Evidence map›Paper›PMID 41654674›Full record

ArticleJournal of exposure science & environmental epidemiology2026

A personalized tutorial to improve understanding of individual chemical results and opportunities for reducing exposure.

Katherine E Boronow, Aaron Maruzzo, Rachel A Morello-Frosch, Anisha Nakagawa Patil, Erin DeMicco, Phil Brown, Amy M Padula, Sarah D Geiger, Julia Green Brody

Abstract read
In one paragraph

Article in Journal of exposure science & environmental epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Katherine E BoronowSilent Spring Institute, Newton, MA, USA. boronow@silentspring.org.
Aaron MaruzzoSilent Spring Institute, Newton, MA, USA.
Rachel A Morello-FroschSchool of Public Health and Department of Environmental Science, Policy and Management, University of California, Berkeley, Berkeley, CA, USA.
Anisha Nakagawa PatilSilent Spring Institute, Newton, MA, USA.
Erin DeMiccoProgram for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
Phil BrownSocial Science Environmental Health Research Institute, Northeastern University, Boston, MA, USA.
Amy M PadulaProgram for Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
Sarah D GeigerDepartment of Health and Kinesiology and Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
Julia Green BrodySilent Spring Institute, Newton, MA, USA.

Funding

Scaling up access and usability of smartphone tools for reporting chemical biomonitoring resultsR21ES030454 · NIEHS · SILENT SPRING INSTITUTE · PI BRODY, JULIA GREEN, BROWN, PHILIP M. · 2019 to 2020
$412k
NIEHS NIH HHS R21 ES030454
6 · The paper itself

Abstract

backgroundEnvironmental health studies frequently measure levels of harmful chemicals in people or personal spaces, and returning those individual levels is an ethical responsibility and important opportunity to teach people about chemical exposures and how to reduce them.

objectiveWe sought to enhance meaningful report-back by quantitatively evaluating a personalized tutorial designed to support environmental health literacy about personal chemical exposures.

methodsWe developed a novel smartphone-based tutorial that used the Predict-Observe-Explain educational framework to increase understanding of personal results graphs and promote taking actions to lower exposure. We deployed the tutorial as part of report-back in the Illinois Kids Development Study and Chemicals in Our Bodies pregnancy cohorts, and we collected digital analytics on how participants (n = 295) interacted with it. We tested the effect of the tutorial on participants' accuracy at answering four graph-reading questions and examined differences by educational attainment and socioeconomic status. The tutorial prompted participants to select exposure sources that were relevant to them, and we calculated response frequencies of participants' self-reported interest in taking related actions.

resultsA total of 92% of participants (n = 270) completed the Predict and Observe phases of the tutorial. Among those participants, 70% (n = 188) correctly answered all four graph-reading questions on their first attempt (without tutorial assistance), and success increased to 96% (n = 258) after the tutorial provided feedback and participants could make a second attempt. Improvement was greatest among participants without a bachelor's degree. Participants who answered the Explain phase (n = 182) expressed high interest in trying new behaviors to reduce exposure. SIGNIFICANCE: While most participants understood their personal exposure graph without assistance, the tutorial successfully reduced differences in understanding by educational attainment. The tutorial was also effective at creating intentions to adopt health-protective behaviors. Scalable tools like this can support effective report-back in populations with all levels of environmental health literacy. IMPACT: To help people at all educational levels learn about their chemical levels and how to reduce them, we developed a personalized tutorial for use in reporting back results in environmental exposure studies. Before tutorial assistance, participants without a bachelor's degree had lower understanding of their personal results graphs. Tutorial assistance successfully reduced differences in understanding between those with and without a bachelor's degree. In addition, the tutorial was effective at creating intentions to adopt health-protective behaviors based on personalized recommendations for each participant. This scalable digital tool supports understanding and action during report-back of chemical exposure results.

Indexed as

Environmental ExposureEnvironmental HealthHealth LiteracyAdultFemaleHumansMaleReturn of Individual Research ResultsSmartphoneYoung AdultEnvironmental chemicalsEnvironmental health literacyGraph literacyReturn of resultsScience communication

Identifiers

PMID41654674
PMCPMC13143806

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.