PDF(Pubmed)
Abstract：
BACKGROUND: Environmental and behavioral factors are responsible for 12.6 million deaths annually and contribute to 25% of deaths and chronic diseases worldwide. Through the One Health initiative, the World Health Organization and other international health organizations plan to improve these indicators to create healthier environments by 2030. To meet this challenge, training primary care professionals should be the priority of national policies. General practitioners (GPs) are ready to become involved but need in-depth training to gain and apply environmental health (EH) knowledge to their practice. In response, we designed the Primary Care Environment and Health (PCEH) online course in partnership with the Occitanie Regional Health Agency in France. This course was used to train GP residents from the Montpelier-Nimes Faculty of Medicine in EH knowledge. The course was organized in 2 successive parts: (1) an asynchronous e-learning modular course focusing on EH knowledge and tools and (2) 1 day of face-to-face sessions.
OBJECTIVE: This study assessed the impact of the e-learning component of the PCEH course on participants\' satisfaction, knowledge, and behavior changes toward EH.
METHODS: This was a pilot before-and-after study. Four modules were available in the 6-hour e-learning course: introduction to EH, population-based approach (mapping tools and resources), clinical cases, and communication tools. From August to September 2021, we recruited first-year GP residents from the University of Montpellier (N=130). Participants\' satisfaction, knowledge improvements for 19 EH risks, procedure to report EH risks to health authorities online, and behavior change (to consider the possible effects of the environment on their own and their patients\' health) were assessed using self-reported questionnaires on a Likert scale (1-5). Paired Student t tests and the McNemar χ2 test were used to compare quantitative and qualitative variables, respectively, before and after the course.
RESULTS: A total of 74 GP residents completed the e-learning and answered the pre- and posttest questionnaires. The mean satisfaction score was 4.0 (SD 0.9) out of 5. Knowledge scores of EH risks increased significantly after the e-learning course, with a mean difference of 30% (P<.001) for all items. Behavioral scores improved significantly by 18% for the participant\'s health and by 26% for patients\' health (P<.001). These improvements did not vary significantly according to participant characteristics (eg, sex, children, place of work).
CONCLUSIONS: The e-learning course improved knowledge and behavior related to EH. Further studies are needed to assess the impact of the PCEH course on clinical practice and potential benefits for patients. This course was designed to serve as a knowledge base that could be reused each year with a view toward sustainability. This course will integrate new modules and will be adapted to the evolution of EH status indicators and target population needs.
OBJECTIVE: This study assessed the impact of the e-learning component of the PCEH course on participants\' satisfaction, knowledge, and behavior changes toward EH.
METHODS: This was a pilot before-and-after study. Four modules were available in the 6-hour e-learning course: introduction to EH, population-based approach (mapping tools and resources), clinical cases, and communication tools. From August to September 2021, we recruited first-year GP residents from the University of Montpellier (N=130). Participants\' satisfaction, knowledge improvements for 19 EH risks, procedure to report EH risks to health authorities online, and behavior change (to consider the possible effects of the environment on their own and their patients\' health) were assessed using self-reported questionnaires on a Likert scale (1-5). Paired Student t tests and the McNemar χ2 test were used to compare quantitative and qualitative variables, respectively, before and after the course.
RESULTS: A total of 74 GP residents completed the e-learning and answered the pre- and posttest questionnaires. The mean satisfaction score was 4.0 (SD 0.9) out of 5. Knowledge scores of EH risks increased significantly after the e-learning course, with a mean difference of 30% (P<.001) for all items. Behavioral scores improved significantly by 18% for the participant\'s health and by 26% for patients\' health (P<.001). These improvements did not vary significantly according to participant characteristics (eg, sex, children, place of work).
CONCLUSIONS: The e-learning course improved knowledge and behavior related to EH. Further studies are needed to assess the impact of the PCEH course on clinical practice and potential benefits for patients. This course was designed to serve as a knowledge base that could be reused each year with a view toward sustainability. This course will integrate new modules and will be adapted to the evolution of EH status indicators and target population needs.
