PDF(Pubmed)
Abstract：
BACKGROUND: 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.
OBJECTIVE: 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).
METHODS: Participants in the Healthy Nevada Project completed EHL and readiness-to-change surveys before (n = 424) and after (n = 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.
RESULTS: 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 (p = 0.053), while men decreased (p = 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 (p = 0.03) and women and participants who rated themselves in better health had higher levels of some phthalates (p = 0.02-0.003 and p = 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 (p < 0.001).
CONCLUSIONS: 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.
OBJECTIVE: 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).
METHODS: Participants in the Healthy Nevada Project completed EHL and readiness-to-change surveys before (n = 424) and after (n = 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.
RESULTS: 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 (p = 0.053), while men decreased (p = 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 (p = 0.03) and women and participants who rated themselves in better health had higher levels of some phthalates (p = 0.02-0.003 and p = 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 (p < 0.001).
CONCLUSIONS: 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.
摘要：
背景：需要采取干预措施来帮助人们减少日常产品和生活习惯中有害化学物质的暴露。个人暴露的报告是提高环境健康素养（EHL）和减少暴露的准备的潜在途径。
目的：我们的目的是确定内分泌干扰化学物质（EDC）的报告是否可以减少EDC暴露。增加EHL,并增加改变的准备程度(即，实施EDC降低暴露行为)。
方法：健康内华达州项目的参与者在报告干预之前（n=424）和之后（n=174）完成了EHL和准备更改调查。参与者使用邮寄试剂盒来测量EDC的尿液生物标志物。结果的报告包括尿液水平，关于健康影响的信息，暴露源,和个性化的建议，以减少曝光。
结果：基线时EHL通常非常高，特别是与一般污染有关的问题。对于与化学暴露有关的问题，在几个人口统计数据中，反应各不相同。在报告后，可以看到EHL反应的统计上可靠的改善。为了准备改变，72%的人已经或计划改变他们的行为。干预后，女性增加了他们的准备(p=0.053)，而男性则减少（p=0.007）。当被问及他们在减少暴露方面面临哪些挑战时，79％的人说不知道该做什么。报告后下降到35％。对羟基苯甲酸丙酯含量较高的参与者较年轻（p=0.03），女性和健康状况良好的参与者的邻苯二甲酸酯含量较高（分别为p=0.02-0.003和p=0.001-0.003）。在报告后，在干预前后接受有效尿检的48名参与者中,邻苯二甲酸单丁酯下降(p<0.001).
结论：报告干预是成功的，EHL行为增加证明，妇女更愿意改变，和邻苯二甲酸单丁酯的减少。对化学暴露更敏感的EHL问卷将有助于区分高识字率和低识字率。未来的研究将集中在理解为什么男性降低了改变的准备程度，以及如何改善所有参与者的干预措施。
目的：我们的目的是确定内分泌干扰化学物质（EDC）的报告是否可以减少EDC暴露。增加EHL,并增加改变的准备程度(即，实施EDC降低暴露行为)。
方法：健康内华达州项目的参与者在报告干预之前（n=424）和之后（n=174）完成了EHL和准备更改调查。参与者使用邮寄试剂盒来测量EDC的尿液生物标志物。结果的报告包括尿液水平，关于健康影响的信息，暴露源,和个性化的建议，以减少曝光。
结果：基线时EHL通常非常高，特别是与一般污染有关的问题。对于与化学暴露有关的问题，在几个人口统计数据中，反应各不相同。在报告后，可以看到EHL反应的统计上可靠的改善。为了准备改变，72%的人已经或计划改变他们的行为。干预后，女性增加了他们的准备(p=0.053)，而男性则减少（p=0.007）。当被问及他们在减少暴露方面面临哪些挑战时，79％的人说不知道该做什么。报告后下降到35％。对羟基苯甲酸丙酯含量较高的参与者较年轻（p=0.03），女性和健康状况良好的参与者的邻苯二甲酸酯含量较高（分别为p=0.02-0.003和p=0.001-0.003）。在报告后，在干预前后接受有效尿检的48名参与者中,邻苯二甲酸单丁酯下降(p<0.001).
结论：报告干预是成功的，EHL行为增加证明，妇女更愿意改变，和邻苯二甲酸单丁酯的减少。对化学暴露更敏感的EHL问卷将有助于区分高识字率和低识字率。未来的研究将集中在理解为什么男性降低了改变的准备程度，以及如何改善所有参与者的干预措施。
