Improving the Health and Environmental Health Literacy of Professionals: Evaluating the Effect of a Virtual Intervention on Phthalate Environmental Health Literacy

Kathryn S. Tomsho (), Marlee R. Quinn, Zifan Wang, Emma V. Preston, Gary Adamkiewicz, Naima T. Joseph, Blair J. Wylie and Tamarra James-Todd
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Kathryn S. Tomsho: Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Marlee R. Quinn: Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Zifan Wang: Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Emma V. Preston: Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Gary Adamkiewicz: Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Naima T. Joseph: Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, USA
Blair J. Wylie: Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY 10032, USA
Tamarra James-Todd: Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA

IJERPH, 2024, vol. 21, issue 12, 1-13

Abstract: The American College of Obstetricians and Gynecologists provided updated guidance in 2021, recommending that reproductive health professionals should include discussion of environmental exposures with their patients. However, environmental health is seldom included in medical training, with endocrine-disrupting chemicals, such as phthalates—linked to adverse pregnancy outcomes—being among the least discussed. We developed a one-hour virtual educational intervention to train reproductive health professionals on the routes of phthalate exposure, potential associated health impacts, and suggestions on how to discuss exposure reduction with patients. The intervention was designed to include perspectives from patients, scientists, and clinicians. Using a pre/post/post design, we evaluated the impact of the intervention on reproductive health professionals’ phthalate-related reproductive health literacy via a validated environmental health literacy (EHL) scale, their confidence in discussing phthalates, and the frequency of discussions about phthalates with patients. All materials, including the study questionnaires and intervention materials, were administered virtually to reproductive health professionals ( n = 203) currently seeing patients working in the United States. After completing the intervention, reproductive health professionals’ average EHL increased (pre-course: 22.3, post-course: 23.7, 2 months post-course: 24.0), as did their confidence in discussing phthalates with their patients (pre-course: 1% (2/203) reported being quite confident, post-course: 64% (131/203) reported being quite confident, and 2 months post course: 86% (174/203) reported being quite confident). Additionally, the reported frequency of discussions about phthalates with patients rose substantially (pre-course: 0% (0/203) reported usually discussing phthalates with patients, and 2 months post-course: 86% (175/203) reported usually discussing phthalates with patients): In line with the recommendations of the American College of Obstetricians and Gynecologists, this online phthalate educational intervention tool increased EHL among reproductive health professionals and shifted clinical care to include discussion about phthalates, a reproductive toxicant.

Keywords: phthalates; reproductive health; environmental health literacy; intervention; clinical practice; obstetrics; environmental health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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