Million Marker Wellness, Inc., Berkeley, CA 94704, USA.
Healthy Nevada Project, Renown Health, Reno, NV 89557, USA.
Int J Environ Res Public Health. 2024 Jul 11;21(7):905. doi: 10.3390/ijerph21070905.
Interventions are needed to help people reduce exposure to harmful chemicals from everyday products and lifestyle habits. Report-back of individual exposures is a potential pathway to increasing environmental health literacy (EHL) and readiness to reduce exposures.
Our objective was to determine if report-back of endocrine-disrupting chemicals (EDCs) can reduce EDC exposure, increase EHL, and increase readiness to change (i.e., to implement EDC exposure-reduction behaviors).
Participants in the Healthy Nevada Project completed EHL and readiness-to-change surveys before ( = 424) and after ( = 174) a report-back intervention. Participants used mail-in kits to measure urinary biomarkers of EDCs. The report-back of results included urinary levels, information about health effects, sources of exposure, and personalized recommendations to reduce exposure.
EHL was generally very high at baseline, especially for questions related to the general pollution. For questions related to chemical exposures, responses varied across several demographics. Statistically reliable improvements in EHL responses were seen after report-back. For readiness to change, 72% were already or planning to change their behaviors. Post-intervention, women increased their readiness ( = 0.053), while men decreased ( = 0.007). When asked what challenges they faced in reducing exposure, 79% cited not knowing what to do. This dropped to 35% after report-back. Participants with higher propylparaben were younger ( = 0.03) and women and participants who rated themselves in better health had higher levels of some phthalates ( = 0.02-0.003 and = 0.001-0.003, respectively). After report-back, monobutyl phthalate decreased among the 48 participants who had valid urine tests before and after the intervention ( < 0.001).
The report-back intervention was successful as evidenced by increased EHL behaviors, increased readiness to change among women, and a decrease in monobutyl phthalate. An EHL questionnaire more sensitive to chemical exposures would help differentiate high and low literacy. Future research will focus on understanding why men decreased their readiness to change and how the intervention can be improved for all participants.
需要采取干预措施来帮助人们减少接触日常产品和生活方式带来的有害化学物质。报告个人接触情况是提高环境健康素养（EHL）和准备减少接触的潜在途径。
我们的目的是确定报告内分泌干扰物（EDC）是否可以减少 EDC 暴露，提高 EHL，并增加改变的意愿（即实施 EDC 暴露减少行为）。
健康内华达州项目的参与者在报告后干预之前（n=424）和之后（n=174）完成了 EHL 和改变意愿的调查。参与者使用邮件试剂盒测量尿液生物标志物的 EDC。结果的报告包括尿液水平、健康影响信息、暴露源和减少暴露的个性化建议。
EHL 在基线时通常非常高，尤其是对于与一般污染有关的问题。对于与化学暴露有关的问题，回答因几个人口统计学因素而异。报告后，EHL 回答的统计学上可靠的改善得到了体现。对于改变意愿，72%的人已经或计划改变他们的行为。干预后，女性增加了她们的意愿（p=0.053），而男性则减少了（p=0.007）。当被问及他们在减少接触方面面临的挑战时，79%的人表示不知道该做什么。这一比例在报告后下降到 35%。尿液中丙酸酯水平较高的参与者年龄较小（p=0.03），自我评估健康状况较好的参与者某些邻苯二甲酸酯水平较高（p=0.02-0.003 和 p=0.001-0.003）。报告后，48 名干预前后尿液检测有效的参与者的邻苯二甲酸单丁酯下降（p<0.001）。
报告后干预是成功的，证据是 EHL 行为增加，女性改变意愿增加，以及邻苯二甲酸单丁酯减少。对化学暴露更敏感的 EHL 问卷将有助于区分高和低素养。未来的研究将集中于理解为什么男性降低了改变意愿，以及如何为所有参与者改进干预措施。
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