Environmental Health Information Research Articles

Promoting child health and environmental equity through a children’s environmental health information system

Promoting child health and environmental equity through a children’s environmental health information system

Exploring associations between the Phthalate Environmental Reproductive Health Literacy (PERHL) scale & biomarkers of phthalate exposure: A pilot study.

Perinatal exposure to phthalates is associated with adverse health impacts for parents and children. The field of environmental health literacy seeks to measure how environmental health information is conceptualized and used to inform behaviors. We assessed whether scores on the validated Phthalate Environmental Reproductive Health Literacy (PERHL) scale were associated with biomarkers of phthalate exposure. 42 members of the Environmental Reproductive and Glucose Outcomes (ERGO) cohort completed the PERHL scale and provided spot urine samples. Phthalate summary measures for model outcomes were created by calculating molar sums of specific gravity-corrected metabolite concentrations representing exposure to parent phthalate, Di(2-ethylhexyl)phthalate (DEHP), personal care product (PCP)-associated phthalates, and parent butyl-phthalates. Linear regression models were used to estimate the associations of the PERHL scale scores with phthalate summary measures, controlling for educational attainment (college degree or higher vs. no college degree), age (years), and race and ethnicity (non-Hispanic White vs. non-White). Higher scores on the PERHL Scale and subscales were generally associated with lower ΣDEHP, Σbutyl, and ΣPCP metabolite concentrations. A one-point increase in the 'Protective Behavior/Risk Control' subscale score was significantly associated with a -30.3% (95% CI: -50.1, -2.6) decrease in ΣDEHP, and a -30.6% (95% CI: -51.5, -0.63) decrease in Σbutyl metabolite concentrations.

The influence of energy-saving information in online reviews on green home appliance purchase behavior based on machine learning

The renewal of green home appliances is a crucial measure for households to save energy and reduce emissions. However, how online reviews, especially those relate to energy-saving, affect green home appliance purchase behavior (GHAPB) lacks exploration. In this paper, we investigate over 1 million online reviews on about 3,116 types of air conditioner from JD. By applying word2vec, we divide energy-saving related information in the following three types: norm information, environmental health information and price information, and construct dictionaries for each. Then, the effect value of energy-saving information is quantified from perspectives of breadth, depth and intensity through sentiment analysis. The influence of energy-saving information in online reviews on GHAPB is finally analyzed by linear regression and machine learning models. The results show that all energy-saving information has positive impact on GHAPB, and environmental health information is the most important one. In addition, the attributes of online reviews impose a greater influence on GHAPB, comparing with those of products. The in-depth exploration of energy-saving information in online reviews provides targeted recommendations for the manufacturer and the retailer to promote the adoption of green home appliances.

Ambient Air Pollution and Chronic kidney disease risk in Deltan communities: A Policy Brief, 2023

Chronic kidney disease (CKD) is a persistent, devastating, yet neglected, non-communicable disease in developing and emerging countries. National, regional, and international agencies’ communications and reports on non-communicable diseases intentionally or non-intentionally do not feature CKD. The traditional risk factors for CKD, such as hypertension and diabetes, which have received relatively ample attention, do not sufficiently explain the high burden of CKD in these countries. Ambient air pollution is an emerging significant environmental risk factor for CKD; however, epidemiological data and evidence are lacking for susceptible populations in developing countries. The Niger Delta region of Nigeria is a petrochemical hub known for environmental degradation, including air pollution, and thus, serves as a good case study for investigating the association between air pollution and CKD. This brief is based on the results of a mixed-methods study conducted in four communities situated near an oil and gas refinery in Warri, Nigeria. Air pollutant concentrations measured in partnership with citizen scientists showed that all except one air pollutant (ozone) exceeded the WHO acceptable limits in all four communities. The overall prevalence of CKD was high (12.3%) but even higher (18%) in a socially deprived semi-urban community closest to the oil refinery. Hypertension, diabetes, other behavioral risk factors, and exposures associated with CKD were prevalent among the inhabitants of the four communities. However, public environmental health information and education are lacking. A multifaceted approach is required to mitigate air pollution and the associated health risks in the state. Public inclusion is strongly recommended for the planning and implementation of future interventions. Kidney disease prevention and treatment should be emphasized in health policies and insurance schemes.

