The environment and children's health care in Northwest China

Leonardo Trasande, Jingping Niu, Juansheng Li, Xingrong Liu, Benzhong Zhang, Zhilan Li, Guowu Ding, Yingbiao Sun, Meichi Chen, Xiaobin Hu, Lung Chi Chen, Alan Mendelsohn, Yu Chen, Qingshan Qu

Research output: Contribution to journalArticle

Abstract

Background: Industrialization in the northwest provinces of the People's Republic of China is accelerating rapid increases in early life environmental exposures, yet no publications have assessed health care provider capacity to manage common hazards.Methods: To assess provider attitudes and beliefs regarding the environment in children's health, determine self-efficacy in managing concerns, and identify common approaches to managing patients with significant exposures or environmentally-mediated conditions, a two-page survey was administered to pediatricians, child care specialists, and nurses in five provinces (Gansu, Shaanxi, Xinjiang, Qinghai, and Ningxia). Descriptive and multivariable analyses assessed predictors of strong self-efficacy, beliefs or attitudes.Results: 960 surveys were completed with <5% refusal; 695 (72.3%) were valid for statistical analyses. The role of environment in health was rated highly (mean 4.35 on a 1-5 scale). Self-efficacy reported with managing lead, pesticide, air pollution, mercury, mold and polychlorinated biphenyl exposures were generally modest (2.22-2.52 mean). 95.4% reported patients affected with 11.9% reporting seeing >20 affected patients. Only 12.0% reported specific training in environmental history taking, and 12.0% reported owning a text on children's environmental health. Geographic disparities were most prominent in multivariable analyses, with stronger beliefs in environmental causation yet lower self-efficacy in managing exposures in the northwestern-most province.Conclusions: Health care providers in Northwest China have strong beliefs regarding the role of environment in children's health, and frequently identify affected children. Few are trained in environmental history taking or rate self-efficacy highly in managing common hazards. Enhancing provider capacity has promise for improving children's health in the region.

Original languageEnglish (US)
Article number82
JournalBMC Pediatrics
Volume14
Issue number1
DOIs
StatePublished - Mar 27 2014

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Self Efficacy
Child Care
China
Delivery of Health Care
Health Personnel
Environmental Health
Environmental Exposure
Causality
Publications
Child Health
Surveys and Questionnaires

Keywords

  • Air pollution
  • Children's environmental health
  • Industrializing world
  • Practice
  • Self-efficacy
  • Survey

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Trasande, L., Niu, J., Li, J., Liu, X., Zhang, B., Li, Z., ... Qu, Q. (2014). The environment and children's health care in Northwest China. BMC Pediatrics, 14(1), [82]. https://doi.org/10.1186/1471-2431-14-82

The environment and children's health care in Northwest China. / Trasande, Leonardo; Niu, Jingping; Li, Juansheng; Liu, Xingrong; Zhang, Benzhong; Li, Zhilan; Ding, Guowu; Sun, Yingbiao; Chen, Meichi; Hu, Xiaobin; Chen, Lung Chi; Mendelsohn, Alan; Chen, Yu; Qu, Qingshan.

In: BMC Pediatrics, Vol. 14, No. 1, 82, 27.03.2014.

Research output: Contribution to journalArticle

Trasande, L, Niu, J, Li, J, Liu, X, Zhang, B, Li, Z, Ding, G, Sun, Y, Chen, M, Hu, X, Chen, LC, Mendelsohn, A, Chen, Y & Qu, Q 2014, 'The environment and children's health care in Northwest China', BMC Pediatrics, vol. 14, no. 1, 82. https://doi.org/10.1186/1471-2431-14-82
Trasande L, Niu J, Li J, Liu X, Zhang B, Li Z et al. The environment and children's health care in Northwest China. BMC Pediatrics. 2014 Mar 27;14(1). 82. https://doi.org/10.1186/1471-2431-14-82
Trasande, Leonardo ; Niu, Jingping ; Li, Juansheng ; Liu, Xingrong ; Zhang, Benzhong ; Li, Zhilan ; Ding, Guowu ; Sun, Yingbiao ; Chen, Meichi ; Hu, Xiaobin ; Chen, Lung Chi ; Mendelsohn, Alan ; Chen, Yu ; Qu, Qingshan. / The environment and children's health care in Northwest China. In: BMC Pediatrics. 2014 ; Vol. 14, No. 1.
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abstract = "Background: Industrialization in the northwest provinces of the People's Republic of China is accelerating rapid increases in early life environmental exposures, yet no publications have assessed health care provider capacity to manage common hazards.Methods: To assess provider attitudes and beliefs regarding the environment in children's health, determine self-efficacy in managing concerns, and identify common approaches to managing patients with significant exposures or environmentally-mediated conditions, a two-page survey was administered to pediatricians, child care specialists, and nurses in five provinces (Gansu, Shaanxi, Xinjiang, Qinghai, and Ningxia). Descriptive and multivariable analyses assessed predictors of strong self-efficacy, beliefs or attitudes.Results: 960 surveys were completed with <5{\%} refusal; 695 (72.3{\%}) were valid for statistical analyses. The role of environment in health was rated highly (mean 4.35 on a 1-5 scale). Self-efficacy reported with managing lead, pesticide, air pollution, mercury, mold and polychlorinated biphenyl exposures were generally modest (2.22-2.52 mean). 95.4{\%} reported patients affected with 11.9{\%} reporting seeing >20 affected patients. Only 12.0{\%} reported specific training in environmental history taking, and 12.0{\%} reported owning a text on children's environmental health. Geographic disparities were most prominent in multivariable analyses, with stronger beliefs in environmental causation yet lower self-efficacy in managing exposures in the northwestern-most province.Conclusions: Health care providers in Northwest China have strong beliefs regarding the role of environment in children's health, and frequently identify affected children. Few are trained in environmental history taking or rate self-efficacy highly in managing common hazards. Enhancing provider capacity has promise for improving children's health in the region.",
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AU - Liu, Xingrong

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AU - Li, Zhilan

AU - Ding, Guowu

AU - Sun, Yingbiao

AU - Chen, Meichi

AU - Hu, Xiaobin

AU - Chen, Lung Chi

AU - Mendelsohn, Alan

AU - Chen, Yu

AU - Qu, Qingshan

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