Prescriptions (Rx) for Prevention: Clinical Tools for Integrating Environmental Health into Pediatric Clinical Care

Abstract

The integration of environmental health (EH) into routine clinical care for children is in its early stages. The vision of pediatric EH is that all clinicians caring for children are aware of and able to help connect families to needed resources to reduce harmful environmental exposures and increase health-enhancing ones. Environmental exposures include air pollution, substandard housing, lead, mercury, pesticides, consumer products chemicals, drinking water contaminants, industrial facility emissions and, increasingly, climate change-related extreme weather and heat events. An identified need is to simultaneously educate clinicians while connecting families to evidence-based EH interventions. Here, we describe a multi-decadal effort to create, refine, and disseminate a clinical tool called Prescriptions (Rxs) for Prevention that responds to that identified need. These tools are modeled on a risk communication framework and use a format that support clinicians when they screen their patients for EH concerns, to then counsel on those topics, and refer to EH resources if needed. Rxs for Prevention—tailored with local resources—are now in use at more than a dozen sites in multiple regions of the U.S. supporting the promotion of healthy homes, communities, and the broader environment for children. These Rxs are reducing barriers to EH integration by educating clinicians, linking families to community resources, and strengthening clinic and community connections. On-going evaluation can help further the implementation of the Rxs for Prevention to help achieve the long-term vision of integrating EH into routine clinical care.