Margaret Willis

Project title: Developing tools for evaluating and enhancing clinician outreach training on pesticides and child health

Degree: MPH | Program: Environmental and Occupational Health (EOH) | Project type: Practicum
Completed in: 2015 | Faculty advisor: Catherine Karr


A survey of healthcare providers and community health workers serving agricultural areas in the Pacific Northwest found that only 22% report any training on pesticides and child health and 61% report feeling uncomfortable responding to questions from patients on the topic. In response, the Northwest Pediatric Environmental Health Specialty Unit (NW PEHSU) developed a 1-hour, in person outreach training course for clinicians. The goal of this practicum project was to develop tools to evaluate and enhance efforts by the NW PEHSU to increase clinician knowledge and confidence on the topic. First, an evaluation tool was created to measure: 1. level of knowledge through multiple-choice questions on important concepts in pesticide and child health; and, 2. level of self-efficacy (one’s confidence in the ability to perform a defined task) through survey questions modified from published peer review research. Effectiveness was defined as an increased score and/or confidence rating in post-training testing compared to pre-training testing. On average, training participants showed increases in both test scores and self-efficacy ratings. The results support the effectiveness of NW PEHSU’s outreach trainings. Second, a factsheet was created that summarized key information from the outreach training on recognizing exposures, proper management, and providing guidance for prevention. An online survey was generated to get feedback on its content, design, and perceived usefulness. It was administered to volunteers from outreach trainings and clinicians identified by the NW PEHSU director. Respondents who had attended training agreed with statements that the factsheet reinforced key information and added value to the training. Next steps should include: incorporating feedback into a final version of the factsheet and placing it online; measuring use of the factsheet by how often the page is visited online or how often the file is downloaded; and, retesting clinicians who attended training for retention of knowledge, sustained level of reported self-efficacy, and increased screening and counseling for pesticide exposure with patients.