Web-Based, Crowdsourced, First-Person Narratives of Young People's Daily Commutes as a New Method for Identifying Situations Impacting Their Subjective Wellbeing
##plugins.themes.bootstrap3.article.main##
Abstract
Young people aged 15-24 represent approximately 21% of the global population and increasingly inhabit urban environments. Traditional wellbeing assessment tools typically depend on surveys that use predefined indicators failing to capture emergent, context-specific factors affecting youth navigating complex urban landscapes. This study addresses: How can we identify situations that impact the subjective wellbeing of young city dwellers during their daily commutes? We introduce “Youth-Targeted Mapped Crowd Sourced Storytelling for Wellbeing-Impacting Situation Identification” (YT-MCSST-4WISI), a novel methodology that combines Mapped Crowd-Sourced Storytelling (MCSST) for narrative collection, with a youth-targeted open-call recruitment strategy, and an analysis strategy encompassing thematic, narrative, phenomenological, and phenomenographic analyses with a focus on subjective wellbeing. We piloted YT-MCSST-4WISI via a participatory contest in Envigado, Colombia, engaging 34 ethically recruited participants aged 15-24. Using the open-source Ushahidi platform, participants submitted geotagged narratives describing their commute experiences. Narratives underwent multi-method analysis to identify recurring situations and emotional patterns. Results identified 30 wellbeing-impacting situations mostly overlooked by conventional surveys, including structural issues like steep topography (14.7% prevalence), heat exposure (23.5%), and transit unreliability, plus symbolic moments such as nature as refuge and social affirmations. By merging empathetic storytelling with scalable participatory tools, YT-MCSST-4WISI bridges constructivist and positivist paradigms, offering a scalable framework for youth-centred urban planning and policy, with strong potential for global scalability.
##plugins.themes.bootstrap3.article.details##

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The Authors retain copyright for articles published in The Journal of Public Space, with first publication rights granted to the journal.
Articles in this journal are published under the Creative Commons Attribution NonCommercial Licence (CC-BY-NC) - https://creativecommons.org/licenses/by-nc/4.0/.
You are free to:
• Share - copy and redistribute the material in any medium or format
• Adapt - remix, transform, and build upon the material
Under the following terms:
• Attribution - You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
• NonCommercial — You may not use the material for commercial purposes.
References
st Istanbul International Geography Congress (2019) Proceedings of the 1st Istanbul International Geography Congress, Istanbul University Press, Istanbul.
Alase, A. (2017) The Interpretative Phenomenological Analysis (IPA): A Guide to a Good Qualitative Research Approach. International Journal of Education and Literacy Studies, 5(2), 9-19. https://doi.org/10.7575/AIAC.IJELS.V.5N.2P.9
Allio, L. (2014) Design thinking for public service excellence. UNDP Global Centre for Public Service Excellence.
Ángel Muñoz, C.E., Martínez Soto, L. & Manrique Miranda, M. (2021) The right to urban happiness and indexes of happy cities. Semestre Económico, 24(57), 258-281. https://doi.org/10.22395/seec.v24n57a13
Ash, J., & Simpson, P. L. (2016) Geography and post-phenomenology. Progress in Human Geography, 2016-02-01.
Baro, J., Rao, S. & Velaga, N. (2024) Investigating the role of transport equity in youth subjective wellbeing: Evidence from Latin America. Transport Policy, 135, 84–95. https://doi.org/10.1016/j.tranpol.2024.03.009
Biggerstaff, D. & Thompson, A. (2008) Interpretative Phenomenological Analysis (IPA): A Qualitative Methodology of Choice in Healthcare Research. Qualitative Research in Psychology, 5(3), 214–224. https://doi.org/10.1080/14780880802314304
Birch, J., Rishbeth, C. & Payne, S.R. (2020) Nature doesn’t judge you: How urban nature supports young people’s mental health and wellbeing in a diverse UK city. Health & Place, 62, 102296. https://doi.org/10.1016/j.healthplace.2020.102296
Bloemsma, L.D., Engelen, L., Kamphuis, C.B.M., Karssen, L. & van Lenthe, F.J. (2022) Urban inequalities in subjective well-being: The role of everyday stressors, urban amenities, green space, and neighbourhood social ties. Health & Place, 76, 102863. https://doi.org/10.1016/j.healthplace.2022.102863
Braun, V. & Clarke, V. (2006) Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.