摘要：
背景：环境和行为因素每年导致1260万人死亡，占全球死亡和慢性病的25％。通过“一个健康”倡议，世界卫生组织和其他国际卫生组织计划改善这些指标，到2030年创造更健康的环境。为了迎接这一挑战,培训初级保健专业人员应该是国家政策的优先事项。全科医生（GP）已准备好参与其中，但需要进行深入的培训，以获得并将环境健康（EH）知识应用于他们的实践。作为回应,我们与法国Occitanie地区卫生局合作设计了初级保健环境与健康（PCEH）在线课程。本课程用于培训蒙彼利埃-尼姆医学院的GP居民的EH知识。该课程分为两个连续部分：（1）异步电子学习模块化课程，重点是EH知识和工具；（2）1天的面对面课程。
目的：本研究评估了PCEH课程的电子学习部分对参与者满意度的影响，知识,和行为向EH改变。
方法：这是一项试验前后研究。在6小时的电子学习课程中提供了四个模块：EH简介，基于人口的方法(制图工具和资源)，临床病例,和通信工具。从2021年8月到9月，我们从蒙彼利埃大学（N=130）招募了第一年的GP居民。参与者的满意度，19个EH风险的知识改进，在线向卫生当局报告EH风险的程序，和行为变化（考虑环境对自身和患者健康的可能影响）使用Likert量表（1-5）的自我报告问卷进行评估。采用配对的Studentt检验和McNemarχ2检验比较定量和定性变量,分别,课程之前和之后。
结果：共有74名GP居民完成了电子学习，并回答了测试前和测试后的问卷。5分的平均满意度评分为4.0（SD0.9）。电子学习课程后，EH风险的知识得分显着增加，所有项目的平均差为30%(P<.001)。参与者的健康行为评分显著提高了18%，患者的健康行为评分显著提高了26%(P<.001)。这些改善根据参与者的特征没有显著差异(例如，性别,孩子们,工作地点)。
结论：电子学习课程改善了与EH相关的知识和行为。需要进一步的研究来评估PCEH课程对临床实践的影响以及对患者的潜在益处。本课程旨在作为一个知识库，每年都可以重复使用，以实现可持续性。本课程将整合新的模块，并将适应EH状态指标和目标人口需求的演变。
目的：本研究评估了PCEH课程的电子学习部分对参与者满意度的影响，知识,和行为向EH改变。
方法：这是一项试验前后研究。在6小时的电子学习课程中提供了四个模块：EH简介，基于人口的方法(制图工具和资源)，临床病例,和通信工具。从2021年8月到9月，我们从蒙彼利埃大学（N=130）招募了第一年的GP居民。参与者的满意度，19个EH风险的知识改进，在线向卫生当局报告EH风险的程序，和行为变化（考虑环境对自身和患者健康的可能影响）使用Likert量表（1-5）的自我报告问卷进行评估。采用配对的Studentt检验和McNemarχ2检验比较定量和定性变量,分别,课程之前和之后。
结果：共有74名GP居民完成了电子学习，并回答了测试前和测试后的问卷。5分的平均满意度评分为4.0（SD0.9）。电子学习课程后，EH风险的知识得分显着增加，所有项目的平均差为30%(P<.001)。参与者的健康行为评分显著提高了18%，患者的健康行为评分显著提高了26%(P<.001)。这些改善根据参与者的特征没有显著差异(例如，性别,孩子们,工作地点)。
结论：电子学习课程改善了与EH相关的知识和行为。需要进一步的研究来评估PCEH课程对临床实践的影响以及对患者的潜在益处。本课程旨在作为一个知识库，每年都可以重复使用，以实现可持续性。本课程将整合新的模块，并将适应EH状态指标和目标人口需求的演变。
