Partnering with Communities to Understand Social Determinants of Health (SDoH) Impacts on Access to Shared...

This study explored the facilitators and barriers of community bike share use in a mid-sized city with high incidence of poverty and racial diversity using a community-based participatory action research (CBPAR) photovoice framework with the Stanford Our Voice (OV) Discovery Tool digital application. Community members participated in one of three community citizen science walks with follow up focus groups facilitated by osteopathic medical student researcher to address "What makes it easy or hard to ride a bike using the bike share?" Twenty-seven diverse community members partnered with four osteopathic medical students exploring vulnerable individuals' lived experiences, beliefs/understanding of the Social Determinants of Health (SDoH) and access to the bike share program. A total of 322 photos and narrative comments from citizen science walk audits developed deductive themes and follow up focus groups informed inductive themes. Themes addressed challenges to access, maintenance, safety in bike transit, comfort, and environment that create barriers to use and increase inequities for lower income and historically underrepresented communities. The use of OV provided photograph, narrative, and geocoded photo location. This novel approach served as an effective tool for community action with city decision makers. The narrative research identified the impact of the barriers, and the photographs and geocoding provided clear descriptions for locations to prioritize change by adding street signs for access and safety, fixing road safety issues or bike maintenance concerns. It actively engaged the community with the city to drive discussions and plans for change in repair systems and infrastructure that also addressed equity and acknowledged the SDoH supporting residents in lower income or historically underrepresented communities. Citizen science engaged community voices, supporting change in city policies and transportation initiatives to support the sustainability of the bike share program.