Background: Industrialization in the northwest provinces of the People�s Republic of China is accelerating rapid\nincreases in early life environmental exposures, yet no publications have assessed health care provider capacity to\nmanage common hazards.\nMethods: To assess provider attitudes and beliefs regarding the environment in children�s health, determine\nself-efficacy in managing concerns, and identify common approaches to managing patients with significant\nexposures or environmentally-mediated conditions, a two-page survey was administered to pediatricians, child\ncare specialists, and nurses in five provinces (Gansu, Shaanxi, Xinjiang, Qinghai, and Ningxia). Descriptive and\nmultivariable analyses assessed predictors of strong self-efficacy, beliefs or attitudes.\nResults: 960 surveys were completed with <5% refusal; 695 (72.3%) were valid for statistical analyses. The role of\nenvironment in health was rated highly (mean 4.35 on a 1-5 scale). Self-efficacy reported with managing lead, pesticide,\nair pollution, mercury, mold and polychlorinated biphenyl exposures were generally modest (2.22-2.52 mean).\n95.4% reported patients affected with 11.9% reporting seeing >20 affected patients. Only 12.0% reported specific\ntraining in environmental history taking, and 12.0% reported owning a text on children�s environmental health.\nGeographic disparities were most prominent in multivariable analyses, with stronger beliefs in environmental\ncausation yet lower self-efficacy in managing exposures in the northwestern-most province.\nConclusions: Health care providers in Northwest China have strong beliefs regarding the role of environment in\nchildren�s health, and frequently identify affected children. Few are trained in environmental history taking or\nrate self-efficacy highly in managing common hazards. Enhancing provider capacity has promise for improving\nchildren�s health in the region.
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