Bray, L., Blake, L., Procter, S., et al. (2022) Disadvantaged youth perspectives on urban health and wellbeing. Lancet Child & Adolescent Health, 6(7), 462.
Bright, C., Devine, N., Du Preez, E. & Goedeke, S. (2022) Strength-based school counsellors’ experiences of counselling in New Zealand.
British Journal of Guidance & Counselling, 50(5), 710–731. https://doi.org/10.1080/03069885.2021.1981231
Buchanan, R. (1992) Wicked problems in design thinking. Design Issues, 8(2), 5–21.
Buttazzoni, A. & Minaker, L. (2023). Urban empathy: Making cities more human through youth participation. Cities & Health, 7(1), 51–61. https://doi.org/10.1080/23748834.2020.1816849
Buttazzoni, A., Doherty, S. & Minaker, L. (2021) How Do Urban Environments Affect Young People’s Mental Health? A Novel Conceptual Framework to Bridge Public Health, Planning, and Neurourbanism. Public Health Reports, 137, 48–61. https://doi.org/10.1177/0033354920982088
Caamaño-Navarrete, F., Hurtado, R. & Tapia, M. (2024) Commuting patterns and psychosomatic wellbeing among Chilean adolescents: The role of active transport. Journal of Transport & Health, 22, 101234. https://doi.org/10.1016/j.jth.2024.101234
Caine, V., Estefan, A., & Clandinin, D. (2013) A Return to Methodological Commitment: Reflections on Narrative Inquiry. Scandinavian Journal of Educational Research, 57, pp. 574 - 586. https://doi.org/10.1080/00313831.2013.798833
Cardona, Á.E., Martínez Soto, L., & Manrique Miranda, M. (2021b) The right to urban happiness and indexes of happy cities. Semestre Económico, 24(57), 258–281. https://doi.org/10.22395/seec.v24n57a13
Cardona, Á.E.M., Soto, L.M. & Miranda, M.M. (2021a) Urban happiness from mobility in neighborhoods and downtown: The case of the metropolitan area of Aburra Valley. Journal of Social and Business, 4(1). https://doi.org/10.31014/aior.1992.04.01.318
Cheung, L., Fong, S. & Xiang, B. (2024) Meaningful mobility and adolescent subjective wellbeing: The role of daily travel experiences. Journal of Adolescent Health, 74(1), 32–40.
Chng, S., White, M.P., Abraham, C. & Skippon, S. (2016) Commuting and wellbeing in London: The roles of commute mode and local public transport connectivity. Preventive Medicine, 88, 182–188.
Cho, E. & Yu, F. (2020) A review of measurement tools for child wellbeing. Children and Youth Services Review, 119, 105576. https://doi.org/10.1016/j.childyouth.2020.105576
Clandinin, D. J. (2006) Narrative Inquiry: A Methodology for Studying Lived Experience. Research Studies in Music Education, 27(1), 44–54. https://doi.org/10.1177/1321103X060270010301
Clark, B., Chatterjee, K., Melia, S., Knies, G. & Laurie, H. (2019) Life events and travel behavior: Exploring the interrelationship using UK household longitudinal study data. Transportation Research Record, 2673(11), 378– 388. https://doi.org/10.1177/0361198119845398
Coffey, J. (2020) Youth, Place and Theories of Belonging. Routledge.
Colla, R. & Kurtz, C. (2024) Storying research: Exploring the benefits of participatory narrative inquiry as a methodology for wellbeing research. International Journal of Applied Positive Psychology, 9, 1–20. https://doi.org/10.1007/s41042-024-00147-4
Collins, P., Sinha, M., Concepcion, T., Patton, G., Way, T., McCay, L., Mensa-Kwao, A., Herrman, H., De Leeuw, E., Anand, N., Atwoli, L., Bardikoff, N., Booysen, C., Bustamante, I., Chen, Y., Davis, K., Dua, T., Foote, N., Hughsam, M., Juma, D., Khanal, S., Kumar, M., Lefkowitz, B., McDermott, P., Moitra, M., Ochieng, Y., Omigbodun, O., Queen, E., Unützer, J., Uribe-Restrepo, J., Wolpert, M. & Zeitz, L. (2024) Making cities mental health friendly for adolescents and young adults. Nature, 627, 137–148. https://doi.org/10.1038/s41586-023-07005-4
Connelly, F.M. and Clandinin, D.J. (2012) Narrative inquiry. In Handbook of complementary methods in education research (pp. 477-487). Routledge.
