publications described participatory approaches to capacity and vulnerability assessments. Applications of participatory capacity and vulnerability assessments were primarily found in natural hazards and climate change literature. Most approaches engaged community groups as study participants in the assessments (20 out of 23 studies). Among examples that were community driven, CBPR and stakeholder engagement were integrated throughout all stages of a climate change vulnerability assessment by first formalizing a small group of subject-matter experts and stakeholders to manage assessment activities, and then by engaging a larger group of local stakeholders (ie, practitioners, policy makers, local nonprofit leaders) to provide input on the assessment results and proposed climate adaptation measures.¹⁰² Participatory Capacities and Vulnerabilities Assessment (PCVA) was another methodology that encouraged a community-driven assessment approach whereby study participants acted as both researchers and subjects of their lived experiences in facing disaster risks.¹⁰³ Through a series of PCVA workshops, a small group of women from the affected community were empowered to collect, analyze, and synthesize narratives of their experiences with disasters and their community’s response.

Community Participation in Risk Pathway Mapping

Seven articles described participatory approaches to pathway mapping and implemented these methods to better understand foodborne illness, natural disaster, and infectious disease related risks.^104-110 Specific approaches used were participatory epidemiology, participatory or rapid rural appraisal, participatory risk assessment, and participatory modelling. Most studies leveraged meetings, interviews, or focus group discussions to gather information.^104-108,110 Uniquely, Alhaji et al triangulated data from qualitative interviews and semiquantitative participatory activities (ie, proportional piling, matrix scoring, seasonal calendar) with quantitative seroprevalence test results.¹⁰⁹ Study authors obtained general information on cattle diseases, perceived risk factors, and risk pathways for Rift Valley fever (RVF) through key informant and semi-structured interviews across nine pastoral communities. After reaching consensus on risk factors, participants engaged in proportional piling and matrix scoring to determine the relative impact of risk factors on RVF occurrence, as well as relative weight of occurrence in each calendar season. This information was then cross-checked with local veterinary offices and compared with serologic survey results from cattle in 3 agrogeographical zones to determine risk pathways for RVF occurrence.¹⁰⁹

Summary of Sampling Strategies

Descriptions of the sampling strategies used to identify or recruit community participation were lacking in many studies (70 out of 138 articles). Among articles that did describe sampling strategies, authors commonly used purposive sampling (36 out of 138) and convenience sampling (15 out of 138), with a few additionally employing snowball sampling. Less frequently described sampling strategies for community participation included random sampling, criteria sampling, stratified sampling, relevance selection, and probability proportional to size.

Discussion

According to the Sendai Framework, “risk reduction requires an all-of-society engagement and partnership. It also requires empowerment and inclusive, accessible and non-discriminatory participation, paying special attention to people disproportionately affected by disasters.”¹¹ For infectious disease risks, particularly those at the human–animal–environment interface, multisectoral engagement and interdisciplinary partnership is essential and supported through a One Health approach to risk assessment.¹¹¹ Although risk assessment methods have a robust evidence base, there is no comprehensive framework on how community participation can be integrated in each risk assessment step. Literature on participatory approaches to risk assessment that were identified through this scoping review highlighted various options for implementation based on the degree of community involvement, types of communities engaged, and methods used to engage communities. Additionally, most of the articles identified were published between 2010 and 2019, which spans with the time period when the Sendai Framework was published, emphasizing building community resilience to disasters.¹¹

A few important features emerged from the literature that could aid in improving community participation in risk assessment for an emerging infectious disease context. They are described next.

Engaging Diverse Communities in Risk Assessment

The term ‘community’ can be defined in a multitude of ways with an emphasis on collective, group-based elements.¹¹² Participatory approaches identified in this scoping review sought engagement from communities that included segments of the affected population, public and private sector stakeholders, and policy makers involved in risk-based decisionmaking. Impacts of broad community engagement supported in the literature include enriched decisionmaking through gathering diverse ideas, information, and resources for assessment and mitigating risks more sustainably.¹¹³ Participatory approaches to risk assessment that involved greater community participation engaged community members in multiple roles and through iterative information gathering stages, for example as advisory group members to define risk assessment priorities and research questions, as study participants through interviews and group-based discussion methods, and as research analysts in synthesizing findings.^{32,49,102,103}

