Air Pollution ExposureVISIONSNCT07713264
Voices Illuminating Solutions for Outdoor Workers' Needs and Safety
A study testing Receive education on heat and air quality health risks and Participate in Photovoice and climate health risk education in people with Air Pollution Exposure, run by Stanford University at 1 site in United States.
Trial summary
The goal for this multidisciplinary randomized controlled trial (RCT) is to actively and meaningfully engage outdoor workers (can include agricultural workers, construction workers, landscaping, wildland firefighters, fire cleanup crews, etc.) and community members in describing the impact of climate change on their… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Air Pollution Exposure
- What is being tested?
- Receive education on heat and air quality health risks and Participate in Photovoice and climate health risk education
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 1 siteUnited States
- Study dates
- 25 Sep 2026to 31 May 2029
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Participants must be 18 years or older.
- Participants must be connected to the San Joaquin Valley, Monterey County, or Kings County as either an outdoor worker or community member.
- Participants must have the capacity to verbally consent in English or Spanish
- Participants must have the ability to walk or otherwise move around their community using the Discovery Tool.
- Have a smartphone capable of loading the Discovery Tool OR willingness to use a TracFone provided by the research team
Who cannot join
- Inability to consent to the study.
- Unable to navigate the Discovery Tool with reasonable technical guidance from the research team.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
Stanford University
Stanford, California, 94306
Manali Patel
About this study
Official title: VISIONS: Voices Illuminating Solutions for Outdoor Workers' Needs and Safety
The goal for this multidisciplinary randomized controlled trial (RCT) is to actively and meaningfully engage outdoor workers (can include agricultural workers, construction workers, landscaping, wildland firefighters, fire cleanup crews, etc.) and community members in describing the impact of climate change on their lives and working conditions in San Joaquin Valley, Kings County, and Monterey County. Participants will be randomly assigned to one of two study arms: (1) the Intervention Group, which will receive bilingual (Spanish and English) Cal/OSHA educational materials and engage in the Our Voice participatory action research (photovoice) method using a bilingual (Spanish and English) mobile application, or (2) the Control Group, which will only receive bilingual (Spanish and English) Cal/OSHA educational materials. Core outcomes will be measured identically across both groups to allow direct comparison of the two approaches. Using the "Our Voice participatory action research method" and Cal/OSHA educational materials, the investigators will learn about participants' attitudes, behaviors, and actions in response to changing climate in the counties and evaluate whether the education and photovoice approach is more impactful than traditional didactic Cal/Osha education only.
Read the detailed description
This study uses a randomized controlled trial (RCT) design with two parallel arms to evaluate whether combining participatory action research with occupational health education produces greater changes in climate-related attitudes, behaviors, and protective actions compared to occupational health education alone. The study targets outdoor workers and community members across California: San Joaquin Valley, Kings and Monterey Counties, regions where outdoor workers face disproportionate exposure to climate-related health hazards including extreme heat and degraded air quality.
Intervention
The Intervention Group will engage in the "Our Voice photovoice program," a community-based participatory action research methodology developed at Stanford University. Our Voice uses a mobile application called the Discovery Tool, which allows participants to document features of their local environment by taking photos and recording written or audio reflections in real time. The app is available in multiple languages, including English and Spanish. Participants in the Intervention Group will complete three sequential activities:
Discovery Tool Training: a live or pre-recorded individual or small group session (by phone, Zoom, or in-person) led by a Stanford RA, orienting participants to the photovoice approach and app use
Discovery Walk: an independent walk in their home or work neighborhood to document environmental features relevant to climate and health using the Discovery Tool
Community Discovery Meeting: a facilitated approximately 2-hour group meeting held within six weeks of the Discovery Walk, where participants collectively review photos, identify common themes, and discuss community assets and challenges they wish to address
Control Both groups will receive bilingual (English and Spanish) Cal/OSHA educational materials covering heat illness prevention, air quality risks, and protective measures for outdoor workers. The Control Group receives these materials as the sole study intervention. The Intervention Group receives the same materials as part of their Community Discovery Meeting.