Marketing plant‐based versus animal‐sourced foods in online grocery stores: A comparative content analysis of sustainability and other product claims in the United States

AbstractThe market share of e‐commerce grocery is swiftly rising, but online product listings may present different environmental sustainability and public health information. We analyzed product marketing content available on retailer websites and product images, comparing plant‐based (PBFs) and animal‐sourced foods (ASFs). Over sixteen thousand marketing and labeling content observations were gathered from seven leading U.S. e‐commerce grocery retailers for top‐selling ASFs and closely‐matched PBFs (N = 134; n = 68 PBFs, n = 66 ASFs), including sustainability, mandatory information, health, sourcing, and hedonic/emotional claims. PBFs averaged 47 total claims, ASFs 28. On‐web claims were substantially higher than on‐pack (PBFs 34 on‐web, 12 on‐pack; ASFs 19 and nine, respectively). On‐web information for the same products varied considerably across retailers, especially for sustainability and mandatory information. PBFs presented mostly sustainability claims on‐pack and health claims on‐web. ASFs led emotional claims and made almost no sustainability claims across settings. Across settings, mandatory information compliance was greater among PBFs whereas ASFs notably lacked disclosures for foods with major allergens. Online grocery lacks standardization—businesses should regard differences as opportunities for marketing sustainable foods.

Navigating health information chaos: Perspectives from Persian-speaking immigrants in Finland

The purpose of this study is to explore health information environment and behaviours of Persian-speaking immigrants in Finland during the COVID-19 pandemic, utilising information chaos framework. Between January to March 2022, semi-structured interviews were conducted with a sample of 18 participants, using an adapted framework of information chaos and previous research as a guide for the interview questions. The study found that participants relied on interpersonal connections, news outlets, and social media to stay informed on current news and health-related information, with messaging apps being particularly popular due to their convenience and ability to connect with friends and family in their home countries. While most participants were satisfied with the amount of information they received, some encountered inaccurate pandemic information. The study also identified significant obstacles related to information scatter and conflict. Participants employed various methods, including verifying with official sources and interpersonal networks, to assess the reliability of their information. Credible health information led to changes in behaviour and lifestyle. The study's findings offer practical implications for health authorities and policymakers to address the health information needs of Persian-speaking immigrants during public health crises. The use of an information-chaos framework could be beneficial in identifying challenges related to channelling accurate and reliable health information among minorities through different information sources. Such initiatives can bridge the gap between the health information needs of immigrants and the available health information, ultimately reducing health disparities and improving health outcomes. This study represents one of the pioneering works exploring the information environment during a pandemic and the strategies adopted by the Persian-speaking minority to address the dissemination of false information during a health crisis. These findings shed light on the complex interplay of individual and health information environments that influence adhering to safety protocols and adopting healthy behaviours in this population.

A Study of COVID‐19 Information Behaviors among Black Americans

ABSTRACTMany Black Americans expressed skepticism and hesitancy about the Covid‐19 vaccine. The objective of this research is to examine whether there is a relationship between Covid‐19 vaccine status, Covid‐19 vaccine knowledge, and information seeking about the coronavirus. A national online questionnaire of 222 Black identified individuals completed the instrument in the Summer of 2021. We conducted data analysis using ANOVA and nonparametric correlation tests among the variables. Findings show that individuals who have received the COVID‐19 vaccine exhibited greater COVID‐19 vaccine‐related knowledge compared to people who declined the vaccine, or were hesitant adopters. There is no significant difference in the level of knowledge between those who are hesitant about the vaccine and those who declined it. Finally, there is a moderate positive correlation between COVID‐19 vaccine knowledge and engagement in COVID‐19‐related information seeking. We conclude with strategies to improve the Black American health information environment by way of practice, policy and action.

