Perinatal Environmental Health Education Intervention to Reduce Exposure to Endocrine Disruptors: The PREVED Project

BackgroundEnvironmental health promotion interventions may reduce endocrine disruptor (ED) exposure. PREVED (PREgnancy, preVention, Endocrine Disruptors) project was developed to improve knowledge, to enhance risk perception and to change exposure behavior. Our objective was to present the phases of PREVED project using the RE-AIM method.MethodsPREVED intervention consisted of 3 workshops during pregnancy. Reach, adoption, and implementation phases were assessed with qualitative studies. Efficacy study consisted of a three-arm randomized controlled trial (RCT) on 268 pregnant women: i) control group (leaflet) ii) intervention group in neutral location iii) intervention group in contextualized location. The main outcome was the percentage evolution of participants who reported consuming canned food. Secondary outcomes were evolution of psycho-social scores, evolution of ED presence in urine and ED presence in colostrum. ResultsThe intervention adoption was centered on upper-privileged women, but implementation assessment showed that key features (highly practical intervention) seemed to be carried out and had initiated some behavior changes. A total of 268 pregnant women participated in the intervention and 230 on randomized controlled trial (control group: 86 and intervention groups: 172). We found no significant differences in consumption of canned food and in percentage of women having a decrease of bisphenol A or parabens in urine, but we found significant increase in the evolution of risk perception score and overall psychosocial score in intervention groups (respectively: +15.73 control versus +21.03 intervention, p=0.003 and +12.39 versus +16.20, p=0.02). We found a significant difference in percentage of women with butylparaben detection between control group and intervention groups (13% versus 3%, p=0.03). ConclusionPREVED intervention is the first intervention research dedicated to perinatal environmental health education in France. By sharing know-how/experience in a positive non-alarmist approach, it improved risk perception, which is a key to behavior change aiming to reduce perinatal ED exposure. Including women in precarious situations stay a major issue.Trial registration number: Retrospectively registered on 31 July 2017 (when the first participant was enrolled in this non-drug intervention, ClinicalTrials.gov was centered in therapeutic trials): NCT03233984 - URL: https://clinicaltrials.gov/ct2/show/NCT03233984