Washington State University College of Nursing, Spokane, WA 99210-1495, USA.
Am J Public Health. 2011 Dec;101 Suppl 1(Suppl 1):S262-70. doi: 10.2105/AJPH.2011.300164. Epub 2011 Aug 11.
Parents need meaningful and actionable information if they are to reduce household environmental health risks to their children. To address this issue, we tested the effectiveness of a multi-risk social/cognitive intervention on rural low-income parents' (1) environmental health self-efficacy and (2) stage of environmental health precautionary adoption.
Biomarker (lead, cotinine) and household samples (carbon monoxide, radon, mold/mildew, and drinking water contaminants) were collected from 235 families (399 adults, 441 children) in Montana and Washington states. Families were randomly assigned to intervention or control groups; intervention families received 4 visits from public health nurses who provided tailored information and guidance to parents; controls received usual and customary public health services.
At 3 months, the intervention group had significantly higher scores on (1) all 6 risk-specific self-efficacy subscales (P < .01), (2) general environmental health self-efficacy (P < .001), (3) 5 of 6 risk-specific precaution adoption subscales (P < .05), and (4) general environmental health precaution adoption (P < .001).
The intervention yielded significant improvements in both outcomes. This evidence supported the need for a policy discussion addressing the added value that broadbased public health nurse interventions might bring to children's environmental health.
如果要降低儿童家庭环境健康风险,家长需要获得有意义且可行的信息。为解决这一问题,我们检验了一种多风险社会/认知干预对农村低收入家长的环境健康自我效能和环境健康预防措施采纳阶段的影响。
从蒙大拿州和华盛顿州的 235 个家庭(399 名成年人,441 名儿童)中收集生物标志物(铅、可替宁)和家庭样本(一氧化碳、氡、霉菌/霉变和饮用水污染物)。家庭被随机分配到干预组或对照组;干预组接受公共卫生护士的 4 次家访,提供针对家长的定制信息和指导;对照组接受常规和惯用的公共卫生服务。
在 3 个月时,干预组在以下方面的得分显著更高:(1)所有 6 种特定风险的自我效能感子量表(P <.01),(2)一般环境健康自我效能感(P <.001),(3)6 种特定风险的预防措施采纳子量表中的 5 种(P <.05),以及(4)一般环境健康预防措施采纳(P <.001)。
干预措施在这两个结果上都取得了显著的改善。这一证据支持了进行政策讨论的必要性,以探讨广泛的公共卫生护士干预措施可能为儿童环境健康带来的附加价值。