Readability levels and thematic content analysis of online and printed lead poisoning informational materials

Background Lead poisoning prevention efforts include preparing and disseminating informational materials such as brochures and pamphlets to increase awareness of lead poisoning, lead exposures and lead poisoning prevention. However, studies have demonstrated that patient education materials for diseases and health conditions are prepared at a reading level that is higher than the recommended 7th–8th grade reading level. This study, therefore, aims to assess the reading levels of lead poisoning informational materials. Methods Lead poisoning materials (N = 31) were accessed from three states; Michigan, New York and Pennsylvania. The readability levels of the materials were assessed using the Flesh Kincaid Grade Level readability test. The Kruskal-Wallis test was conducted to determine if the readability levels differed between the materials obtained from the different states. Thematic content analyses were carried out to assess the inclusion of four themes; definition of lead poisoning, risk factors and exposures, testing and referral and prevention covering 12 subtopics. The Wilcoxon rank sum test was used to examine if there was a difference in the number of subtopics by readability level (dichotomized to >8th grade and < 8th grade). Results The median readability level of the informational materials was 6.7 (IQR: 5.1–8.1). However, there was variability in the readability levels of the materials (range 3.5 to 10.6); materials obtained from Michigan had the highest median reading level of 8.1 (IQR: 6.9–9.0) followed by Pennsylvania. Heterogeneity was observed in the content of the materials. Most of the materials (80%) from Michigan focused on water as a source of lead poisoning, whereas materials from New York and Pennsylvania focused on lead-based paint and other sources. The materials prepared at >8th grade reading level contained fewer topics than materials prepared at <8th grade reading level. Conclusions We find that the materials were often prepared at reading levels lower than the recommended 8th grade reading level. However, there is variability in the reading levels and in the content of the materials. While the materials met the general readability guidelines, they did not necessarily meet the needs of specific groups, especially groups at risk.

Lead poisoning prevention: A community-based participatory research program in Mississippi

Background and objectives: Lead poisoning is a preventable environmental health hazard. Although the prevalence of lead poisoning is declining, the rates are disproportionately high in selected communities. This community-based participatory research (CBPR) program aimed to enhance people’s awareness on lead poisoning prevention through community outreach and educational interventions in Mississippi. Methods: Secondary data of 42,372 children obtained from the Mississippi State Department of Health were analyzed to identify the most affected communities in Mississippi. Community-based outreach and education activities were carried out in the most affected areas to increase population awareness on lead poisonig prevention. Results: Hands-on training was offered to 25 participants at homebuilding retail stores. Of them, 23 (92%) reported the hands-on training was very useful or useful. Among 91 home-buyers and rental home owners who attended workshops offered by the Neighborhood Association, 90% mentioned that the training was useful or very useful. An online visual training was given to 220 realtors, and 75 inspectors, contractors, and Do-It-Yourself (DIY) workers. At posttest, 59.4%, 67.9%, 65.1% of the realtors, inspectors, contractors and DIY workers (n = 295) identified soil, car batteries and paint as sources of lead in the environment, respectively. A total of 62.3%, 48.1% and 58.5%, at posttest, identified three complications - behavioral, physical and psychological, respectively. The mean posttest score was significantly higher than the pretest scores (7.47 ± 2.07 vs. 6.60 ± 1.68, p = 0.04, respectively). Conclusion: These outreach activities were successful in improving the knowledge of the community people on lead poisoning prevention. Ibrahim Med. Coll. J. 2021; 15(1): 16-25

Insights into the Slow Uptake of Residential Lead Paint Remediation Funds: A Lancaster, Pennsylvania, Case Study

Lead poisoning is a preventable condition that continues to affect thousands of children each year. Given that local governments and municipalities are eligible to apply for federal funds to perform lead remediation in low-income family homes, we sought to understand how lead poisoning knowledge levels may affect the uptake of these funds. We recruited and conducted 28 in-depth, semi-structured interviews with community members from Lancaster County in the state of Pennsylvania in the USA. We audio-recorded and transcribed each interview, and analyzed each transcript for salient themes. The interviewed participants displayed a varying degree of knowledge about lead and lead poisoning. Most of the participants were unaware of the lead paint remediation funds. Participants learned about lead from various sources, such as social media, and personal experiences with lead poisoning appeared to enhance knowledge. Some participants assumed lead poisoning prevention would be addressed by other stakeholders if necessary, including healthcare professionals and landlords. The results of this study suggest that in order to increase the timely uptake of the remediation funds, community-based organizations should design interventions that aim to increase awareness and knowledge about lead poisoning and lead poisoning prevention. These interventions should be tailored for different audiences including community members, healthcare professionals, and landlords.

Bridging Silos: A Research Agenda for Local Environmental Health Initiatives

The environment and public health are managed by separate institutions that often operate in isolation from each other. This system is often referred to as managing in “silos.” The resulting lack of coordination, inadequate consideration of cumulative effects, and diffuse targets for change contribute to the persistence of many environmental justice problems. There are many barriers to bridging these silos, particularly at state and federal levels. Local collaborations, however, may have greater potential for changing these systems. There has been limited assessment of successful local environmental health initiatives. This paper explores three case studies of local collaboration: lead poisoning prevention in Rochester, New York; promoting a healthy and equitable built environment in Duluth, Minnesota; and increasing consideration of community health in decisions around the ports of Los Angeles and Long Beach, California. It develops a research agenda to inform future collaborations to improve environmental health equity through local systems change.