Advancing Environmental Health Literacy: Validated Scales of General Environmental Health and Environmental Media-Specific Knowledge, Attitudes and Behaviors

Abstract

Environmental health literacy (EHL) involves understanding and using environmental information to make decisions about health. This study developed a validated survey instrument with four scales for assessing media-specific (i.e., air, food, water) and general EHL. The four scales were created as follows: 1) item generation: environmental health scientists and statisticians developed an initial set of items in three domains: knowledge, attitudes, and behaviors; 2) item review: items were reviewed for face validity; 3) validation: 174 public health students, the exploratory sample, and 98 community members, the test sample, validated the scales. The scales’ factor structure was based on exploratory factor analysis (EFA) and model fit was assessed through confirmatory factor analysis (CFA). For each scale, the final EFA resulted in an independent three-factor solution for knowledge, attitudes, and behaviors. Good fit for the three-factor structure was observed. Model fit for CFA was generally confirmed with fit indices. The scales showed internal consistency with Cronbach’s alpha from 0.63 to 0.70. The 42-item instrument represents an important contribution towards assessing EHL and is designed to enable meaningful engagement between researchers and community members about environmental health. The intended outcome is sustained community–academic partnerships benefiting research design, implementation, translation, dissemination, and community action.

Managing Exacerbations in Thunderstorm Asthma: Current Insights

“…The capacity to recognize and act on environmental threats to health is measured as Environmental Health Literacy (EHL). 83 EHL can be defined as a strategy that can enable individuals and communities to moderate environmental exposures that pose a risk to health outcomes. 84 EHL in its substantive context embraces community and socioeconomic diversity in a hierarchy of knowledge and empowerment to recognize, understand, analyze, evaluate, and respond to environmental health risks to enable and inform mitigation strategies.…”

Knowledge and Beliefs Associated with Environmental Health Literacy: A Case Study Focused on Toxic Metals Contamination of Well Water

“…They also demonstrated increases in specific environmental health skills. Lichtveld et al [12] developed and validated a survey that included scales for general EHL and media-specific (e.g., air, food, water) EHL. Each scale incorporated items that addressed knowledge, attitudes, and behaviors; and the authors asserted that the instrument could serve as a model for similar scales in additional environmental health domains.…”

Selecting Indicators to Monitor and Assess Environmental Health in a Portuguese Urban Setting: A Participatory Approach

“…The meaning of the value of Cronbach’s α depends on the context, but when Cronbach’s α is close to 1.0, it means that the participants’ choices are strongly associated, while values close to 0 suggest that the participants’ choices are highly unrelated to one another. A cutoff of the Cronbach’s α of 0.70 was adopted, taking the view that values above 0.7 are aligned with the inclusion of the indicator within an environmental health monitorization tool [ 16 ].…”

“…Associated with this challenge, comes the need to do so while collecting population’ intelligence through collaborative practices and to support innovation in EH interventions [ 13 , 14 ]. EH indicators are particularly important in monitoring and assessing the environment status and its trends in urban settings [ 15 ], in order to improve interventions, allocate resources, and investigate the effectiveness of health policies [ 16 ]. It is known that the collection of monitoring and surveillance data is a key task for many governmental organizations and industries charged with ensuring the wellbeing of the population [ 17 ].…”