The Primary Care and Environmental Health e-Learning Course to Integrate Environmental Health in General Practice: Before-and-After Feasibility Study (Preprint)

Abstract

BACKGROUND According to the WHO, environmental exposures are responsible for 12.6 million deaths each year worldwide and contribute to cancer, cardiovascular, respiratory, neurological, and infectious diseases. We designed the Primary care environment and health (PCEH) course both e-learning and presential with the partnership of the Occitanie regional health agency. OBJECTIVE To assess the impact of the e-learning part on participants satisfaction, knowledge, and behavior changes. METHODS It was a before-and-after study. In this 6-hour e-learning course, 4 modules were available: introduction to environmental health (EH), population-based approach (mapping tools, resources), clinical cases and communication tools. From August to September 2021, we recruited 1st year general practice (GP) residents from the University of Montpellier (n=130). The questionnaires used self-assessed Likert scale (1 to 5) to estimate participants’ satisfaction, knowledge improvements for 19 EH risks and procedure to web report EH risks to health authorities, behavior change (to consider the possible effects of the environment on their health and on their patients' health). RESULTS 74 residents completed the e-learning and answered the pre- and post-test questionnaires. Mean satisfaction was 4.0 of 5 (+/-0.9). Knowledge scores of EH risks increased significantly before and after with a mean difference of 30% (p<0.0001) for all parameters. Behavioural scores improved significantly by 18% on participant’s health and by 26% on their patient’s health (p<0.0001). CONCLUSIONS The course improved knowledge and behavior in EH. We need further studies to assess the impact on clinical practice and potential benefits for patients. This course will integrate new modules and will adapt to the needs of the population.