Last week, based on a review of the evidence, the American Heart Association began recommending the use of “personal-level protective actions” for people at high risk of health harm from air pollution. Their press statement explained: “People who are exposed to high levels of air pollution or are at high risk for health complications from polluted air should seriously consider personal protective measures such as avoiding polluted areas, staying indoors, being physically active in the safest way possible and utilizing affordable protective devices. Th(is) include(s) populations living or working near factories or high-traffic roads that produce significant amounts of pollution, communities impacted by wildfires and people with a wide range of health conditions that put them at risk.”

One of those conditions is pregnancy. Today, we are pleased to announce the publication of a new article, “The effectiveness of narrative versus didactic information formats on pregnant women's knowledge, risk perception, self-efficacy, and information seeking related to climate change health risks,” in the International Journal of Environmental Research and Public Health. This article is directly relevant to the Heart Association’s recommendation in that it focuses on how to most effectively educate pregnant women about the health risks associated with air pollution and heat waves—conditions made more frequent and worse by climate change.

Climate change is a global threat that poses significant risks to pregnant women and to their developing fetus and newborn. Educating pregnant women about the risks to their pregnancy may improve maternal and child health outcomes. Prior research suggests that presenting health information in narrative format can be more effective than a didactic format.
The purpose of our current study was to test the effectiveness of two brief educational interventions in a diverse group of pregnant women (n = 151). Specifically, using a post-test only randomized experiment, we compared the effectiveness of brief information presented in a narrative format versus a didactic format; both information formats were also compared to a no information control group.
The didactic information was an abbreviated version of the Environmental Protection Agency’s brochure titled “Climate Change and the Health of Pregnant Women,” from which the graphics and additional information deemed to be less important or confusing had been removed. 

We then used the information in the modified EPA brochure to provide the factual content for the narrative information presentation. This was an important design feature in our research because it ensured consistency of the factual information provided in both treatment conditions.

The narrative information took the form of a full-color comic book. The characters in the comic book were a pregnant woman (the protagonist), her doctor, her child, and one of her pregnant friends. The story presents her interactions with her doctor, her child, and her friend. During these interactions, she learns about the maternal and child health risks of climate change from her doctor and shares the information with her child and friend. The protagonist also suggested to her child that they avoid the risky behavior, thereby in effect modeling the recommended behavior, which should increase the reader’s sense of self-efficacy.