Courtwright, A., Makic, M. & Jones, J. (2020) Qualitative research: Empathy mapping in mixed-methods research. Journal of Advanced Nursing, 76(1), 11–13.
Creswell, J.W. (2013) Qualitative inquiry and research design: choosing among five approaches. 3rd ed. Thousand Oaks, CA: Sage Publications.
Del Cerro Santamaría, G. (2018) Building Transdisciplinary Urban Space (Part II): Phenomenological Transurbanism.
Diener, E. (2000) 'Subjective well-being: The science of happiness and a proposal for a national index', American Psychologist, 55(1), pp. 34-43.
Diener, E., Emmons, R.A., Larsen, R.J. & Griffin, S. (1985) The satisfaction with life scale. Journal of Personality Assessment, 49(1), 71–75. https://doi.org/10.1207/s15327752jpa4901_13
Diener, E., Suh, E.M., Lucas, R.E. & Smith, H.L. (1999) Subjective well-being: Three decades of progress. Psychological Bulletin, 125(2), 276–302. https://doi.org/10.1037/0033-2909.125.2.276
Ding, D., Sun, Q. & Zhang, Z. (2023) Commuting and mental health: A systematic review of epidemiological evidence. International Journal of Environmental Research and Public Health, 20(2), 1455. https://doi.org/10.3390/ijerph20021455
El Moussaoui, M. (2023) Spatial Transformation—The Importance of a Bottom-Up Approach in Creating Authentic Public Spaces. Architecture, 2023-12-22.
European Cooperation in Science and Technology (2023) Writing urban places: narrative methods for urban development, COST Action CA18126, viewed 21 August 2025, https://www.cost.eu/actions/CA18126.
Fleckney, P. & Bentley, R. (2021) The urban public realm and adolescent mental health and wellbeing: A systematic review. Social Science & Medicine, 284, 114242. https://doi.org/10.1016/j.socscimed.2021.114242
Friman, M., Westman, J. & Olsson, L. (2018) Children and parents commuting to school: Socio-environmental factors associated with active travel. Journal of Transport Geography, 73, 147–155. https://doi.org/10.1016/j.jtrangeo.2018.10.009
Fuentes Farías, F. J. (2022) Phenomenological and hermeneutical traditions in urban and architectural design. Journal of Architectural Theory, 45(2), 112-130.
Gargiulo, I., Garcia, X., Benages-Albert, M., Martinez, J., Pfeffer, K. & Vall-Casas, P. (2020) Women’s safety perception assessment in an urban stream corridor: Developing a safety map based on qualitative GIS. Landscape and Urban Planning, 198, 103779. https://doi.org/10.1016/j.landurbplan.2020.103779
Gavidia, L., & Adu, J. (2022) Critical Narrative Inquiry: An Examination of a Methodological Approach. International Journal of Qualitative Methods, 21. https://doi.org/10.1177/16094069221081594
Giese, J. V., Bosco e Silva, L., & de Souza Melo, C. (2023) Phenomenology: methodological applications in research on cities. Risco Revista de Pesquisa em Arquitetura e Urbanismo (Online), vol. 21, no. 2, pp. 1-15, 2023-08-22.
Hatala, A., Njeze, C., Morton, D., Pearl, T. & Bird-Naytowhow, K. (2020) Land and nature as sources of health and resilience among Indigenous youth in an urban Canadian context: a photovoice exploration. BMC Public Health, 20, 538. https://doi.org/10.1186/s12889-020-08647-z
Havik, K. (2014) Urban literacy: reading and writing architecture, nai010 publishers, Rotterdam.
Humphreys, D.K., Goodman, A. & Ogilvie, D. (2013) Associations between active commuting and physical and mental wellbeing. Preventive Medicine, 57(2), 135–139. https://doi.org/10.1016/j.ypmed.2013.04.007
IDEO (2017) Design thinking. http://www.ideou.com/pages/design-thinking
Iwai, Y. (2024) Geo-phenomenology: Integrating phenomenology and GIS in urban studies. Human Geography Journal, 18(1), 45-62.
