Fostering Environmental Health Literacy in Contaminated Sites: National and Local Experience in Italy From a Public Health and Equity Perspective

The present article deals with environmental health literacy (EHL) in contaminated sites. The Italian national epidemiological surveillance system of population resident in contaminated sites, including vulnerable subgroups, and the local epidemiological studies and communication initiatives implemented in specific sites are considered. The Italian experience in contaminated sites corroborates the importance of EHL as a key component of community capacity to participate in mitigating environmental health risks. Effective access to evidence-based information on environmental health risk is the basis for improving awareness of local institutional and social actors. The proactive involvement of stakeholders in preventive actions and the adoption of shared practices reflect the progressive increase of their EHL. Bidirectional communication relying on participative approaches, collaborative nationallocal initiatives, and dialogue with the communities is an effective tool for increasing EHL at each site. This enhances the community capacity to use the acquired knowledge in promoting prevention actions. Consideration of socioeconomic fragilities and vulnerable groups in well-designed EHL practices contributes to prevent adverse health effects induced by specific environmental exposures and to promote environmental justice at local level.

Knowledge and Beliefs Associated with Environmental Health Literacy: A Case Study Focused on Toxic Metals Contamination of Well Water

Environmental health literacy (EHL) is developing as a framework that can inform educational interventions designed to facilitate individual and collective action to protect health, yet EHL measurement poses several challenges. While some studies have measured environmental health knowledge resulting from interventions, few have incorporated skills and self-efficacy. In this study, a process-focused EHL instrument was developed, using the Newest Vital Sign (NVS) health literacy instrument as a model and tailoring it for the context of private well contamination with toxic metals. Forty-seven (47) participants, including undergraduate students and residents of communities with contaminated well water, piloted a prototype EHL instrument alongside NVS. Results suggested a moderate degree of correlation between NVS and the EHL prototype, and significant differences in scores were observed between students and residents. Responses to a self-efficacy survey, tailored for drinking water contaminated with arsenic, revealed significant differences between students and residents on items related to cost and distance. In response to open-ended questions, participants identified a range of potential environmental contaminants in drinking water and deemed varied information sources as reliable. This study highlights differences in knowledge and self-efficacy among students and residents and raises questions about the adequacy of EHL assessments that mimic formal education approaches.

What Do Childcare Providers Know about Environmental Influences on Children’s Health? Implications for Environmental Health Literacy Efforts

Children are uniquely vulnerable to toxicant exposures in their environment, which can have long-lasting impacts on their health. Childcare providers are an important population to target for environmental health literacy, as most children in the United States under five years of age spend a significant number of waking hours in non-parental care. There is an increasing body of evidence that children are exposed to toxicants in the childcare environment, and yet little is known about what childcare providers know about environmental influences on the health of children in their care. We conducted semi-structured interviews with 36 home- and center-based Illinois childcare providers to better understand their knowledge, attitudes, and behaviors as they relate to environmental influences on children’s health. We found that the majority of providers had a low level of understanding of potential sources of exposure in the childcare environment, and they did not feel that environmental exposures posed a significant risk to children. Future efforts to increase environmental health literacy should focus on raising awareness and knowledge of environmental health issues for childcare providers before addressing ways that providers can reduce or prevent toxicant exposures to children in their care.

THE EARLY EDUCATION OF ENVIRONMENTAL HEALTH LITERATION AS THE EFFORT OF DEVELOPING RURAL TOURISM

Awareness of environmental preservation begins with learning about environmental health for children in the tourist village area. The main objective of this program is to build a strong community foundation regarding the importance of environmental health in maintaining the balance of rural nature. The research objective was to determine the implementation and pattern of environmental health literacy education in the village of Paledah, Padaherang District, Pangandaran Regency. The research method used is qualitative. The consideration of choosing this method is the character of data that is able to maintain the integrity of the object. This means that research data is understood as an integrated unit. The process of collecting data was accomplished through interviews, discussions, observations, and library studies. Validity and reliability tests are carried out through the process of data triangulation and source triangulation—descriptive data analysis through stages of data reduction, data presentation, and conclusion drawing. Sources of data in this study are 5 persons. They are the managers of a tourist village 3 people and two people of parents’students. The results showed that there were five components in the implementation of environmental health literacy education in Paledah, Padaherang District, Pangandaran Regency. The components are (1) learning starts from simple experience, (2) provides positive experiences outside the house, (3) focuses on experience rather than teaching, (4) shows the person who cares about the environment and pleasure being in the real world, (5) the teacher as a model in maintaining the natural environment. The pattern of learning environmental health literacy involves four main elements, namely the teacher, children as students, parents, and learning media. Through this pattern, a synergy of instructors in village tourism managers and parents at home can be built to act in harmony in providing environmental health literacy for children, especially regarding the control of the implementation of environmental health literacy in children's daily lives.