Integrating Community Perspectives Throughout All Risk Assessment Phases

Involving the community in risk assessment steps provides an opportunity to incorporate local perspectives earlier in the risk management process, thereby improving the acceptability of risk management decisions.¹¹³ For example, Community-Based Disaster Risk Management has broad applications before, during, and after a disaster, and recognizes community participation in each step of the risk assessment process.¹¹⁴ While approaches like participatory risk assessment, ecological risk assessment, and participatory rural appraisal demonstrate that communities can be involved in multiple risk assessment stages, the degree to which the risk assessment is community-driven varies depending on how methods are implemented.^33,34

Information Gathering and Report-Back Using Multiple Methods

One Health risk assessment frameworks, like the Joint Risk Assessment Operational Tool (JRA OT), further support operationalizing community participation in risk assessment, risk framing, and risk management.¹¹⁵ The JRA framework establishes the key decisionmakers of the risk assessment within the first steps of the process. Within the first module, the main steps are to establish a national steering committee, identify a lead, establish a technical team, and establish and convene a stakeholder group. The role of the stakeholder group is to provide perspectives, relevant information, and support the implementation and communication of risk management decisions. The stakeholder group also does not have a technical or decisionmaking function. Although the JRA recommends a stakeholder analysis to determine the appropriate groups to involve as part of the stakeholder group, this framework does not explicitly discuss how to engage with each stakeholder or the stakeholder group.¹¹⁵ Participatory approaches to risk assessment identified in this scoping review gathered information through a variety of quantitative and qualitative data generating activities, including workshops, interviews, surveys, observation, and sample testing. Approaches like participatory modelling, citizen science, participatory mapping, and methods stemming from rapid rural appraisal (eg, proportional piling, transect walks) in particular synthesized community perspectives to produce quantitative measures to inform risk assessment.^53,55,62,106 Environmental sampling, specimen testing, and report-back were also paired with CBPR partnerships and activities to facilitate information exchange between risk assessment teams and affected communities.^69,87,89,93

Limitations and Suggestions for Future Research

Limitations for this scoping review include geographical and temporal representation in the participatory approaches identified. Most of the literature identified in the scoping review described studies conducted in the United States, in addition to examples from the African and Asian regional contexts, demonstrating potential applicability of similar approaches across numerous cultural and health system settings. However, representativeness of the studies at local levels is unclear as more than half of the articles identified did not discuss the sampling strategy. Further analysis of subregional and subnational variation in where participatory methods have been applied may better inform potential acceptability of these methods. Evaluating the participatory approaches highlighted in this study against current day and potential future applications across a variety of contexts would be important. Lastly, as a separate search in grey literature was not conducted and only English language articles were included in the review, we recognize that other relevant literature may have been missed. All articles reviewed are located in the Appendix (located after the reference section).

Conclusion

The purpose of this scoping review was to assess the breadth of literature describing the use of participatory approaches in the risk assessment process. The review highlighted several variations on how participatory approaches were implemented for risk assessments. Notably, evidence describing the use of participatory risk assessment approaches for infectious disease related hazards at the human–animal interface was limited. Among studies that did use participatory approaches for infectious disease risk assessment, communities were primarily involved as study participants, whereas community-initiated and community-driven approaches were less commonly applied. Studies describing community participation in problem formulation, capacity assessments, hazard prioritization, data report-back and pathway mapping were also limited. The substantial evidence from environmental health and climate risk disciplines for conducting risk assessments through community-based participatory research demonstrates how established partnerships could be leveraged to involve communities in emerging infectious disease risk assessments.

Involving communities in risk assessment through participatory approaches provides an opportunity to build trust and incorporate local perspectives earlier in the risk management process. Although multiple risk assessment frameworks describe the significance of community engagement, there is limited guidance on the best practices and recommended approaches to effectively involve communities in early stages of risk assessment. Additionally, as demonstrated in this scoping review, participatory methods in risk assessment have been implemented to varying degrees of community involvement. These findings call for identifying further opportunities for community involvement and clarifying best practices for implementing participatory approaches in all stages of risk assessment—from conceptualization through data collection, analysis, and interpretation—to manage risks at the human–animal–environment interface.

Footnotes

Acknowledgments

The authors thank Jenna Slutsker for valuable contributions as a second-screener in this scoping review.