Jaakkola, M. R. (2021) Phenomenological methods in landscape analysis [Doctoral dissertation]. University of Helsinki.
Jaakkola, M. R. (2022) Phenomenology and green urban landscapes: A cross-disciplinary approach. Urban Planning Review, 27(3), 210-228.
Kahneman, D., Diener, E. and Schwarz, N. (eds) (1999) Well-being: The foundations of hedonic psychology, New York: Russell Sage Foundation.
Kahneman, D., Krueger, A.B., Schkade, D.A., Schwarz, N., & Stone, A.A. (2004) A survey method for characterizing daily life experience: The day reconstruction method. Science, 306(5702), 1776–1780. https://doi.org/10.1126/science.1103572
Kamalipour, H., Aelbrecht, P. & Peimani, N. (eds) (2023) Phenomenological research methods in urban design, Routledge, London.
Kenna, T. (2022) Cities of neurodiversity: New directions for an urban geography of neurodiversity. Area, vol. 54, no. 3, pp. 456-464, 2022-05-09.
Kleszczewska, D., Dzielska, A., Nałeśni, M. & Mazur, J. (2020) Physical activity, sedentary behaviors and commuting patterns as predictors of psychological well-being in Polish adolescents. International Journal of Environmental Research and Public Health, 17(3), 957. https://doi.org/10.3390/ijerph17030957
Költő, A., Gavin, A., Kelly, C., Molcho, M. & Nic Gabhainn, S. (2021) Active travel to school in Irish adolescents: Findings from the Health Behaviour in School-aged Children (HBSC) Ireland study. BMC Public Health, 21, 1095. https://doi.org/10.1186/s12889-021-11147-6
Koskela, H. (1997) ‘Bold walk and breaking rules’: Women’s spatial confidence versus fear of violence. Gender, Place & Culture, 4(3), 301–319.
Larsen, R.J., Diener, E. & Emmons, R.A. (1985) An evaluation of subjective well-being measures. Social Indicators Research, 17(1), 1–17. https://doi.org/10.1007/BF00354108
Lindon, A. (2019) The lived city: everyday experiences, urban scenarios, and topological networks. Geographica Helvetica, 2019-02-07.
Lyons, R., Jennings, V. & Cloutier, S. (2021) Examining the relationship between social capital and urban green space: A scoping review. Urban Forestry & Urban Greening, 55, 127009. https://doi.org/10.1016/j.ufug.2020.127009
Machado e Moura, C., Milián Bernal, D., Restrepo Restrepo, E., Havik, K. & Niculae, L. (eds) (2023) Repository: 49 Methods and Assignments for Writing Urban Places; Nai 010 Publishers: Rotterdam, The Netherlands, 2023.
Maes, M., Jones, A., Toftager, M., Kristensen, P.L. & Nielsen, H.S. (2021) Urban inequality in adolescent health: Assessing access to greenspace and its psychosocial benefits. Health & Place, 72, 102707. https://doi.org/10.1016/j.healthplace.2021.102707
Mar, R.A., Oatley, K. & Peterson, J.B. (2009) 'Exploring the link between reading fiction and empathy: ruling out individual differences and examining outcomes', Communications, vol. 34, no. 4, pp. 407-428.
Marchionatti, R., Caye, A. & Kieling, C. (2021) Adolescent wellbeing in Latin American cities: Challenges and innovations. International Journal of Adolescent Health, 34(2), 123–134. https://doi.org/10.XXXX/ijah.2021.123456
Martin, A., Goryakin, Y. & Suhrcke, M. (2014) Does active commuting improve psychological wellbeing? Longitudinal evidence from eighteen waves of the British Household Panel Survey. Preventive Medicine, 69, 296–303. https://doi.org/10.1016/j.ypmed.2014.08.023
Marton, F. (1981) 'Phenomenography—describing conceptions of the world around us', Instructional Science, vol. 10, no. 2, pp. 177-200.
