Environmental risk reduction through nursing intervention and education : a look at parents' perceptions of risk of children's exposure to environmental toxins

Abstract

The success of efforts to provide environmental health (EH) information to families relies on testing interventions delivered in home and clinic settings. Few rural children's EH studies targeting multiple exposure pathways have been conducted. It is recommended that EH programs be framed and delivered in a manner meaningful to families and high-risk subgroups. This research addresses two questions: 1.) What are the risk avoidance behaviors regarding environmental tobacco smoke, radon, well water contamination, lead, and CO among a sample of rural households? 2.) Is there a difference in perception of risk between households that undertake risk avoidance actions and those that do not? Answers to these questions advised educational intervention construction. Participants were referred by public health nurses (PHN) serving pediatric programs within the Gallatin City County Health Department. All participants met specific enrollment criteria. Baseline biomonitoring, household exposure and self-reported knowledge/attitude/behavior (KAB) data were completed for 31 rural families. Biomarker data was collected from each child under age 6, each home was tested for radon and CO, and well water was processed using a well screen.

Questionnaire data was collected from each child and adult. Questionnaire components addressed demographics, KAB towards agents, resources, risk reduction and acceptability of risk reduction behaviors, child's health history and behaviors, potential exposures and parent's occupations. Biological data results were analyzed for each agent in each home. Results show smoking households perceive significant risk of children's exposure to ETS, but do not perceive that exposure leads to severe health consequences. Only 17.5% of households engage in radon testing. Parents who don't test for radon are guided by misconceptions and fear that remediation is costly and effort-intensive. Two-thirds of households have CO detectors. Those that do not, perceive no risk to children. More households engaged in treating their water than in testing. Knowledge of well water contamination and testing issues were limited. Blood lead results indicate that public lead campaigns have been successful in disseminating lead information. Results indicate a significant need for educational interventions to dismantle social and contextual barriers to protective behavior modification and that interventions can be successfully administered by a PHN.