Appendix

Appendix. Articles Reviewed, by Hazard, Participatory Approach, and Study Method(s)

Author (Year)	Hazard Studied	Participatory Approach	Study Methods
Multiple assessment stages (n = 27)
Cains and Henshel (2019)¹¹⁶	Climate change	Undefined	Workshops or meetings
Campos et al (2015)¹¹⁷	Human waste	Rapid participatory assessment	Survey, workshops or meetings, GIS
Christoffersen et al (2019)¹¹⁸	Mining, environmental contamination	Community engagement	Workshops or meetings
Corburn (2002)³⁶	Environmental contamination	CBPR	Focus group discussion, survey, interviews
Dana et al (2012)³⁹	Genetic modification	Ecological risk assessment	Workshops or meetings, multicriteria decision analysis
Davis (2013)⁶⁷	Engineered nanomaterials	Nominal group technique	Workshops or meetings
Dobariya et al (2023)⁴⁴	Natural disaster	Participatory risk assessment	Secondary data collection, site visit
Eggers et al (2018)³⁵	Environmental contamination	CBPR	Environmental sampling, interviews, GIS, workshops or meetings, survey
Fawkes et al (2024)¹¹⁹	Environmental contamination	CBPR	Workshops or meetings
Fletcher (2005)⁴²	Bycatch	Qualitative risk assessment	Workshops or meetings
Furcion et al (2018)¹²⁰	Natural disaster	Participatory disaster risk assessment	Interviews, workshops or meetings, secondary data collection
Galarza-Villamar et al (2018)⁴³	Flooding	Participatory risk assessment	Interviews, storytelling
Kellett et al (2007)³⁴	Environmental contamination	Ecological risk assessment	Workshops or meetings
Napogbong et al (2021)¹²¹	Climate change	Participatory/rapid rural appraisal	Interviews, focus group discussion, observation, seasonal calendar
Oguttu et al (2014)³¹	Food safety	Participatory risk assessment	Food sampling, focus group discussion, interviews
Oteng-Ababio and Sarpong (2015)³⁸	Fire	CBDRA	Workshops or meetings, participatory mapping, observation
Payne-Sturges et al (2015)³⁷	Nonchemical stressors	CBPR	Workshops or meetings, participatory mapping, focus group discussion
Powers et al (2016)³²	Engineered nanomaterials	Collective judgement, nominal group technique	Workshops or meetings
Purseid et al (2020)⁴¹	Infectious disease	Participatory modeling	Workshops or meetings
Samhouri et al (2019)¹²²	Food security	CBPR	Workshops or meetings
Saravanamuthu (2018)⁴⁵	Mining	Participatory risk assessment	Workshops or meetings
Tiepolo et al (2021)¹²³	Flooding	Undefined	Workshops or meetings, participatory mapping, observation
Tran and Shaw (2009)¹²⁴	Flooding	Participatory/rapid rural appraisal	Participatory mapping, focus group discussion, interviews, quantitative measurement
Treffny and Beilin (2011)⁴⁰	All hazards	Ecological risk assessment	Workshops or meetings, interviews
Verutes et al (2020)¹²⁵	Bycatch	Bycatch risk assessment	Workshops or meetings, observation, interviews, participatory mapping
Victoria et al (2014)³³	Natural disaster	Participatory risk assessment	Participatory rural appraisal, workshops or meetings, GIS, seasonal calendar
Vigna et al (2024)¹²⁶	Fire	Cultural ecosystem services assessment	Interviews
Problem formulation (n = 2)
Burger et al (2009)⁴⁹	Foodborne illness	Undefined	Workshops or meetings, specimen collection
Judd et al (2005)⁴⁸	Foodborne illness	Analytic-deliberative risk process	Site visit, environmental sampling
Hazard assessment and prioritization (n = 34)
Amiri and Zhao (2019)⁶¹	Environmental contamination	CBPR, data report-back	Workshops or meetings, site visit, observation, focus group discussion, survey, environmental sampling
Bell et al (2015)⁶⁴	Climate change	Community risk assessment	Workshops or meetings
Bhuyan et al (2024)¹²⁷	Flooding, environmental contamination	Undefined	Interviews, focus group discussions, survey
Bibi et al (2019)⁵¹	Flooding	Participatory risk assessment, PGIS	Interviews, seasonal calendar, transect walks, observation, focus group discussion, social and resource mapping, hazard mapping
Bonano et al (2000)⁶⁵	Environmental contamination	Analytic hierarchy process	Interviews, workshops or meetings, multicriteria decision analysis