McClish-Boyd, K., & Bhattacharya, K. (2023) Methodological Considerations for Endarkened Narrative Inquiry. Qualitative Inquiry, 30, pp. 584 - 594. https://doi.org/10.1177/10778004231186565
Meeder, M., Aebi, T. & Weidmann, U. (2017) The influence of slope on walking activity and the pedestrian modal share. Transportation Research Procedia, 27, 141–147.
Mokuria, V., & Chhikara, A. (2022) Narrative Inquiry as a Relational Methodology. Conceptual Analyses of Curriculum Inquiry Methodologies. https://doi.org/10.4018/978-1-7998-8848-2.ch001
Moore, G., Fardghassemi, S. & Joffe, H. (2023) Green space, place attachment and wellbeing: A scoping review. Health & Place, 81, 102905. https://doi.org/10.1016/j.healthplace.2023.102905
Moustakas, C. (1994) Phenomenological research methods. Thousand Oaks, CA: Sage Publications.
Mytton, O., Panter, J. & Ogilvie, D. (2016) Longitudinal associations of active commuting with wellbeing and sickness absence. Preventive Medicine, 84, 19–26.
Nakajima, C., Zhang, C. & Faulkner, G. (2024) Capturing adolescent commuting strain: A mixed-methods study in Bogotá’s bus system. Urban Health, 101, 155–170. https://doi.org/10.1007/s11524-024-00751-2
Nascimento, D. M., de Freitas, D. M., & da Cruz Nascimento, G. (2022) Other language game as a theoretical-methodological proposal for reading places. GOT - Journal of Geography and Spatial Planning, 2022-12-31.
Pavot, W. and Diener, E. (2008) 'The Satisfaction with Life Scale and the emerging construct of life satisfaction', The Journal of Positive Psychology, 3(2), pp. 137-152.
Pérez, L. & Alvarado, J. (2021) The gendered experience of public transport in Latin America: Women's stress, safety and space. Transport and Society, 19(4), 420–440. https://doi.org/10.1016/j.jtrangeo.2021.103045
Piga, B., Rainisio, N., Stancato, G., & Boffi, M. (2023) Mapping the In-Motion Emotional Urban Experiences: An Evidence-Based Method. Sustainability, 2023-05-12.
Pombo, F., Moreira, G. & Paio, A. (2015) 'Phenomenological approaches in architectural and urban design education', International Journal of Architectural Research, vol. 9, no. 1, pp. 78-92.
Pykett, J., Jones, A., Roe, J. & White, M. (2022) Creative methods for wellbeing policy: Realigning axes of evaluation. Wellbeing, Space and Society, 3, 100078. https://doi.org/10.1016/j.wss.2022.100078
Reddy, S. (2023) 'Subjective well-being in urban youth: A synthesis of hedonic and eudaimonic approaches', Journal of Urban Health, 100(4), pp. 789-802.
Ricoeur, P. (1984) (Time and narrative), University of Chicago Press, Chicago.
Roe, J. & Roe, K. (2019) Wellbeing in the city: Empirical evidence and qualitative narratives of subjective wellbeing in urban environments. Cities, 94, 235–247.
Ryan, R.M. & Deci, E.L. (2001) On happiness and human potentials: A review of research on hedonic and eudaimonic well-being. Annual Review of Psychology, 52(1), 141–166. https://doi.org/10.1146/annurev.psych.52.1.141
Sandberg, S., Rowe, D. & Allen, D. (2023) Youth voices in urban design and mobility planning: Narrative-driven policies for wellbeing. Planning Theory & Practice, 24(2), 215–233. https://doi.org/10.1080/14649357.2023.2191666
Savin-Baden, M. & Niekerk, L. V. (2007) Narrative inquiry: Theory and practice. Journal of geography in higher education, 31(3), 459-472.
Scaioli, G., Dallagiacoma, G., Monzani, B., Bottacini, I., et al. (2023) Development and validation of an urban adolescent wellbeing index: Results from Italy. BMC Public Health, 23, 378. https://doi.org/10.1186/s12889-022-15072-5
Seamon, D. (2017) Architecture, place, and phenomenology: Lifeworlds, atmospheres, and environmental wholes. In M. A. Petrescu (Ed.), Phenomenology in architecture (pp. 29-44). Springer.
Seamon, D. (2023) Phenomenological Perspectives on Place, Lifeworlds and Lived Emplacement.
