What do Parents Know about Environmental Health Literacy in relation to Children’s Health?

Document Type : Original Article


1 Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences,

2 Social Determinants of Health Research Center, Mashhad University of Medical Sciences


Background and Objective: Parents are the main target group for environmental health literacy (EHL), because most children under 7 years of age spend a lot of awake time under the care of parents. Children are exposed to toxic contaminants in the home and society, and yet little evidence is known about what parents know about the effect of the environmental contaminants on the children's health in their care. Therefore, this study tried to better understand how parents conceptualize “environment health literacy” and its impact on the health of children in their care. We also seek to understand what parents’ attitudes, and knowledge regarding the source and effect of environmental pollution that affect their children’s health. 

Materials and Methods: The qualitative content analysis method was conducted on 35 eligible parents from kindergartens throughout Mashhad, Razavi Khorasan province, Iran. A semi-structured interview based on open-ended questions from topics was conducted to better understand what parents know about the effect of EHL on their children’s health. The results were classified into them and contents. 
Results: parents identified physical environment, social and emotional environment, and intellectual and learning environment as the main characteristics for EHL and they had limited information on the EHL terminology and characterization.  Majority of parents had a low level of understanding about source and effect of toxic exposures that affect their children’s health.

Conclusion: This study highlights the need to raise parents’ knowledge and awareness toward environmental exposure that influences health of children. Such knowledge and awareness are critical starting point to facilitate movement a continuum of EHL and improve level of action in each community to protect human health, specially children.


1. Finn S, O'Fallon L. The emergence of environmental health literacy-from its roots to its future potential. Environmental health perspectives. 2017;125(4):495-501.
PMid:26126293 PMCid:PMC5382009
2. Koester BD, Sloane S, Fujimoto EM, Fiese BH, Su LY-F. What Do Childcare Providers Know about Environmental Influences on Children's Health? Implications for Environmental Health Literacy Efforts. International journal of environmental research and public health. 2021;18(10):5489.
PMid:34065537 PMCid:PMC8160689
3. Davis LF, Ramirez-Andreotta MD, McLain JE, Kilungo A, Abrell L, Buxner S. Increasing environmental health literacy through contextual learning in communities at risk. International journal of environmental research and public health. 2018;15(10):2203.
PMid:30304865 PMCid:PMC6210322
4. Khorasani MY, Langari H, Sany SBT, Rezayi M, Sahebkar A. The role of curcumin and its derivatives in sensory applications. Materials Science and Engineering: C. 2019;103:109792.
5. Jafari Y, Vahedian-Shahroodi M, Tehrani H, Haresabadi M, Shariati M. The relationship between caregivers' health literacy and the behavior of women with multiple sclerosis. Iranian Journal of Obstetrics, Gynecology and Infertility. 2018;21(7):71-64.
6. Sany ST, Monazami G, Rezayi M, Tajfard M, Borgheipour H. Application of water quality indices for evaluating water quality and anthropogenic impact assessment. International journal of environmental science and technology. 2019;16(7):3001-12.
7. Sany SBT, Hashim R, Salleh A, Rezayi M, Safari O. Ecological quality assessment based on macrobenthic assemblages indices along West Port, Malaysia coast. Environmental earth sciences. 2015;74(2):1331-41.
8. Rezayi M, Heng LY, Abdi MM, Noran N, Esmaeili C. A thermodynamic study on the complex formation between tris (2-Pyridyl) methylamine (tpm) with Fe 2, Fe 3, Cu 2 and Cr 3 cations in water, acetonitrile binary solutions using the conductometric method. Int J Electrochem Sci. 2013;8:6922-32.
9. LaVeaux D, Simonds VW, Picket V, Cummins J, Calkins E. Developing a Curriculum for Change: Water & Environmental Health Literacy in a Native American Community. Progress in community health partnerships: research, education, and action. 2018;12(4):441.
10. Hashemi M, Sadeghi A, Saghi M, Aminzare M, Raeisi M, Rezayi M, et al. Health risk assessment for human exposure to trace metals and arsenic via consumption of hen egg collected from largest poultry industry in Iran. Biological Trace Element Research. 2019;188(2):485-93.
11. Tehrani GM, Rosli H, Sulaiman A, Sany BT, Salleh A, Owfi F, et al. Petroleum hydrocarbon assessment in the wastewaters of petrochemical special economic zone and sediment benchmark calculation of the coastal area-northwest of the Persian Gulf. Iranian Journal of Fisheries Sciences. 2014;13(1):119-34.
12. Sany SBT, Narimani L, Soltanian FK, Hashim R, Rezayi M, Karlen DJ, et al. An overview of detection techniques for monitoring dioxin-like compounds: latest technique trends and their applications. RSC advances. 2016;6(60):55415-29.
13. Tajfard M, Tavakoly Sany SB, Avan A, Latiff LA, Rahimi HR, Moohebati M, et al. Relationship between serum high sensitivity C‐reactive protein with angiographic severity of coronary artery disease and traditional cardiovascular risk factors. Journal of cellular physiology. 2019;234(7):10289-99.
14. Sany BT, Sulaiman A, Monazami G, Salleh A. Assessment of Sediment Quality According to heavy metal status in the West Port of Malaysia. World Academy of Science, Engineering and Technology. 2011;74:639-43.
15. Alami A, Tavakoly Sany SB, Tehrani H, Lael-Monfared E, Hosseini Z, Jafari A. The effect of educational intervention on iron and vitamin D consumption based on the theory of planned behaviour in Iranian adolescent girls: a quasi-experimental study. International Journal of Health Promotion and Education. 2019;57(6):316-31.
16. Afshari A, Eslami A-a, Mostafavi F, Moazam E, Golzari M, Etminani R. Self-assessment for implementation of health promotion standards in hospitals, in medical education centers of Isfahan city. Iranian Journal of Health Education and Health Promotion. 2020;8(3):249-60.
17. Olyani S, Peyman N. Health Literacy and Health Outcomes in Iranian Adolescents: A Systematic Review. Journal of Health Literacy. 2021;6(3):78-85.
18. Qi S, Hua F, Xu S, Zhou Z, Liu F. Trends of global health literacy research (1995-2020): Analysis of mapping knowledge domains based on citation data mining. Plos one. 2021;16(8):e0254988.
PMid:34370749 PMCid:PMC8351965
19. Marsili D, Pasetto R, Iavarone I, Fazzo L, Zona A, Comba P. Fostering Environmental Health Literacy in Contaminated Sites: National and Local Experience in Italy From a Public Health and Equity Perspective. Frontiers in Communication. 2021:175.
20. Gray KM. From content knowledge to community change: A review of representations of environmental health literacy. International Journal of Environmental Research and Public Health. 2018;15(3):466.
PMid:29518955 PMCid:PMC5877011
21. Finn S, O'Fallon LR. Environmental health literacy: Springer; 2018.
22. Mahdifar M, Ghavami V, Vahedian-Shahroodi M. Health Literacy and Body Image Concern Among Healthcare Employees in Binaloud, Iran. Journal of Health Literacy. 2021;6(1):31-40.