title: The environmental history in pediatric practice: a study of pediatricians' attitudes, beliefs, and practices.
abstract: We conducted a mail survey of practicing pediatricians in Georgia to assess their knowledge, attitudes, and behaviors regarding recording patients' environmental histories. Of 477 eligible pediatricians, 266 (55.8%) responded. Fewer than one in five reported having received training in environmental history-taking. Pediatricians reported that they strongly believe in the importance of environmental exposures in children's health, and 53.5% of respondents reported experience with a patient who was seriously affected by an environmental exposure. Pediatricians agreed moderately strongly that environmental history-taking is useful in identifying potentially hazardous exposures and in helping prevent these exposures. Respondents reported low self-efficacy regarding environmental history-taking, discussing environmental exposures with parents, and finding diagnosis and treatment resources related to environmental exposures. The probability of self-reported history-taking varied with the specific exposure, with environmental tobacco smoke and pets most frequently queried and asbestos, mercury, formaldehyde, and radon rarely queried. The pediatricians' preferred information resources include the American Academy of Pediatrics, newsletters, and patient education materials. Pediatricians are highly interested in pediatric environmental health but report low self-efficacy in taking and following up on environmental histories. There is considerable opportunity for training in environmental history-taking and for increasing the frequency with which such histories are taken.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.
authors.forename: Nikki
authors.initials: N
authors.lastname: Kilpatrick
authors.forename: Howard
authors.initials: H
authors.lastname: Frumkin
authors.forename: Jane
authors.initials: J
authors.lastname: Trowbridge
authors.forename: Cam
authors.initials: C
authors.lastname: Escoffery
authors.forename: Robert
authors.initials: R
authors.lastname: Geller
authors.forename: Leslie
authors.initials: L
authors.lastname: Rubin
authors.forename: Gerald
authors.initials: G
authors.lastname: Teague
authors.forename: Janice
authors.initials: J
authors.lastname: Nodvin
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D004781:Environmental Exposure; D004782:Environmental Health; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000379:methods*; D008875:Middle Aged; D010372:Pediatrics; D018570:Risk Assessment