Public Health Nursing Practice: Finding Evidence to Apply to Environmental Health Issues

Background: Public health nursing (PHNs) competencies in the basic public health sciences require knowledge of the environment as a determinant of health and retrieval of this scientific evidence for practice. Most PHN practitioners and faculty understand lead poisoning and infectious diseases, but do not have sufficient knowledge of the broad scope of the physical environment, which encompasses biological, chemical, and physical agents and the built environment. However, these exposures are the key determinants of most health problems of the 21st Century. Methods: We convened a 7.5 hour computer laboratory workshop (repeated once) to accommodate 60 PHNs and nursing faculty in SE Wisconsin. Exemplars of environmental exposures (methylmercury in fish, environmental tobacco smoke, and the built environment) were used as paradigms for understanding environmental health and their application in public health practice. We used an interdisciplinary team to help workshop participants learn to sort through the maze of information on the internet, to recognize and access peer-reviewed articles and other credible references, to summarize findings and apply them to practice, and to identify additional resources including state consultants and environmental health centers funded by the National Institute of Environmental Health Sciences. Teaching strategies included PubMed searches, short video clips of toxicology experiments that illustrate adverse effects, and videos that demonstrate how to apply scientific evidence when educating communities (e.g., risk communication regarding fish in the Hmong community). We used case studies and other strategies to learn and apply information. We evaluated learning qualitatively by using content analysis and quantitatively by paired analyses of nominal and interval level data. Post-workshop support is provided through on-site consultation by the regional PHN consultant with additional support by the other team members. Results: Formative and initial summative findings indicate that this intensive workshop format with case-studies is effective in increasing knowledge and abilities to apply the information, as well as when and from whom to seek additional consultation. Summative evaluation is ongoing. Conclusions: Intensive hands-on multi-method learning is effective in increasing the competence of PHNs' use of evidence-based resources to address environmental health exposures to prevent environmentally-induced health problems.