Expanding effective report-back of environmental exposures among new researchers and clinic-based studies

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PROJECT SUMMARY By reporting back to study participants on their personal biomonitoring and environmental exposure results, researchers can advance environmental health literacy (EHL), empower individual actions to reduce harmful chemical exposures, activate civic engagement in policymaking, respect right-to-know ethics, and improve study recruitment and retention. Despite this report-back is not yet a widespread practice in environmental health. We hypothesize that barriers to report-back include limited funding, inexperience, and concerns about participant worry. In line with the diffusion of innovation theory, we expect that a training program will expand researcher knowledge of report-back ethics and methods and increase their willingness and ability to engage with this form of community-based research. We also hypothesize that involving clinicians with little previous training in environmental health will result in broadly accrued benefits, including improved clinical outcomes and clinician-patient relationships, heightened study engagement, and increased EHL for both health professionals and patients. This study will use semi-structured interviews and pre- and post-tests to pursue three specific aims: 1) Identify factors that hinder and promote report-back for individual studies and federally-funded programs; 2) Evaluate a program to train researchers to participate in report-back; 3) Develop effective strategies for engaging health practitioners in report-back and assess outcomes for clinicians and patients. This research is innovative because it is the first to study the considerations of investigators who do not report-back, as well as the perspectives and experiences of funding agencies that support this research, so that guidance and tools can be developed and evaluated (Aim 1). Furthermore, our project will create a model of report-back for the large number of federal programs and funding that support environmental health measurements in clinical settings, including mega-cohorts like ECHO, the NIEHS’ Superfund Research Program, and NIH’s All of Us (Aim 2). By partnering with pregnancy and early childhood cohort studies focused on low-income populations and communities of color, the proposed project will allow us to develop guidance on reporting back for vulnerable populations and sensitive periods of development, an understudied area of research. The proposed research is significant because it will increase researcher and clinician knowledge of report- back, help surmount barriers to its adoption, develop new methods to evaluate its effectiveness, encourage the development of federal guidance and policies on report-back, and advance NIEHS’ strategic goal to translate data to knowledge to action.