Campe et al (2011)¹²⁸	Occupational hazards	CBPR	Interviews, workshops or meetings, observation
Canevari-Luzardo et al (2017)⁵⁵	Natural disaster	PGIS	Participatory mapping, survey, workshops or meetings
Carey et al (2007)¹²⁹	All hazards	Ecological risk assessment	Workshops or meetings
Coffin et al (2015)⁶²	Anthrax	Participatory epidemiology	Focus group discussion, observation, interviews, survey, proportional piling, participatory mapping
Coletta et al (2024)¹³⁰	Flooding	Participatory modelling	Document review, interviews
Dean et al (2013)¹³¹	All hazards	Community engagement	Focus group discussion
Gibson (2011)⁶³	Climate change, environmental contamination	Deliberative method for ranking risks	Focus group discussion
Granderson (2018)¹³²	Climate change	Participatory risk assessment	Interviews
Gutberlet et al (2013)¹³³	Occupational hazards	Participatory action research	Workshops or meetings
Hewett et al (2018)¹³⁴	Erosion	Decision-support matrix, participatory action research	Case studies, workshops or meetings, interviews
Hicks et al (2019)⁵³	Natural disaster	Citizen science	Participatory mapping
Jelks et al (2018)⁵²	Environmental contamination	Citizen science	Participatory mapping
Jelks et al (2020)¹³⁵	Environmental contamination	CBPR	Photovoice
Joseph et al (2019)⁵⁷	Environmental contamination	Citizen science	Quantitative measurement, environmental sampling
Kanankege et al (2020)¹³⁶	Infectious disease, invasive species	Stakeholder engagement	Workshops or meetings
Kuser Olsen et al (2018)¹³⁷	Flooding	Stakeholder decision support system, stakeholder engagement	Workshops or meetings, interviews, survey
Landström et al (2011)¹³⁸	Flooding	Participatory modeling, competency groups	workshops or meetings
Mason et al (2024)¹³⁹	Environmental contamination	Citizen science	Survey, environmental sampling
Morey and Venette (2021)⁶⁶	invasive species	Analytic hierarchy process	Focus group discussion, multicriteria decision analysis
Mulopo (2020)⁵⁶	Infectious disease	Undefined	Participatory mapping, transect walks, interviews
Nafee et al (2024)¹⁴⁰	Natural disaster	Participatory rural appraisal	Participatory mapping
Nontapet et al (2022)⁵⁹	Infectious disease	Participatory action research	Survey, home visits, environmental sampling
Okotto-Okotto et al (2021)⁵⁸	Environmental contamination	PGIS	Survey, focus group discussion, participatory mapping
Oliver et al (2017)¹⁴¹	Environmental contamination	Stakeholder decision support system, stakeholder engagement	Workshops or meetings
Pasquier et al (2020)¹⁴²	Flooding	Undefined	Workshops or meetings, interviews
Paulus et al (2019)⁵⁴	Climate change	PGIS	Participatory mapping
Penningroth et al (2013)⁵⁰	Fracking, environmental contamination	CBPR	Environmental sampling
Suwanbamrung et al (2021)¹⁴³	Infectious disease	Participatory action research	Workshops or meetings, quantitative measurement
Tiepolo and Braccio (2017)⁶⁰	Flooding, drought	Community risk assessment	Transect walks, workshops or meetings, GIS
Exposure and hazard assessments (n = 23)
Acker et al (2016)⁸⁴	Human waste	Participatory rapid sanitation system risk assessment	Interviews, transect walks, participatory mapping, site visit, survey
Boniardi et al (2021)⁸⁰	Air pollution	Citizen science	Environmental sampling
Brody et al (2005)⁷⁸	Environmental contamination	Undefined	GIS, specimen collection, environmental sampling
Brugge et al (2006)⁶⁸	Environmental contamination	CBPR	Survey
Commodore et al (2017)⁶⁹	Air pollution	CBPR	Personal exposure monitoring
Costanza et al (2021)⁸³	Bycatch	Bycatch risk assessment	Interviews, participatory mapping
DeLemos et al (2007)⁷⁰	Mining, environmental contamination	CBPR	Environmental sampling
Downs et al (2010)⁷¹	Air pollution	CBPR	Environmental sampling
Grace et al (2008)¹⁴⁴	Food safety	Participatory risk assessment	Interviews, observation
Huy et al (2014)⁷⁹	Arsenic, environmental contamination	Australian EHRA	Survey, interviews
