Integrating Environmental Health Into Medical Education

Gehle, Kimberly; Crawford, Jewel L.; Hatcher, Michael T.

doi:10.1016/j.amepre.2011.06.007

Cited by 58 publications

(41 citation statements)

References 23 publications

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“…While researchers gave participants recommendations for individual actions to reduce chemical exposures, they recognized that some participants, particularly low-income people and workers, may not be able to make changes. In medical studies, participants can be referred to healthcare agencies for follow-up, but environmental researchers have trouble referring participants to public health agencies or physicians due to an absence of environmental health training among most health professionals (Gehle et al 2011; Stotland et al 2014). While one study we followed had an established relationship with a county health department, and a protocol in place to follow up with participants with unusually high lead exposures, such relationships are rare.…”

Section: Discussionmentioning

confidence: 99%

Researcher and institutional review board perspectives on the benefits and challenges of reporting back biomonitoring and environmental exposure results

Ohayon

Cousins

Brown

et al. 2017

Environmental Research

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As the number of personal exposure studies expands and trends favor greater openness and transparency in the health sciences, ethical issues arise around reporting back individual results for contaminants without clear health guidelines. Past research demonstrates that research participants want their results even when the health implications are not known. The experiences of researchers and institutional review boards (IRBs) in studies that have reported personal chemical exposures can provide insights about ethical and practical approaches while also revealing areas of continued uncertainty. We conducted semi-structured interviews with 17 researchers and nine IRB members from seven personal exposure studies across the United States to investigate their experiences and attitudes about the report-back process. Researchers reported multiple benefits of report-back, including increasing retention and recruitment, advancing environmental health literacy, empowering study participants to take actions to reduce exposures, encouraging shifts in government and industry practices, and helping researchers discover sources of exposure through participant consultation. Researchers also reported challenges, including maintaining ongoing contact with participants, adopting protocols for notification of high exposures to chemicals without health guidelines, developing meaningful report-back materials, and resource limitations. IRB members reported concern for potential harm to participants, such as anxiety about personal results and counterproductive behavior changes. In contrast, researchers who have conducted personal report-back in their studies said that participants did not appear overly alarmed and noted that worry can be a positive outcome to motivate action to reduce harmful exposures. While key concerns raised during the early days of report-back have been substantially resolved for scientists with report-back experience, areas of uncertainty remain. These include ethical tensions surrounding the responsibility of researchers to leverage study results and resources to assist participants in policy or community-level actions to reduce chemical exposures, and how to navigate report-back to vulnerable populations.

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Section: Discussionmentioning

confidence: 99%

Researcher and institutional review board perspectives on the benefits and challenges of reporting back biomonitoring and environmental exposure results

Ohayon

Cousins

Brown

et al. 2017

Environmental Research

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“…These academic efforts have built upon conceptual frameworks from the fields of health literacy and risk communication to define the progression of understanding from basic knowledge to comprehension and application (Colucci-Gray et al 2006; Guidotti 2013; Nutbeam 2008). Addressing gaps in education and promoting EHL among health care professionals via curricula and educational module development is another major theme that emerged from the literature review (Barnes et al 2010; Gehle et al 2011). …”

Section: Defining the Scope And Purpose Of Environmental Health Litermentioning

confidence: 99%

The Emergence of Environmental Health Literacy—From Its Roots to Its Future Potential

Finn

OʼFallon²

2017

Environ Health Perspect

173

183

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Background:Environmental health literacy (EHL) is coalescing into a new subdiscipline that combines key principles and procedural elements from the fields of risk communication, health literacy, environmental health sciences (EHS), communications research, and safety culture. These disciplines have contributed unique expertise and perspectives to the development of EHL. Since 1992, the National Institute of Environmental Health Sciences (NIEHS) has contributed to the evolution of EHL and now seeks to stimulate its scientific advancement and rigor.Objectives:The principal objective of this article is to stimulate a conversation on, and advance research in, EHL.Discussion:In this article, we propose a definition of and conceptual framework for EHL, describe EHL in its social and historical context, identify the complementary fields and domains where EHL is being defined and implemented, and outline a research agenda. Extensive reviews of web and literature searches indicate that the concept of EHL is evolving rapidly, as are the definitions of its scope and inquiry. Although several authors have outlined different frameworks, we believe that a more nuanced model based on Bloom’s taxonomy is better suited to EHL and to future research in this area.Conclusions:We posit that EHL can potentially benefit the conduct and outcomes of community-engaged and health disparities EHS research and can ensure that the translation of research findings will lead to greater understanding of specific risks, reduction of exposures, and improvement of health outcomes for individuals and communities. We provide four recommendations to advance work in EHL.Citation:Finn S, O’Fallon L. 2017. The emergence of environmental health literacy—from its roots to its future potential. Environ Health Perspect 125:495–501; http://dx.doi.org/10.1289/ehp.1409337

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“…It has been estimated that environmental causes account for about 25% of global related diseases [Gehle 2011]. Global warming and an increased level of pollutants on a world-wide basis are changing the biometric characteristics and the environment in various geographical locations in an unpredicted manner.…”

Section: Global Healthmentioning

confidence: 99%