Randomization Eligible participants will be randomly assigned in a 1:1 ratio to either the Intervention or Control Group using simple randomization via REDCap.
- Conditions
- Air Pollution Exposure
- Being tested
- Receive education on heat and air quality health risks, Participate in Photovoice and climate health risk education
- Keywords
- air quality, San Joaquin Valley
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Receive education on heat and air quality health risksBehavioural
Participants will receive Cal/OSHA educational materials covering heat and air quality risks for outdoor workers [will insert more info (how often, method etc once MP revises protocol].
Participate in Photovoice and climate health risk educationBehavioural
Participants will engage in the full Our Voice photovoice program, including training on the Discovery Tool, a Discovery Walk, attendance at a Community Discovery Meeting, and receive the same Cal/OSHA educational materials [will insert more info (how often, method etc once MP revises protocol].
| Study group | Role | What they receive |
|---|---|---|
| Control | Active comparator | Participants will receive bilingual (Spanish and English) Cal/OSHA educational materials about improving awareness of air quality risks, promoting protective behaviors, and fostering community empowerment. Receives: Behavioral: Receive education on heat and air quality health risks |
| Intervention | Experimental | Participants will receive the same bilingual (Spanish and English) Cal/OSHA educational materials from Control arm but also engage in the Our Voice participatory action research (photovoice) method using a bilingual (Spanish and English) mobile application. Receives: Behavioral: Participate in Photovoice and climate health risk education |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in self-efficacy as assessed by the Individual Community-Related Empowerment (ICRE) Scale.
Each participant will complete the Individual Community-Related Empowerment (ICRE) at baseline, immediately after the intervention photovoice activity or control education activity, and 6 months. The ICRE Scale is an 18-item measure of empowerment capturing the following five dimensions: self-efficacy (personal confidence in capacity to change one's community), intention (desire to engage with or for the community), participation (actual community involvement), motivation (beliefs surrounding community engagement), and critical awareness (perceived seriousness of community issues). Response options are on a five point rating scale ranging from 1 = "strongly agree" (the most favorable perception) to 5= "strongly disagree" (the most unfavorable perception). Lower raw scores indicate greater empowerment.
Measured: Change in self-efficacy from baseline to immediately after the intervention photovoice activity or control education activity and at 6 months
Secondary outcomes (2)
Change in social cohesion and collective efficacy as assessed by the Social Cohesion and Self-Efficacy scale.
Each participant will complete the Social Cohesion and Self-Efficacy scale at baseline, immediately after the intervention photovoice activity or control education activity, and 6 months. The scale includes 6 questions answered on a five point rating scale ranging from 1 = "strongly disagree" (the least favorable perception) to 5= "strongly agree" (the most favorable perception). Higher scores indicate greater social cohesion and self-efficacy.
Measured: Change in social cohesion and collective efficacy from baseline to immediately after the intervention photovoice activity or control education activity and 6 months
Change in climate change hope and agency as assessed by the Climate Change Hope Scale (CCHS).
Each participant will complete the CCHS at baseline, immediately after the intervention photovoice activity or control education activity, and 6 months. The scale consists of 11 statements to which participants respond to on an 8-point scale. The scale goes from -3 (strongly disagree) to 0 (neutral) to 3 (strongly agree) and one last choice of X which means "I do not think climate is changing." Higher scores indicate greater hope.
Measured: Change in climate change hope and agency from baseline to immediately after the intervention photovoice activity or control education activity and 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Jul 2026
- Study start25 Sep 2026
- Primary completion31 Dec 2028 (estimated)
- Study completion31 May 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Air Pollution ExposureStudies of the same condition, open and under way.
- More trials run by Stanford UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Randomized Controlled Trial among 50 outdoor workers across San Joaquin Valley, Kings and Monterey Counties.
- Masking
- Double blind
- Who is masked
- Investigator, Outcomes assessor
- Enrolment
- 50 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Stanford University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Manali Indravadan Patel, Stanford University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07713264
- Sponsor's protocol ID
- 83894
- Acronym
- VISIONS
- Status last verified
- Oct 2026
- First submitted
- 8 Jun 2026
- Last updated
- 8 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Institutional review board did not approve data sharing