Leveraging Coalitions for Health Policy Advocacy: Research on PFAS and Mental Health

Abstract

Purpose: This quality improvement (QI) project aims to earn the support and resources of the Healthy Housing Military Action Group for policy improvement on researching human neuropsychiatric effects from per- and poly-fluoroalkyl substances (PFAS) contamination of drinking water. Background: Every day, millions of people across the United States (US) are consuming water contaminated with PFAS chemicals. Human research studies show associations between PFAS exposure and impairment of several organ function systems. Animal research studies show associations between PFAS exposure, abnormal cerebral dopamine levels, impaired cerebral dopamine receptor function, and abnormal behavior. No studies on human dopamine levels, dopamine receptor function, or behavior exist, and policy does not address this insufficiency. Coalition-building is a studied and proven strategy for agenda promotion. Methods: Kingdon’s Multiple Streams Framework and the Associates in Process Improvement’s Model for Improvement underpinned the development of the intervention and guided stakeholder selection. A coalition, the Healthy Housing Military Action Group, consented to participate based on an interest in the project’s topic. An educational seminar with associated pre- and post-seminar surveys were created, and non-probability sampling obtained from seminar participants (n = 7) and survey respondents (n = 3) from the coalition. The Knowledge, Attitude, Practice model (KAP) guided pre- and post-seminar survey development. An open forum for questions and discussion at the end of the seminar, along with open-ended evaluation questions on the post-seminar survey, provided additional data for future use. Results: Respondents indicated a 330% increase in feeling more knowledgeable about the health effects of PFAS exposure after the presentation. Respondents also indicated a 100% increase in feeling more supportive about bringing awareness to national policymakers about the need for research on the effects of PFAS exposure on dopamine in the human brain after the presentation. In the post-seminar open forum and open-ended survey questions, participants indicated wanting more specific information about health effects, their personal exposure and risk, how to access more information, and how to discuss their concerns with healthcare providers. Conclusions: The educational seminar successfully increased coalition knowledge and policymaking support, making it an effective coalition-building strategy.