TRIBAL/COUNTY HCP PERCEPTIONS OF PRIORITY PEDIATRIC ENVIRONMENTAL HEALTH ISSUES

2.50
Hdl Handle:
http://hdl.handle.net/10755/211531
Type:
Research Study
Title:
TRIBAL/COUNTY HCP PERCEPTIONS OF PRIORITY PEDIATRIC ENVIRONMENTAL HEALTH ISSUES
Abstract:
Purpose/Aims: This study emanated from a community-academic partnership that sponsored an environmental health continuing education event for health care providers who work with the tribal/non-tribal local population. A community-based participatory research (CBPR) approach was used to tap local health care provider (HCP) expertise to identify potential environmental exposures on one Montana Indian reservation and the principal county within the reservation. The research questions included: (a) What are the perceptions of HCPs  regarding environmental hazards that could affect fetal, infant and child morbidity/mortality? (b) What are the potential environmental health issues that could impact the fetus infant and child on the reservation-of-interest? (c) What are the HCP educational needs related to improving competencies in environmental health? Rationale/Background: Fetal, infant and child mortality and morbidity is significantly higher in American Indian children (8.8/1000) compared to the dominant culture (6.9/1000). Exposure to toxins is one preventable cause of illness and death. Although healthcare providers are uniquely positioned to serve as partners to reduce environmental exposures, many lack formal or continuing education in environmental health. The Translational Environmental Research in Rural Areas (TERRA) framework addresses environmental health and justice issues by emphasizing areas of risk and risk perception” (Butterfield & Postma, 2009, p. 107). Methods: A descriptive, naturalistic, qualitative research design was applied using focus groups as the primary data collection method. Forty HCPs, five groups of eight, including physicians, nurses, community health representatives, public health workers, social workers, and sanitarians participated in post-conference focus groups. Five trained moderators used an established protocol to guide a two-hour discussion based on 12 pre-tested questions. Demographic data were collected from participants; content analysis on the five focus groups audio-recorded transcripts established primary themes. Results: Demographics: 75% of HCPs indicated they had no previous pediatric environmental health formal or continuing education; 47% indicated <10 years of practice; 33% of providers noted tribal affiliation; and, approximately half of the participants held a high school diploma or associate degree only. For each question, the top three themes were generated accompanied by descriptive quotes for each theme. For instance, “When I hear the phrase environmental health I think of . . .” (Response summary times five groups = community (14); safety (11); toxins (8). Interrater reliability was 90-100% (3 questions). Implications: Results of this study, although non-generalizable, indicated HCPs are concerned about both behavioral mediated environmental toxins (substance abuse; ETS) and invisible toxins (methylmercury and water quality). Generally HCPs felt they needed more EH education on chemicals, pesticides, and exposure effects but are burdened with acute practice issues (diabetes, heart disease, accidental injury), which often take priority.
Keywords:
Community based participatory research; Montana Indian reservation; Health care provider
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5375
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleTRIBAL/COUNTY HCP PERCEPTIONS OF PRIORITY PEDIATRIC ENVIRONMENTAL HEALTH ISSUESen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211531-
dc.description.abstractPurpose/Aims: This study emanated from a community-academic partnership that sponsored an environmental health continuing education event for health care providers who work with the tribal/non-tribal local population. A community-based participatory research (CBPR) approach was used to tap local health care provider (HCP) expertise to identify potential environmental exposures on one Montana Indian reservation and the principal county within the reservation. The research questions included: (a) What are the perceptions of HCPs  regarding environmental hazards that could affect fetal, infant and child morbidity/mortality? (b) What are the potential environmental health issues that could impact the fetus infant and child on the reservation-of-interest? (c) What are the HCP educational needs related to improving competencies in environmental health? Rationale/Background: Fetal, infant and child mortality and morbidity is significantly higher in American Indian children (8.8/1000) compared to the dominant culture (6.9/1000). Exposure to toxins is one preventable cause of illness and death. Although healthcare providers are uniquely positioned to serve as partners to reduce environmental exposures, many lack formal or continuing education in environmental health. The Translational Environmental Research in Rural Areas (TERRA) framework addresses environmental health and justice issues by emphasizing areas of risk and risk perception” (Butterfield & Postma, 2009, p. 107). Methods: A descriptive, naturalistic, qualitative research design was applied using focus groups as the primary data collection method. Forty HCPs, five groups of eight, including physicians, nurses, community health representatives, public health workers, social workers, and sanitarians participated in post-conference focus groups. Five trained moderators used an established protocol to guide a two-hour discussion based on 12 pre-tested questions. Demographic data were collected from participants; content analysis on the five focus groups audio-recorded transcripts established primary themes. Results: Demographics: 75% of HCPs indicated they had no previous pediatric environmental health formal or continuing education; 47% indicated <10 years of practice; 33% of providers noted tribal affiliation; and, approximately half of the participants held a high school diploma or associate degree only. For each question, the top three themes were generated accompanied by descriptive quotes for each theme. For instance, “When I hear the phrase environmental health I think of . . .” (Response summary times five groups = community (14); safety (11); toxins (8). Interrater reliability was 90-100% (3 questions). Implications: Results of this study, although non-generalizable, indicated HCPs are concerned about both behavioral mediated environmental toxins (substance abuse; ETS) and invisible toxins (methylmercury and water quality). Generally HCPs felt they needed more EH education on chemicals, pesticides, and exposure effects but are burdened with acute practice issues (diabetes, heart disease, accidental injury), which often take priority.en_GB
dc.subjectCommunity based participatory researchen_GB
dc.subjectMontana Indian reservationen_GB
dc.subjectHealth care provideren_GB
dc.date.available2012-02-20T12:00:35Z-
dc.date.issued2012-02-20T12:00:35Z-
dc.date.accessioned2012-02-20T12:00:35Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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