Experiences of clinicians engaged in report-back of individual chemical exposures in two pregnancy cohorts.

Reporting individualized chemical exposure results increases environmental health literacy, empowers study participants to reduce harmful exposures, and supports researchers in identifying and addressing exposure sources. Despite recommendations to increase clinicians’ roles in environmental health promotion, clinician-involvement in environmental health report-back remains limited. This study investigates clinician-facilitated environmental health report-back as a promising approach to results dissemination. We partnered with two pregnancy cohort studies to implement report-back of individual chemical results delivered by clinicians. Nine clinicians provided individualized exposure results to 87 participants across the two cohort studies. Following report-back sessions, we conducted semi-structured interviews to assess clinician experiences, perceived facilitators and barriers to report-back, and shifts in environmental health knowledge. Clinician-facilitated report-back was described as a rewarding process that enhanced clinicians’ ability to not only guide study participants through their individual chemical results but also expand their ability to provide environmental health information to other patients. Clinicians reported increased environmental health knowledge and adoption of personal exposure reduction habits. Clinicians from both cohorts discussed the challenge of communicating scientific uncertainty surrounding specific chemical exposures and related health outcomes. To address this, clinicians relied on structured training and materials developed by the study team to provide practical and actionable exposure reduction recommendations. Expanding training opportunities, embedding environmental health information into medical curricula and clinical practice, and developing guidance for clinician participation could advance communication of environmental exposure results.