Validity of Environmental Health Literacy Scale for Homebound and Bedbound Elder of Village Health Volunteer

Background: The goal of global environmental health is to increase health literacy. The elder is the group that has lower health literacy. The health volunteers can support them to improve this aspect. Objective: To develop an environmental health literacy (EHL) scale and examine a causal relationship model of environmental management behavior (EMB). Materials and Methods: The cross-sectional study of 454 village health volunteers that were selected by a quota cluster random sampling. Data were collected through the five points Likert rating scale questionnaire. A confirmatory factor analysis (CFA) and a structural equation model (SEM) were conducted by LISREL software. Results: The quality assessment of the EHL consisted of 25 items and four key components. Those components are accessible, understanding, assessment, and decision-making. The EHL has a high acceptable reliability (alpha=0.91 to 0.93), validity (IOC 0.80 to 1.00), and factor loading (0.50 to 0.84). The EHL measurement model on the development and validation sample fit the empirical data. All factors can explain EHL and EMB of total sample with variance of 80% and 69%, respectively. The environmental literacy (EL) directly influenced EHL (beta=0.90), EL, and EHL directly, which influenced awareness of environmental management for the elder (beta=0.35 and 0.28, respectively). Additionally, EHL and awareness of environmental management directly influenced EMB towards the homebound and bedbound elder (beta=0.34 and 0.59, respectively) at significance level of 0.05. Conclusion: The EHL scale should be used to encourage EMB towards the homebound and bedbound elder among village health volunteers. Keywords: Environmental health, Health literacy, management, Health volunteer, Homebound, Bedbound, Elder

Media Reporting on Air Pollution: Health risk and precautionary measures in national and regional newspapers

Background Exposure to air pollution is one of the primary global health risk factors, yet individuals lack the knowledge to engage in individual risk mitigation and the skills to mobilize for change necessary to reduce such risks. The news media are an important tool for influencing individual actions and support for public policies to reduce environmental threats; thus, a lack of news coverage of such issues may exacerbate knowledge deficits. This study examines the reporting of health risk and precautionary measures regarding air pollution in national and regional print news using an environmental health literacy perspective.Methods We conducted a content analysis of two national (New York Times and Washington Post) and two local newspapers (Fresno Bee and Bakersfield Californian) newspapers covering the country’s most polluted region, California’s San Joaquin Valley, during a 5-year period (2011-2015). Using a constructed week sampling approach, 276 newspaper articles were coded for information on threat, efficacy information, and information sources.Results News coverage of air pollution mostly failed to mention human health risks. Moreover, fewer than 10 percent of news stories about air pollution provided information on the precautionary measures necessary for individuals to take action to mitigate their risk. Despite being located in one of the most polluted areas in the US, local newspapers did not report significantly more threat and efficacy information. News coverage of air pollution consistently missed opportunities to raise environmental health literacy.Conclusions Although air pollution levels are high and continue to rise at alarming rates, our findings suggest that news media reporting is not conducive to raising environmental health literacy. Public health advocates and health promotion experts must develop more effective strategies for disseminating information about the health risks of air pollution, balancing the need for recognizing the structural causes of poor air quality and the actions individuals and communities can take to reduce air pollution related morbidity and mortality. National and local news media may be useful partners for such dissemination.

Developing Youth Environmental Health Literacy and Civic Leadership through Community Air Monitoring in Imperial County, California

With a rapidly changing climate, new leaders must be trained to understand and act on emerging environmental threats. In California’s Imperial Valley, a collaborative of community members, researchers, and scientists developed a community air monitoring network to provide local residents with better air quality information. To expand the reach of the project and to prepare the next generation of youth leaders we developed an internship program to increase environmental health literacy and civic leadership. In the 10-week program, high school students learned about air quality science, respiratory health, community air monitoring, and policies intended to improve air quality. The students learned to present this information to their peers, neighbors, family, and community leaders. The program used participatory approaches familiar to community-engaged research to center the students’ experience. Surveys and interviews with the students were used to assess the program and found that the students became more familiar with air quality policies, increased their ability to use air monitoring resources, and increased their own confidence in their ability to effect change. With the growing threats related to environmental hazards, it is vital to prepare youth leaders to understand, communicate, and act.

Advancing Environmental Health Literacy: Validated Scales of General Environmental Health and Environmental Media-Specific Knowledge, Attitudes and Behaviors

Environmental health literacy (EHL) involves understanding and using environmental information to make decisions about health. This study developed a validated survey instrument with four scales for assessing media-specific (i.e., air, food, water) and general EHL. The four scales were created as follows: 1) item generation: environmental health scientists and statisticians developed an initial set of items in three domains: knowledge, attitudes, and behaviors; 2) item review: items were reviewed for face validity; 3) validation: 174 public health students, the exploratory sample, and 98 community members, the test sample, validated the scales. The scales’ factor structure was based on exploratory factor analysis (EFA) and model fit was assessed through confirmatory factor analysis (CFA). For each scale, the final EFA resulted in an independent three-factor solution for knowledge, attitudes, and behaviors. Good fit for the three-factor structure was observed. Model fit for CFA was generally confirmed with fit indices. The scales showed internal consistency with Cronbach’s alpha from 0.63 to 0.70. The 42-item instrument represents an important contribution towards assessing EHL and is designed to enable meaningful engagement between researchers and community members about environmental health. The intended outcome is sustained community–academic partnerships benefiting research design, implementation, translation, dissemination, and community action.