266912 Translating environmental health research into clinical practice: A survey of Pediatric Hematologists and Oncologists

Wednesday, October 31, 2012 : 12:30 PM - 12:50 PM

Christine Zachek, MPH , Pediatric Environmental Health Specialty Unit, University of California San Francisco, San Francisco, CA
Gary Dahl, MD , School of Medicine, Stanford University, Palo Alto, CA
Mark Miller, MD MPH , School of Medicine and Pediatric Environmental Health Specialty Unit, University of California San Francisco, San Francisco, CA
Clinical practice plays an important role in advancing children's environmental health and preventing harmful exposures. Specifically, clinical history taking can enhance data collection and promote doctor-patient communications in this area. While scientific studies have recently highlighted evidence of environmental contributions to the incidence of childhood leukemia worldwide, we hypothesize that there have not been corresponding advances in the clinical world to incorporate this evidence into routine practice. To test this assumption, we conducted a survey of Pediatric Hematologists and Oncologists to assess their environmental history-taking behavior and perceptions of environmental health evidence relevant to their work. The survey was piloted among a group of practitioners at Lucile Packard Children's Hospital at Stanford, and expanded to include members of professional clinical networks across the country. Results indicate that environmental exposures are of concern to clinicians, but a lack of familiarity or comfort in discussing these issues with patient's families presents a significant barrier. Although a substantial percentage of practitioners often suspected cases to have environmental etiologies, rates of asking about environmental exposures during routine history taking were low and the questions inconsistent. This research implies a need for increased training and awareness of environmental health among clinical practitioners, and interventions related to history taking practices such as identifying behavior change strategies or incorporating self-administered intake questionnaires into patient care.

Learning Areas:
Environmental health sciences
Other professions or practice related to public health
Public health or related research

Learning Objectives:
1) Describe the importance of clinical history taking to environmental public health and individual patient care. 2) Assess gaps in history taking behavior and environmental health familiarity among practitioners specializing in childhood cancers. 3) Identify perceived barriers facing clinicians to incorporating environmental health research into clinical practice. 4) Discuss potential interventions in research translation to the clinical community.

Keywords: Children's Health, Environmental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I developed the survey tool and conducted data analysis for this study. Authors also have extensive practical and theoretical knowledge of environmental contributors to pediatric cancers and environmental health history-taking in clinical settings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.