Integrating participant feedback and concerns to improve community and individual level chemical exposure assessment reports

BackgroundAs exposure assessment has shifted towards community-engaged research there has been an increasing trend towards reporting results to participants. Reports aim to increase environmental health literacy, but this can be challenging due to the many unknowns regarding chemical exposure and human health effects. This includes when reports encompass a wide-range of chemicals, limited reference or health standards exist for those chemicals, and/or incompatibility of data generated from exposure assessment tools with published reference values (e.g., comparing a wristband concentration to an oral reference dose).MethodsHouston Hurricane Harvey Health (Houston-3H) participants wore silicone wristbands that were analyzed for 1,530 organic compounds at two time-points surrounding Hurricane Harvey. Three focus groups were conducted in separate neighborhoods in the Houston metropolitan area to evaluate response to prototype community and individual level report-backs. Participants (n = 31) evaluated prototype drafts using Likert scales and discussion prompts. Focus groups were audio-recorded, and transcripts were analyzed using a qualitative data analysis program for common themes, and quantitative data (ranking, Likert scales) were statistically analyzed.ResultsFour main themes emerged from analysis of the transcripts: (1) views on the report layout; (2) expression of concern over how chemicals might impact their individual or community health; (3) participants emotional response towards the researchers; and (4) participants ability to comprehend and evaluate environmental health information. Evaluation of the report and key concerns differed across the three focus groups. However, there was agreement amongst the focus groups about the desire to obtain personal exposure results despite the uncertainty of what the participant results meant.ConclusionsThe report-back of research results (RBRR) for community and individual level exposure assessment data should keep the following key principles in mind: materials should be accessible (language level, data visualization options, graph literacy), identify known information vs unknown (e.g., provide context for what exposure assessment data means, acknowledge lack of current health standards or guidelines), recognize and respect community knowledge and history, and set participant expectations for what they can expect from the report.

Behavior patterns and influencing factors: Health information acquisition behavior of Chinese senior adults on WeChat

Due to the gradual adoption of WeChat by older adults in China and their interest in health information, Chinese older people started to acquire health information through WeChat. We explored the specific patterns and influencing factors of the elderly's health information acquisition behavior senior adults. The cross-sectional study collected self-reported data with survey (N = 336) in the southeast of China, Zhejiang province. The findings of this study extend the previous research by suggesting that elderly adults' health information acquisition behavior has three patterns (actively seeking, passively browsing, and long-term collecting). These findings contribute to a better understanding of digital literacy, three dimensions of health literacy and their relationship with three specific patterns of health acquisition behavior. This study also provides practical insights related to narrow the technological gap of the older adults, improve their e-Health literacy of the elderly, and purify the health information environment in the network.

Integrating “One Health” Concepts in the Design of Sustainable Systems for Environmental Use

Ensuring for the national defense requires the use of substances such as energetics, propellants, pyrotechnics, and other materials in environmental applications. Systems that use these materials do so in testing and training environments and must be used in an environmentally sustained manner to ensure success during actual kinetic defensive operations. Environmental and occupational health assessments require a weighted evaluation of toxicity, bioaccumulation, persistence, and environmental fate and transport considerations for each substance in the formulation to include potential combustion products. Data that support these criteria need to be collected in a phased and matrixed approach and considered iteratively as technology advances. Further, these criteria are often considered as disparate and separate; hence, comparing favorable aspects of one may or may not offset detrimental data from another. Here, we describe an approach to the phased collection of environmental, safety, and occupational health (ESOH) information for new systems and substances and provide recommendations for evaluating such data streams in making decisions for use and for evaluating alternatives.

