The purpose of this study is to assess Missouri primary care physicians’ education, knowledge, attitudes, and beliefs about environmental hazards and the current level of incorporation of environmental medicine into their everyday practice. Barriers to receiving training on environmental hazards and method preferences for receiving such training are also assessed. A main focus of the study is to evaluate if there are major differences between primary care physicians in designated communities at risk (in communities with a designated hazardous waste or NPL site) who have received specific, targeted educational programs through the ATSDR and those who do not practice in such communities. The study also aims to assess whether there are major differences between physicians who practice in different geographic areas (urban area - population of 50,000 or greater, mixed urban/rural area - population of 2,500 to 50,000, and rural area – population of less than 2,500). Through a population based qualitative and quantitative research methodology this project will:
· Identify communities specifically impacted by hazardous environmental exposures in Missouri and health care provider educational programs that have been delivered;
· Develop appropriate and project specific survey instruments to assess perceptions, needs, knowledge, barriers and practice impact of health care providers;
· Pilot and perform a population-based survey of health care providers in Missouri;
· and propose development of material type and content, and approaches for delivery based on findings.