Can a smartphone tutorial improve environmental health literacy?
People want to understand and reduce the levels of harmful chemicals in their body. Researchers tried to see if a quick tutorial could help them interpret test results.
Flame retardants, plasticizers, and “forever” chemicals are common in household items like cookware and cosmetics. But these materials that people are exposed to everyday have also been linked to health issues like decreased fertility and increased risk of certain cancers.
While environmental health studies have helped explore the relationship between these common chemicals and our health, these studies don’t always report back to participants what they found.
But that doesn’t mean people aren’t curious. That’s what Phil Brown, university distinguished professor of sociology and health sciences and the director of Northeastern University’s Social Science Environmental Health Research Institute, learned over the course of his work: Many people who participated in studies about the harmful chemicals in their body wanted to know what the researchers found.
“Most environmental health research does not share the results, surprising as that may seem,” Brown said.
He also wanted to change that.
“It was, at that point, a very unique thing for us to say, ‘Okay, we’re going to visit people and show them (their results),’” he added.
A new study co-led by Brown, found a smartphone tutorial could help people better understand the amount of harmful chemicals found in their body and how to reduce their exposure to them.
The graph-reading tutorial “[has] been very important, both for improving science, and improving environmental health literacy on the part of the participants,” Brown told Northeastern Global News. “It’s an improvement in helping people make sense of what’s in their bodies.”
The study resulted from a longstanding collaboration that includes, among others, Northeastern and the Silent Spring Institute, a Boston-area research organization dedicated to uncovering the environmental causes of breast cancer. The work is funded by the National Institute of Environmental Health Sciences and began with a 1993 study from the Silent Spring Institute that looked at potential environmental links to high rates of breast cancer among women on Cape Cod, Massachusetts. It was one of the first studies to look at the levels of harmful chemicals in a woman’s body, Brown said.
“And people really wanted to know the results,” he added.
This became a model for other environmental health studies and also led to the creation of the report back, Brown said, a model his team later used to share results with interested participants.
Using texts, graphs and images, researchers designed personal reports to answer participant questions about their exposure. These reports were first on paper, then on a web application. But they wanted to see if a tutorial could further help people understand the graphs that charted their results.
In their latest work, published in the Journal of Exposure Science & Environmental Epidemiology, Brown and his team tested a smartphone tutorial on people from two different cohorts focused on examining the effects of chemical and psychosocial stressors during pregnancy on child neurodevelopment.
The tutorial was built into the web application where people get their results and was optional for them to take before getting their information. Most people who were offered the tutorial chose to take it, the study said.
Nearly 300 people from the California-based Chemicals in Our Bodies cohort and the Illinois Kids Development Study received test results with their personalized chemical exposure levels. People in the California group received measurements looking at the levels of a common type of flame retardant and harmful “forever” chemicals. People in the other group also got information about such chemicals.
Katie Boronow, a research scientist at the Silent Spring Institute who was involved in the study, said the tutorial used a “predict, observe and explain” framework. Before receiving the results of their chemical exposure tests, participants were asked to guess what they thought their exposure level would be.
In the “observe” phase, participants received multiple choice questions that focused on how to interpret their results graph and what it said about their own exposure compared to the national median.
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“The tutorial was intended to build people’s confidence in interpreting their results,” Boronow said. “The middle phase was really about building graph literacy and confidence. What we’ve seen in our research is that people generally see graphs and feel some hesitation. People generally understand graphs on their own, but we really wanted to give people the confidence they’re interpreting them correctly.”
Boronow said that the study found most people felt comfortable reading their results even without the tutorial.
“Even without the tutorial assistance, 70 percent of people answered all four graph reading questions correctly on their first attempt,” Boronow said.
At the same time, the study found that people without a bachelor’s degree had a lower understanding of their personal results graph before the tutorial, but watching the tutorial helped improve their understanding. That group had a 46 percentage point improvement in answering all four questions correctly with the tutorial assistance, Boronow said.
The final phase of the tutorial, “explain,” gave people personalized recommendations to reduce exposure, such as avoiding personal care products.
The teams behind the study will continue to build on this research by expanding the tutorial, specifically the “explain” phase to make it more easy to access in people’s daily lives, Boronow said.
“People are deeply interested in exploring these issues, seeing what’s in their bodies, what’s in the air around them, and really learning how to read graphs and talk about it and to raise questions,” Brown said. “This whole body of research has been showing that this doesn’t require high levels of education that the average person can make sense of their health and environmental factors.”