Transgender and Gender-Nonconforming Populations Experience Unique Challenges in Health Information Environment Developed for Heteronormative Audience

A Review of: Tenny, C. S., Surkan, K. J., Gerido, L. H., & Betts-Green, D. (2021). A crisis of erasure: Transgender and gender-nonconforming populations navigating breast cancer health information. The International Journal of Information, Diversity, & Inclusion, 5(4), 132–149. https://doi.org/10.33137/ijidi.v5i4.37406 Objective – To understand the lived experiences of transgender and gender-nonconforming populations in seeking health information about breast cancer. Design – Thematic literature review. Setting – Four English-language databases featuring clinical, patient engagement, and library and information sciences (LIS) research. Subjects – Twenty-one published articles. Methods – The researchers chose three concepts (trans, LGBTQ+, and breast cancer), identified related terms for each, and used these terms to conduct literature searches in four databases: PubMed, Web of Science, Library Literature & Information Science Full Text, and Library, Information, Science & Technology Abstracts. Search results were reviewed for relevance to the research objective. The researchers applied grounded theory to analyze the 21 selected articles through open, axial, and selective (thematic) coding. The qualitative research software NVivo was used to perform thematic analysis of each article, and a shared codebook was developed to ensure saturation of axial themes and consistency of coding amongst researchers. Main Results – Three overarching themes emerged from selective coding that exemplify experiences of transgender and gender-nonconforming persons seeking health information about breast cancer: access, erasure, and quality. Compared to their cisgender peers, these historically marginalized populations and their caregivers experience more difficulty accessing the already limited breast cancer information, healthcare, and support services suited to their needs. In particular, transgender and gender-nonconforming patients are often burdened with choosing between receiving health information and care designed for heteronormative persons and risking self-disclosure and possible discrimination by culturally incompetent health professionals. Conclusion – The researchers noted the alarmingly limited resources available for gender-nonconforming patients seeking information and support for health matters other than mental health or sexually transmitted diseases. The researchers also called for increased efforts by LIS curriculums and professionals to study and understand the needs of transgender and gender-nonconforming patrons, and to improve the quality and quantity of information resources specifically dedicated to these unique populations.

Climate change and health informatics: pilot survey of perspectives across the field.

Establish a baseline of informatics professionals' perspectives on climate change and health. Anonymized survey sent to 9 informatics listservs March 31, 2022 to April 15, 2022. N = 85 participants completed part or all of survey. Majority of participants worked at hospitals with 1000+ employees (73%) in urban areas (60%) in the United States. Respondents broadly reported general understanding of climate change and health (51%), but 71% reported unfamiliarity with technologies that could help clinicians and informaticians address the impacts of climate change. Seventy-one percent of surveyed wanted climate-driven environmental health information included in EHRs. Seventy-six percent of respondents reported that informaticians should be involved in institutional decarbonization. Seventy-eight percent of respondents felt that it was extremely, very, or moderately important to receive education on climate change. General consensus on need to engage informaticians in climate change response, but gaps identified in knowledge dissemination and tools for adaptation and mitigation. Informaticians broadly concerned about climate change and want to be engaged in efforts to combat it, but further education and tool development needed.

Quality of Chinese government environmental health information disclosure during COVID-19 pandemic: Satisfaction survey on University students.

Government played a vital role during the COVID-19 pandemic by disclosing related environmental health information to the public. A satisfaction survey is often used to evaluate the public's satisfaction of the government's information disclosure while reflecting problems in the current disclosure system. As University students generally have better cognitive skills, they efficiently received related information during the pandemic, and therefore 717 questionnaires completed by University students were selected for this study. During the pandemic, the quality of the government's environmental health information disclosure system ranked at 13.89, marginally higher than average. Moreover, the timeliness and content adequacy of the disclosure system ranked at a level slightly above average. By adopting Hayes PROCESS Model 4 and 8, this study found that there is a direct impact of environmental health knowledge and environmental health awareness on satisfaction. Furthermore, University students' environmental health knowledge and awareness enhanced satisfaction through the mediating effect of self-reported environmental behavior. Finally, this study attempted to discover the conditions under which environmental health knowledge and awareness would have a greater direct and indirect influence on satisfaction, that is, the reverse moderating effect of household income level. In addition, this paper offers policy recommendations to enhance quality of government environmental health information disclosure system.