Johnston et al (2019)⁷²	Environmental contamination	CBPR	Survey, workshops or meetings
Keeler et al (2002)⁷³	Air pollution	CBPR	Personal exposure monitoring, environmental sampling
Kondo et al (2014)⁷⁴	Air pollution	CBPR	Interviews, personal exposure monitoring, Photovoice
Chensheng (2013)⁷⁵	Environmental contamination	CBPR	Environmental sampling
Masri et al (2021)⁷⁶	Environmental contamination	CBPR	Environmental sampling
McCourt et al (2024)¹⁴⁵	Environmental contamination	CBPR, health impact assessment	Workshops or meetings, interviews, social surveys, consumption diaries, environmental sampling
Ngo et al (2017)¹⁴⁶	Air pollution	Undefined	Environmental sampling, interviews, focus group discussion
Peplow and Augustine (2012)⁷⁷	Environmental contamination	Participatory action research	Specimen collection, workshops or meetings
Robinson et al (2010)⁸²	Human waste	Multibarrier approach	Focus group discussion, interviews, participatory mapping, environmental sampling, survey
Ross et al (2013)¹⁴⁷	Human waste	Participatory rapid sanitation system risk assessment	Workshops or meetings
Thomas et al (2018)¹⁴⁸	Occupational hazards	Body mapping	Focus group discussion, survey
Walker et al (2018)⁸¹	Oil spill	Comparative risk assessment	Survey, workshops or meetings, advisory committee
Weed et al (2024)¹⁴⁹	Environmental contamination	CBPR	Environmental sampling
Vulnerability and hazard assessments (n = 9)
Cronin et al (2004)¹⁰⁰	Natural disaster	Participatory/rapid rural appraisal	Transect walks, hazard mapping, focus group discussion, storytelling
Fleming et al (2023)¹⁰¹	Climate change	Stakeholder engagement	Advisory committee, workshops or meetings, participatory mapping
Grohma et al (2024)¹⁵⁰	Infectious diseases	Community engagement and vulnerability assessment in epidemics	Interviews, focus group discussions, desk review
Hossain et al (2008)⁹⁹	Natural disaster	Participatory risk assessment	Survey, site visit, focus group discussion, participatory mapping, seasonal calendar
Kulatunga et al (2010)⁹⁷	Environmental contamination	Community risk assessment	Transect walks, secondary data collection, workshops or meetings, participatory mapping
Masri et al (2020)⁷⁶	Environmental contamination	CBPR	Environmental sampling
Meyer et al (2018)⁹⁶	Flooding	CBPR, participatory action research, PGIS	Workshops or meetings, GIS, environmental sampling, site visit
van Riet et al (2012)⁹⁵	Natural disaster	CBDRA	Workshops or meetings, transect walks, hazard-specific timeline exercise
Zweig (2017)⁹⁸	Environmental contamination	Community risk assessment	Transect walks, workshops or meetings
Capacity and vulnerability assessments (n = 23)
Ahmed and Kelman (2018)¹⁵¹	Natural disaster	Participatory/rapid rural appraisal	Transect walks, vulnerability and dream mapping, SWOT analysis, social and resource mapping, survey, quantitative measurement
Antwi et al (2015)¹⁵²	Flooding	Community vulnerability assessment	Transect walks, observation, interviews, survey, focus group discussion
Bele et al (2014)¹⁵³	Climate change	Participatory action research	Focus group discussion, interviews, observation
Below et al (2015)¹⁵⁴	Climate change	Participatory/rapid rural appraisal, participatory modeling	Survey, workshops or meetings, focus group discussion
Bhadwal et al (2013)¹⁵⁵	Climate change	Undefined	Interviews, focus group discussion, participatory rural appraisal, analytical hierarchy process
Bitsura-Meszaros et al (2019)¹⁵⁶	Climate change	PGIS	Survey, focus group discussion, participatory mapping
Derbile et al. (2022)¹⁵⁷	Climate change	Participatory/rapid rural appraisal	Interviews, workshops or meetings, survey, focus group discussion
File and Derbile (2020)¹⁵⁸	Climate change	Participatory/rapid rural appraisal, community risk assessment	Interviews, focus group discussion, seasonal calendar
Gumiran et al (2019)¹⁵⁹	Natural disaster	Undefined	Workshops or meetings
Jones et al (2013)¹⁶⁰	Natural disaster	Participatory action research	Workshops or meetings, interviews
