Pediatrician perceptions and prescription of environmental and social interventions to combat childhood lead poisoning

Despite reductions in reported cases of child lead poisoning, the illness still disproportionately affects many socially disadvantaged communities. The literature revealed that multiple non-clinical factors including housing, income, race, and lack of information provided to parents, contributed to lead poisoning. However previous research did not indicate how pediatricians viewed the importance of environmental and social interventions in combating child lead poisoning. Therefore, this study examined pediatricians' perceptions on conveying nonclinical information about child lead poisoning to patients' families. The health belief model served as the foundation to examine the extent to which pediatricians revealed their perceptions on the importance of environmental and social contributions to child lead poisoning to the parents and guardians of their patients. A mixed methods study was conducted that included an interview with a subgroup of pediatricians. The interview data established some basic pediatrician perceptions about environmental and social contributions to lead poisoning. Tabulated responses were complementary to the main quantitative survey. That survey involved 113 of 449 contacted pediatricians who completed a survey designed to quantify their perceptions on social and environmental influences to child lead poisoning. Logistic regression and split data analyses revealed that pediatricians with 50% or more Medicaid practices were at least twice as likely as their pediatrician colleagues to emphasize the importance of assessing environmental and social information to their patients (OR 2.62, 95% CI 1.15-5.96). The social change implication of this research is that as they treat more socially disadvantaged patients, pediatricians will increasingly elevate social and environmental literacy about lead poisoning for larger percentages of their clients.