Sanitation and hygiene practices of secondary school students from Mtwara town in Tanzania

ABSTRACT This study evaluated the sanitation and hygiene practices of secondary school students from Mtwara town in Tanzania. A questionnaire survey was used to collect data on participants’ characteristics and responses to sanitation and hygiene practices were analyzed using descriptive statistics. Pearson's Chi-Square test was used to determine whether there was a statistically significant difference between participants’ characteristics and study variables. Of the 685 responses received, 672 (98.50%) were valid, while 13 (1.50%) were invalid due to missing information. The majority of respondents (97.02%) reported participating in environmental protection activities because it is the most effective way to manage environmental health. Some hygiene practices showed statistically significant differences based on the students' age and gender. Female students practiced sanitation and hygiene more than males, and the practices of hygiene increased as students aged. Furthermore, while 396 female students (91.45%) reported having a menstrual cycle every month, only (97.66%) knew what to do when they had their menstrual cycle. Both the female students' age and study class revealed a statistically significant difference in their knowledge of what to do when they menstruate (p=0.017 vs. p<0.001), use of cloth pads (p<0.001 vs. p<0.001) and commercial pads (p=0.017 vs. p<0.001). It is recommended that environmental health information dissemination programs be maintained in order to uphold positive sanitation and hygiene practices.

The Role of Pandemic Fatigue in Seeking and Avoiding Information on COVID-19 Among Young Adults

ABSTRACT The health information environment surrounding COVID-19 is complex, with varying and competing information. This study uses the risk information seeking and processing model (RISP) to examine COVID-19 information seeking and avoiding among young adults. Pandemic fatigue is also operationalized and tested as a more nuanced measure of negative affective response within the RISP framework. Survey results (N = 527) reveal pandemic fatigue predicts information seeking and avoidance, but may have a weaker influence on these outcome variables than the RISP’s original construct of negative affective response. Additionally, the original RISP model achieved slightly more explanatory power in predicting risk information seeking than our revised RISP model, using pandemic fatigue as an alternative measure of negative affective response. These findings indicate that contemporary concepts such as pandemic fatigue may be incorporated into applications of the RISP model, thus allowing researchers to evaluate other types of negative affective responses to risk and further expanding the utility of the model. Theoretical implications and practical recommendations for public health officials and health care workers are discussed.

Standard Document Development for Health Information Exchange in Korea.

Background Health information exchange (HIE) allows healthcare providers to access a patient's medical information to improve patient care continuity. The standardized data realize the HIE values. Since the Health Level 7 Clinical Document Architecture (CDA) is flexible, implementation guides (IG) are needed for use cases. Although many CDA IGs have been developed, they did not describe how these CDA IGs were developed. A national CDA IG that meets the local requirements is demanded since the data differs according to the digital divide and social–cultural background of the country that wants to establish HIE. Due to their localized contents, other countries cannot directly adopt the published CDA IGs. Objectives We developed the national CDA IG, namely, Korean (K)-CDA IG that meets the local requirement, including reusable structured templates, value sets, and object identifiers (OIDs). We present a detailed description of the development process and the technical methods of the national CDA IG in the Korean context. Methods The K-CDA IG was developed in the following stages: analysis, development, and evaluation. First, we investigated the health information environment and electronic health record (EHR) systems and conducted a gap analysis with published CDA IGs. Second, a templated CDA approach was taken for designing modular. Lastly, we consulted a technical advisory group for comments on the validity of the K-CDA IG. Results A total of 35 CDA templates were developed. We improved 28 value sets of which 13 were Korea specific and 15 were based on the ones used in other IGs, and made a set of rules to establish the OID structure. Conclusion We presented the development process and the technical specifications of K-CDA IG. We explored how the results can be used as interoperability criteria in the national EHR systems certification program. Finally, we provided recommendations that could guide other entities planning their HIE programs.

Environmental Health Information Partnership (EnHIP): Strengthening the capacity of minority serving institutions.

