Translating knowledge about environmental health to practitioners: are we doing enough?

Area of Science:

• Pediatric Environmental Health
• Translational Science
• Healthcare Provider Education

Background:

• Children frequently encounter environmental exposures requiring medical attention.
• A national network of pediatric environmental health specialty units aims to improve prevention.
• The effectiveness of these specialized units as a translational resource remains unevaluated.

Purpose of the Study:

• To assess the effectiveness of pediatric environmental health specialty units.
• To identify knowledge and self-efficacy gaps among healthcare providers regarding environmental hazards.
• To evaluate the current capacity of healthcare providers in managing pediatric environmental exposures.

Main Methods:

• A qualitative systematic review of previous healthcare provider capacity assessments was conducted.
• A self-administered survey was distributed to members of the Michigan chapter of the American Academy of Pediatrics.
• Surveys were mailed twice between October 2007 and January 2008, achieving a 39.4% response rate.

Main Results:

• Systematic review identified 8 studies, all using self-report methods.
• Consistent gaps in self-efficacy and knowledge regarding environmental hazards were found nationally and in state samples.
• Respondents reported high confidence with lead and secondhand smoke, but lower confidence with pesticides, mercury, mold, PCBs, and air pollution (P < 0.0001).
• Pediatricians referred patients to specialized clinics but not to regional pediatric environmental health specialty units.

Conclusions:

• Persistent gaps in practitioner knowledge of environmental health exist nationwide and across disciplines.
• Despite methodological limitations, there is a need to study educational interventions.
• Best practices for evaluating environmental health concerns in children require further investigation.