A process for creating data report-back tools to improve equity in environmental health

Abstract

Background Although there is increasing interest in reporting results of environmental research efforts back to participants, evidence-based tools have not yet been applied to developed materials to ensure their accessibility in terms of literacy, numeracy, and data visualization demand. Additionally, there is not yet guidance as to how to formally assess the created materials to assure a match with the intended audience. Methods Relying on formative qualitative research with participants of an indoor air quality study in Dorchester, Massachusetts, we identified means of enhancing accessibility of indoor air quality data report-back materials for participants. Participants (n = 20) engaged in semi-structured interviews in which they described challenges they encountered with scientific and medical materials and outlined written and verbal communication techniques that would help facilitate engagement with and accessibility of environmental health report-back materials. We coupled these insights from participants with best practice guidelines for written materials by operationalizing health literacy tools to produce accessible audience-informed data report-back materials. Results The resulting data report-back materials had a 7th -grade reading level, and between a 4th -8th grade level of overall document complexity. The numeracy skills required to engage with the material were of the lowest demand, and we incorporated best practices for risk communication and facilitating understanding and actionability of the materials. Use of a rigorous assessment tool provides evidence of accessibility and appropriateness of the material for the audience. Conclusions We outline a process for developing and evaluating environmental health data reports that are tailored to inspire risk-reduction actions, and are demonstrably accessible in terms of their literacy, numeracy, and data visualization demand. Adapting health literacy tools to create and evaluate environmental data report-back materials is a novel and evidence-based means of ensuring their accessibility.

Integrating participant feedback and concerns to improve community and individual level chemical exposure assessment reports

“…The key differences between the prototype report pages were the community report centered around broad descriptions that reduced the number of technical terms and complex sentences, and contained more graphics, whereas the individual reports were focused on specific chemical categories and therefore contained more terminology that participants may have been unfamiliar with. Similar with the findings from this study, previous research has shown that barriers to understanding scientific materials, even if they were geared for a public audience, include insufficiently explained terminology, and complex sentence structures [ 38 ]. Thus, the revised reports reduced the use of technical terms when possible and the overall reading level, and used graphics to increase comprehension [ 39 ].…”

Report-Back of Personal Air Sampling Results and Study Participants’ Perceived Knowledge, Attitudes, and Awareness of Air Pollution

“…who also engaged research participants to develop accessible report-back reports of indoor air quality data. 10 Given that personal air monitors generate information regarding times, locations, and activities associated with increased exposure, report-back may provide actionable information to guide personalized avoidance or intervention strategies Our study does have limitations that should be considered, including the limited racial diversity of EcoMAPPE participants and the completion of the follow-up questionnaire shortly after receiving the report-back document. In addition, adolescent participation rates were less than one-third of the total enrolled, likely due to incomplete or out-of-date contact information for some adolescent participants.…”

Cohort profile: the Environmental Reproductive and Glucose Outcomes (ERGO) Study (Boston, Massachusetts, USA) — a prospective pregnancy cohort study of the impacts of environmental exposures on parental cardiometabolic health

“…In June 2020, pregnant participants and those within 1 year postpartum completed a supplemental COVID-19 impact questionnaire, querying pandemic-related stress; infection history and precautions; and the Edinburgh Postnatal Depression Scale (EPDS) 96 97. Between May 2021 and August 2022, we deployed an Environmental Health Literacy (EHL) Questionnaire to ERGO participants who were at least a year postpartum, as part of a Harvard National Institute for Environmental Health Sciences centre-funded pilot study (P30ES000002) 98. The EHL Questionnaire included sections related to participants’ views on the environment (eg, phthalate exposure) and reproductive health, comfort with medical communications and personal health habits.…”