Increasing Parents Knowledge on Reducing Child Lead Exposure through Education Provided by Community Health Workers in El Paso, Texas

Background and significance: Childhood lead exposure continues to be a significant public health concern, especially within Hispanic and Latino communities. Exposure to environmental lead is associated with various adverse health outcomes among children. Unfortunately, parents may have limited knowledge on the topic of lead exposure and may be unaware of screening and mitigation options available to their families. Research on culturally competent educational interventions that focus on increasing parents\u27 knowledge on reducing childhood lead exposure is limited, particularly within Hispanic border communities. This study aimed to assess if a brief education session provided by Community Health Workers increased parents\u27 knowledge of reducing childhood lead exposure while also connecting families to needed screening and mitigation services. Methods: For this study, a door-to-door campaign approach was used. Two Community Health Workers (CHWs) went door-to-door, offering parents education on reducing childhood lead exposure and to enroll children in blood lead level screenings. The CHWs were accompanied most days by the team researcher, who helped keep field notes and organize the effort. When a parent or guardian-type family member was at home and agreed to participate, the session required a total of approximately 10 to 15 minutes. It included administering the 12-item knowledge questionnaire before and after the education and a verbal explanation of a brightly colored educational brochure designed especially for this study. The brochure included information on the most common sources of lead exposure in children, possible effects of lead exposure in children, and simple methods for preventing child exposure to lead in the home environment. Results: Due to the pandemic shutdowns, the full sample of subjects planned for this study could not be obtained. The available data were analyzed quantitatively and qualitatively. A total of 603 homes were approached door-to-door in 7 weeks. Of these approaches, 51 family members answered their doors, and 35 agreed to participate in the brief education session. For these analyses, data from 35 parents were used. Qualitative data in the form of field notes kept during door to door outreach, pertaining to parents responses and attitudes towards the intervention, and reasons for refusal to participate, were also summarized. All materials were available in Spanish and English, and the research workers were fully bi-lingual. The majority of the participants were female (88.6%, 31/35) and indicated Spanish as their preferred language for receiving educational materials (77%, 27/35). Comparison of pre-and post-education knowledge scores showed a significant knowledge increase following the one-on-one education session offered by Community Health workers (mean diff = –3.086; SD diff = 2.147) (p-value \u3c 0.001). Of the 35 participants who received the education session, 23 agreed to enroll their children in blood lead level screenings. Conclusions: While the brief education sessions provided by CHWs on reducing childhood lead exposure effectively increased knowledge among parents, a door-to-door method of outreach was not effective in recruiting a substantial amount of participants for this study, as answering rates were exceedingly low. Future educational interventions should build trust between parents and researchers to increase recruitment in education and screening programs. This can be achieved through multidisciplinary approaches, such as partnering with schools and trusted community centers. This study\u27s findings add to the currently limited research available on brief educational interventions on reducing childhood lead exposure in Hispanic communities