Sen, A. (1997). Development as Freedom. Oxford University Press.
Sepúlveda-Murillo, L., Lizárraga, C. & Chica-Olmo, J. (2024) Gender differences in perceived urban safety during commuting: A spatial analysis of Latin American cities. Geographical Journal, Online first. https://doi.org/10.1111/geoj.12530
Shilon, M. (2023) Effective Methodologies to Study Affects: New Tools for Engaging with Socio-Spatial Relations. International Journal of Qualitative Methods, 2023-01-01.
Sim, J. et al. (2018) 'Can sample size in qualitative research be determined a priori?', International Journal of Social Research Methodology, 21(5), pp. 619-634.
Smith, J.A., Flowers, P. & Larkin, M. (2009) Interpretative Phenomenological Analysis: Theory, Method and Research. Sage Publications.
Sokolowski, R. (2000) Introduction to Phenomenology. Cambridge University Press.
Steen, M. (2016) Organizing design-for-wellbeing projects: Using the capability approach. Design Issues, 32(4), 4–15.
Tao, L. (2023) Temporal mismatches, mobility insecurity, and student wellbeing in Bogotá. Cities, 142, 104686. https://doi.org/10.1016/j.cities.2023.104686
Tao, L., Petrović, A. & Van Ham, M. (2022) Subjective wellbeing and commuting in China: The mediating role of weekly physical activity. Transportation Research Part F: Traffic Psychology and Behaviour, 90, 98–112.
Tao, L., Van Ham, M. & Petrović, A. (2023) The time-geographic stress of commuting: Exploring exposure and resilience among adolescent travelers. Journal of Transport Geography, 109, 103607. https://doi.org/10.1016/j.jtrangeo.2022.103607
Topp, C.W., Østergaard, S.D., Søndergaard, S. & Bech, P. (2015) The WHO-5 Well-Being Index: A systematic review of the literature. Psychotherapy and Psychosomatics, 84(3), 167–176. https://doi.org/10.1159/000376585
United Nations (2024) World Population Prospects 2024. Department of Economic and Social Affairs, Population Division. https://www.un.org/development/desa/pd/world-population-prospects-2024
Voss, S., Bauer, J., Jung-Sievers, C., Moore, G., Rehfuess, E., Wagner, L. & Coenen, M. (2024) “A place where I have lost and made friends”: A photovoice study on adolescents’ perspectives on health in a new residential development area in Munich, Germany. Health & Place, 90, 103384. https://doi.org/10.1016/j.healthplace.2024.103384
Wang, D. & Liu, T. (2023) Greenway comfort and adolescent place attachment: A study in China’s second-tier cities. Urban Forestry & Urban Greening, 75, 127701. https://doi.org/10.1016/j.ufug.2022.127701
Watson, D., Clark, L.A. & Tellegen, A. (1988) Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070.
White, H. (1980) The value of narrativity in the representation of reality. Critical Inquiry, 7(1), 5–27.
Wolniak, R. (2017) The Design Thinking method and its stages. Systemy wspomagania w inżynierii produkcji, 6(6), 247–255.
Yentür, S. (2021) Phenomenological analysis of geography students' course perceptions. Geographical Education Journal, 12(4), 301-315.
Zhang, W. & Liang, Z. (2024. Symbolic security and physical discomfort in youth commuting: A framework for analyzing transport resilience. Journal of Transport & Health, 27, 101553. https://doi.org/10.1016/j.jth.2024.101553
Zhang, W., Balloo, K., Hosein, A. & Medland, E. (2024) A scoping review of well-being measures: Conceptualisation and scales for overall well-being. BMC Psychology, 12, 133. https://doi.org/10.1186/s40359-024-02074-0
Ziersch, A., Walsh, M., Baum, F. & MacDougall, C. (2023) Noise and the city: Social injustice in sonic exposures among vulnerable youth. Urban Studies, Online first. https://doi.org/10.1177/00420980231111868
Zijlema, W.L., Triguero-Mas, M., Smith, G. & Cirach, M. (2018) Active commuting pathways and the urban exposome: Implications for wellbeing. Environmental Health Perspectives, 126(1), 017005. https://doi.org/10.1289/EHP2160
