HOUSEHOLD ENVIRONMENTAL RISK REDUCTION IN RURAL CHILDREN

University Of Montana, Missoula MT

Investigators

Linked publications & trials

Abstract

More than seven million families participate in Women, Infants, and Children (WIC) and other pediatric public health programs. Providing environmental health information to these families is a common-sense way of integrating risk reduction efforts into existing public health programs. However, the success of such efforts will be predicated on testing interventions that can be easily delivered in home and clinic settings. The proposed study will yield evidence addressing: 1) baseline estimates of rural children's exposure to multiple agents in the home setting, and 2) the effectiveness of a risk reduction intervention delivered by public health nurses. Subjects will include child-parent dyads residing in rural Montana; there is preliminary evidence that exposures to children living in the rural West may differ significantly from those living in other parts of the country. The research involves four phases. In Phase 1, biomonitoring (i.e., children's blood lead, urinary cotinine), household (i.e., analysis of water for total coliforms, E-coli, lead, nitrate/nitrite, arsenic, mercury, and a pesticide and petroleum screen; air monitoring for radon and carbon monoxide), and parents' knowledge / attitude / behavior data will be collected from 50 families. In Phase 2, these data will be reviewed by an expert panel to identify priority agents--there is preliminary evidence that these will include radon, lead, arsenic, and nitrate/nitrite. Phase 3 will focus on finalizing agent-specific and general risk reduction interventions. General risk reduction actions will be based on national pediatric health recommendations. During Phase 4, the intervention will be tested with a sample of 150 families using private wells; 75 treatment families will receive the home visit intervention and 75 control families will receive an alternate (addressing a non-environmental health topic) intervention. The intervention will be delivered by local public health nurses who are already making home visits to families participating in child health programs for lower-income families. Outcome measures of interest include: 1) estimates of exposure (biomarkers and household monitoring), and 2) parents' knowledge and attitudes toward reduction actions on behalf of their children. The proposed research is consistent with recommendations that communitybased environmental health programs be framed and delivered in a manner that is meaningful to families and high-risk subgroups.