The U.S. National Library of Medicine’s (NLM) Environmental Health Information Partnership (EnHIP) collaborates with Historically Black Colleges and Universities (HBCUs) and other minority-serving academic institutions to enhance their capacity to reduce health disparities through the access, use, and delivery of environmental health information on their campuses and in their communities. The partnership began in 1991 as the Toxicology Information Outreach Panel (TIOP) pilot project, and through successive iterations it is NLM’s longest running outreach activity. EnHIP’s continued relevance today as an information outreach and training program testifies to the prescience of NLM director, Donald A.B. Lindberg M.D’s initial support for the program. Dr. Lindberg’s seeing to its continued success to benefit participating institutions and help achieve the societal goals of environmental justice serve as well to benefit NLM by increasing its visibility, and use of its resources in the classroom, for research, and in community outreach. NLM envisions an expanding role for EnHIP in advancing health equity as the impact of environmental exposure, climate change, and increasing zoonotic diseases disproportionately impact their communities.

Coronavirus-Related Health Literacy: A Cross-Sectional Study during the COVID-19 Pandemic in Italy.

The COVID-19 pandemic has caused an overabundance of valid and invalid information to spread rapidly via traditional media as well as by internet and digital communication. Health literacy (HL) is the ability to access, understand, appraise, and apply health information, making it fundamental for finding, interpreting, and correctly using COVID-19 information. A cross-sectional study of a sample of 3500 participants representative of the Italian adult population aged 18+ years was conducted in Italy in 2021. A validated HL questionnaire was employed, including sections on coronavirus-related HL, general HL, sociodemographic characteristics, risk factors, and respondents’ lifestyle. Of our sample, 49.3% had “excellent” levels of coronavirus-related HL and 50.7% had “sufficient” (20.7%) or “limited” (30.0%) levels. Although the overall HL-COVID level was high, many participants reported difficulties dealing with COVID-19 information; in particular, participants older than 65 years, with a low education level, living in southern regions of Italy, and with high financial deprivation. Targeted public information campaigns and the promotion of HL are required for better navigation of health information environments. The COVID-19 pandemic has highlighted the need to improve HL and to prepare the general population for future emergency and non-emergency situations, confirming that HL can be considered a social vaccine.

Environmental Health Information Partnership (EnHIP): Strengthening the Capacity of Minority Serving Institutions.

The U.S. National Library of Medicine's (NLM) Environmental Health Information Partnership (EnHIP) collaborates with Historically Black Colleges and Universities (HBCUs) and other minority-serving academic institutions to enhance their capacity to reduce health disparities through the access, use, and delivery of environmental health information on their campuses and in their communities. The partnership began in 1991 as the Toxicology Information Outreach Panel (TIOP) pilot project, and through successive iterations it is NLM's longest running outreach activity. EnHIP's continued relevance today as an information outreach and training program testifies to the prescience of NLM director, Donald A.B. Lindberg M.D's initial support for the program. Dr. Lindberg's seeing to its continued success to benefit participating institutions and help achieve the societal goals of environmental justice serve as well to benefit NLM by increasing its visibility, and use of its resources in the classroom, for research, and in community outreach. NLM envisions an expanding role for EnHIP in advancing health equity as the impact of environmental exposure, climate change, and increasing zoonotic diseases disproportionately impact their communities.

A profile of the health information seeker in Chile: Introducing the Chilean health information environments (EIS) survey

AbstractIn recent years, many countries have sought to assess health information acquisition among their populations. The Health Information Environments (Entornos de Información de Salud; EIS) survey is the first systematic and representative study that addresses access and use of health information in Chile. Modeled after the National Cancer Institute's Health Information National Trends Survey (HINTS), the survey included measures of general health information acquisition, source trust, and health behaviors, with a special focus on physical activity, fruit and vegetable consumption, and smoking cessation. The EIS survey was applied face‐to‐face in Santiago, the capital of Chile, between December 2020 and February 2021 in a sample of 1411 individuals older than 24 years. In this paper, we present the main sections of the EIS questionnaire, the application procedure, response rates, and sample characteristics. Additionally, we used EIS data to present a profile of health information seekers in Chile.