RURAL LEAD EDUCATION--EVALUATION OF CONSULTANT METHODS

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DESCRIPTION: (Adapted from investigator's abstract) Between 9% and 17% of rural children are estimated at risk for the devastating effects of lead poisoning. Community health nurse consultants have traditionally worked with rural public health providers to reduce risk factors and increase prevention activities with no provision for evaluation of alternative strategies in the consultant role. This study will test the effectiveness of consultation provided at three levels (minimal/control, moderate, & maximum) to three randomly assigned rural counties for the development of county-wide, collaborative education programs. Consultation will be assessed for its impact on: community knowledge of lead hazards; interagency collaboration; cost; rates of lead screenings and identified cases; and number of implemented lead education programs. Each county will be asked to form an interagency community lead education coalition. The intensity of the consultation provided to the coalition will differ by county. In County A, consultation will occur during routine quarterly contacts; in County B, the consultant will initiate monthly contacts and serve as an ad-hoc member of the Coalition; in County C, the consultant will initiate weekly contacts, be on the coalition, and co-plan program initiatives. The community lead education initiatives will have three major foci: public service announcements; education of pre-schoolers and parents; and education of those involved in remodeling of older homes. Changes in community lead knowledge level will be assessed via pre and post intervention surveys of: random selected residents with a phone; WIC participants without a phone; minority residents; and the Committee Effectiveness Inventory. Costs will be determined by monitoring direct consultant costs, program costs, and cost effectiveness. Lead screenings will be charted monthly for 12 months prior to and 12 months post-intervention. Data on the community lead education initiatives will be gathered as they occur and consultant contact will be documented after each encounter. Results from this study will build empirical guidelines for interventions by public health nurse consultants and providers planning rural community health education.