Michelle Sommargren

Project title: Reducing Childhood Pesticide Exposure by Targeting the Clinician Pesticide Training Gap: The Design, Implementation, and Evaluation of an Online Curriculum

Degree: MPH | Program: Environmental and Occupational Health (EOH) | Project type: Thesis/Dissertation
Completed in: 2007


In 2005, a key informant survey conducted by researchers with the Pacific Northwest Agricultural Safety & Health (PNASH) Center identified a clinician pesticide training gap. In this survey, physicians, mid-level providers, and community health workers serving agricultural communities in the Pacific Northwest were asked about their familiarity, experience and interest in the subject of pesticide exposure and child health. Although the key informants provided care to children at high risk for pesticide exposure, only 50% of those questioned had any pesticide related health training, and only 22% had received child-specific information. An overwhelming majority of providers (92%) expressed an interest in receiving child-specific pesticide information. Format preferences for future training varied, with physicians preferring web-based training materials, mid-level clinicians requesting written summaries, and community health workers favoring a conference or workshop format. Building upon these results, a web-based curriculum entitled Organophosphate Pesticides & Child Health: A Primer for Health Care Providers was developed to target the pesticide training gap in physicians, principally, and mid-level practitioners, secondarily. The curriculum follows a case-based format, tracking the presentation, diagnosis, treatment and follow-up of an infant poisoned by organophosphate pesticides in the home. The curriculum is freely available on the web and may be taken for 2 AMA PRA Category 1 CreditsTM through October 31, 2008. Embedded in the CME curriculum is an online evaluation, made up of a quantitative pre/posttest and a qualitative survey. Preliminary results from a pilot test of the online curriculum indicate that the course can improve clinician competency regarding pesticides and child health. Mean test scores improved 19% from pretest to posttest (n=8, p<0.0002). As important, qualitative feedback about the content, format and usefulness of the curriculum has been positive. The embedded online evaluation will be used to gauge the future success of the curriculum. Efforts are now turning towards disseminating these materials to a wide audience of health care providers, regionally as well as nationally.

The curriculum can be viewed at: http://depts.washington.edu/opchild/