A Scoping Review of Maternal and Child Health Clinicians Attitudes, Beliefs, Practice, Training and Perceived Self-Competence in Environmental Health

Abstract

Clinicians regularly assess, diagnose and manage illnesses which are directly or indirectly linked to environmental exposures. Yet, various studies have identified gaps in environmental assessment in routine clinical practice. This review assessed clinicians’ environmental health practices, attitudes and beliefs, and competencies and training. Relevant articles were sought using a systematic search strategy using five databases, grey literature and a hand search. Search strategies and protocols were developed using tailored mesh terms and keywords. 43 out of 11,291 articles were eligible for inclusion. Clinicians’ attitudes and beliefs towards environmental health and routine clinical practice were generally positive, with most clinicians believing that environmental hazards affect human health. However, with the exception of tobacco smoke exposure, environmental health assessment was infrequently part of routine clinical practice. Clinicians’ self-competence in environmental assessment was reported to be inadequate. Major challenges were the time required to complete an assessment, inadequate training and concerns about negative patients’ responses. Clinicians have strong positive attitudes and beliefs about the importance of environmental health assessments. However, more concerted and robust strategies will be needed to support clinicians in assuming their assessment and counselling roles related to a wider range of environmental hazards.

Perception of Environmental Risks and Behavioral Changes during Pregnancy: A Cross-Sectional Study of French Postpartum Women

“…Few pregnant women were counselled about the environment by health providers. Several studies have shown that perinatal health providers do not generally ask patients about their environmental exposure, except for the consumption of toxic substances [30,31]. An American survey found that less than 20% of obstetricians routinely interview their patients about their environment [32].…”

“…An American survey found that less than 20% of obstetricians routinely interview their patients about their environment [32]. The difficulties most frequently cited were the lack of training and knowledge in environmental health, the lack of evidence-based information, the short duration of consultations [30,31,32,33], the fear of patient reactions, and the lack of solutions [33].…”

Environmental Health Knowledge, Attitudes, and Practices of French Prenatal Professionals Working with a Socially Underprivileged Population: A Qualitative Study

“…Contrary to tobacco exposure during pregnancy, which remains the principal risk referred to by perinatal health professionals [6], exposure to emergent risks is not mentioned in the existing French existing guidelines [1] but in American’s [7].…”

How to Educate Pregnant Women about Endocrine Disruptors?

“…The adaption of education to these determinants is a necessity [19]. Health professionals ought to perform educational tasks, but consultation time, educational tools, and psychosocial training are insufficient [23].…”