Jonsson et al (2012)¹⁶¹	Climate change	Undefined	Workshops or meetings, interviews
Kusratmoko et al (2017)¹⁶²	Natural disaster	PGIS	Participatory mapping, focus group discussion
Linh et al (2022)¹⁶³	Flooding	CBDRA	Interviews, focus group discussion
Noi et al (2015)¹⁶⁴	Climate change	Participatory/rapid rural appraisal	Survey, focus group discussion, interviews
Partidário et al (2022)¹⁶⁵	Fire	Participatory action research	Participatory mapping
Romero et al (2021)¹⁰³	Flooding	Participatory capacities and vulnerabilities assessment	Workshops or meetings
Sales Jr (2009)¹⁶⁶	Climate change	Vulnerability and adaptation assessment	Workshops or meetings, focus group discussion, interviews, case studies, secondary data collection
Santa-Cruz et al (2016)¹⁶⁷	Natural disaster	CBDRA	Survey, workshops or meetings
Schick et al (2018)¹⁶⁸	Climate change	Management of Vulnerability and Risks at Conservation Sites (MARISCO)	Workshops or meetings, participatory mapping
Schneiderbauer et al (2020)¹⁰²	Climate change	CBPR, stakeholder engagement	Workshops or meetings
van Aalst et al (2008)¹⁶⁹	Climate change	Community risk assessment	Survey, focus group discussion, seasonal calendar, transect walks, interviews, participatory mapping, livelihood survey
van der Ven et al (2021)¹⁷⁰	Infectious disease, COVID-19	Concept mapping	Workshops or meetings
Yedinak et al (2021)¹⁷¹	Infectious disease	Participatory modeling	Participatory mapping
Needs assessment (n = 2)
Little et al (2015)⁴⁶	Natural disaster	Stakeholder decision support system	Workshops or meetings, interviews
Muzaffar et al (2019)⁴⁷	Obesity	CBPR	Survey, quantitative measurement
Risk pathway mapping (n = 7)
Alhaji et al (2018)¹⁰⁹	Infectious disease, Rift Valley fever	Participatory epidemiology, participatory/rapid rural appraisal	Specimen collection, interviews, proportional piling, seasonal calendar, triangulation
Gallagher et al (2020)¹⁰⁴	Food security	Participatory modeling	Workshops or meetings
Grace et al (2012)¹⁰⁸	Infectious disease	Participatory risk assessment	Participatory mapping, interviews, focus group discussion, environmental sampling
Henly-Shepard et al (2015)¹⁰⁶	Natural disaster	Participatory modeling	Workshops or meetings
Makita et al (2012)¹⁰⁵	Food safety	Participatory/rapid rural appraisal	Food sampling, interviews
Riddell et al (2019)¹⁰⁷	Natural disaster	Participatory modeling, PGIS	Survey, interviews, workshops or meetings
Wyrwoll et al (2018)¹¹⁰	Drought	Participatory risk assessment	Workshops or meetings
Data-report back (n = 11)
Adams et al (2011)⁸⁶	Environmental contamination	CBPR	Interviews, environmental sampling, workshops or meetings
Brody et al (2018)⁹²	Environmental contamination	CBPR	Interviews, observation
Brody et al (2014)⁹¹	Environmental contamination	CBPR, data report-back	Interviews, focus group discussion
Brody et al (2007)⁸⁵	Environmental contamination	CBPR	Interviews, workshops or meetings
Claudio et al (2018)⁹⁰	Environmental contamination	CBPR	Survey, periodic mailing
Miller et al (2013)⁸⁷	Environmental contamination	CBPR	Specimen collection, environmental sampling, workshops or meetings
Perovich et al (2018)⁹²	Environmental contamination	Data report-back	Interviews, workshops or meetings, environmental sampling
Ramirez-Andreotta et al (2016)⁹³	Environmental contamination	Data report-back, environmental health literacy	Environmental sampling
Thompson et al (2017)⁸⁸	Environmental contamination	CBPR	Workshops or meetings, interviews, home visits
Tomsho et al (2019)⁹⁴	Air pollution, environmental contamination	Data report-back	Workshops or meetings
White et al (2004)¹⁷²	Environmental contamination	Undefined	Workshops or meetings, periodic mailing

Abbreviations: CBDRA, community-based disaster risk assessment; CBPR, community-based participatory research; EHRA, Environmental Health Risk Assessment; GIS, geographic information system; PGIS, patient global impression of severity; SWOT, strengths, weaknesses, opportunities, threats.

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