Protecting Children's Environmental Health in a Changing Climate: A Model Collaboration of the Maternal and Child Health Section and the Environment Section of APHA.

PURPOSE: The complexities of modern civilization, coupled with challenges including systemic racism and climate change-related impacts, compel public health professionals to break down silos and collaborate towards the shared goals of protecting the wellbeing of current and future generations. This article highlights the growing collaboration between the Maternal and Child Health (MCH) and the Environment (ENV) Sections of the American Public Health Association (APHA) as members bring their collective focus to the protection of children's and pregnant people's environmental health. DESCRIPTION: The MCH Section and the Children's Environmental Health (CEH) Committee of the ENV Section are collaborating on efforts to: inform key stakeholders?including public health and health care professionals, child care professionals, families, and youth?about environmental hazards and climate change impacts to children's and pregnant people's health and wellbeing; and provide tools and guidance about how to best protect these groups and how to advocate for climate action. The CEH Committee embraces a health equity paradigm and intentionally centers environmental, racial, and social justice as integral to effective children's health and climate change initiatives. ASSESSMENT: Projects to date include multiple joint sessions about children's environmental health and climate change at APHA's annual meetings, publications and various children's environmental health tools and resources, including a toolkit and lesson plan that equips public health professionals to provide guest lectures at their local high schools on climate change and health, and educational materials for caregivers on extreme heat, wildfires, and ticks and mosquitos. CONCLUSION: This collaboration could serve as a replicable model that can be applied to other interdisciplinary efforts seeking strategic partnerships to address complex health issues.

Integrating Environmental Management of Asthma into Pediatric Health Care: What Worked and What Still Needs Improvement?

The National Environmental Education Foundation (NEEF) launched an initiative in 2005 to integrate environmental management of asthma into pediatric health care. This study, a follow-up to a 2013 study, evaluated the program's impact and assessed training results by 5 new faculty champions. We surveyed attendees at training sessions to measure knowledge and the likelihood of asking about and managing environmental triggers of asthma. To conduct the program evaluation, a workshop was held with the faculty champions and NEEF staff in which we identified major program benefits, as well as challenges and suggestions for the future. Trainee baseline knowledge of environmental triggers was low, but they reported robust improvement in environmental triggers knowledge and intention to recommend environmental management. The program has a broad, national scope, reaching more than 12 000 physicians, health care providers, and students, and some faculty champions successfully integrated materials into health record. Program barriers and future endeavors were identified.

Improving pediatrician knowledge about environmental triggers of asthma.

BACKGROUND: Control of environmental triggers (ETs) greatly improves asthma outcomes in children. Disseminating these findings to general pediatricians has not been well established. METHODS: After delivering a structured and standardized presentation on ET identification and control to pediatricians, we surveyed them about knowledge and practices of ET assessment and management. We analyzed matched responses for pre/post and 3- to 6-month follow-up using McNemar's χ(2) test. RESULTS: Matched data were available for 367 participants, and 3- to 6-month follow-up data were available for 83. There was a significant posttraining increase in intention to ask about ETs and recommend ET management. After 3 to 6 months, all responses remained significantly higher than baseline, except "likely to refer to an asthma specialist." CONCLUSION: Pediatricians reported a significant improvement in knowledge about ETs of asthma and a willingness to incorporate exposure history questions and remediation recommendations in their routine practice.

Using nature and outdoor activity to improve children's health.

Childhood obesity affects 17% or 12.5 million of America's children, contributing to the rise in children's health disparities. Type 2 diabetes, asthma, vitamin D deficiency, and attention-deficit/hyperactivity disorder have also increased over the past few decades. A shift toward a sedentary lifestyle is a major contributor to the decline in children's health. Children spend more time indoors using electronic media and less time engaged in outdoor unstructured play. This article reviews the current evidence of the mental and physical health benefits associated with unstructured, outdoor activities and time spent in a natural environment such as a park or other recreational area. Pediatric health care providers should recommend outdoor activities for children and refer families to safe and easily accessible outdoor areas. Pediatric health care providers can incorporate this simple, lifestyle-based intervention into anticipatory guidance.