FIGURE 2
Likelihood of A) Nurse Practitioners/Registered Nurses and B) Physicians/Physician Assistants Distributing Educational Resources on Drinking Water Quality to Patients
A) Nurse Practitioners/Registered Nurses ( n = 319)
B) Physicians/Physician Assistants ( n = 169)
Not at All Likely 9%
Not at All Likely 13%
Very Likely 17%
Very Likely 23%
Somewhat Likely 29%
Likely 27%
Somewhat Likely 43%
Likely 39%
cational resources on drinking water quality to patients. A majority of participants for both phy- sicians/physician assistants (78.3%) and nurse practitioners/registered nurses (74.7%) responded that they were not planning on receiving any formal education or training on the health risks of consuming nitrate-contam- inated water ( χ ² = 0.872; p = .351). When eval- uated for behavior and openness to change, 58.7% of physicians/physician assistants and 71.5% of nurse practitioners/registered nurses reported that they would be “likely” to “very likely” to use resources if these were made available ( χ ² = 9.174; p = .002). Responses were mixed, however, when participants were asked about their likeli- hood of distributing educational resources on drinking water quality to patients, with 54.1% of physicians/physician assistants stat- ing that they would be “somewhat” to “not at all likely” to do so. In contrast, 59.0% of the nurse practitioners/registered nurses stated that they would be “likely” or “very likely” to distribute these resources if made available ( χ ² = 8.415; p = .004) (Figure 2). Confidence Domain Participants were also asked to rate their level of confidence related to patient care and nitrate contamination in drinking water. Participants were asked, based on their cur- rent knowledge, how confident they were in
advising their patients about the health risks of nitrate contamination in drinking water, how confident they were in referring patients to appropriate resources if the patients were concerned about their drinking water quality, and how confident the HCPs were in treating patients for the adverse effects of nitrate con- tamination in their drinking water. When asked to rate their confidence in advising patients about the health risks of nitrate contamination in drinking water, 71.1% of physicians/physician assistants and 71.9% of nurse practitioners/registered nurses stated that they were “not at all con- fident” ( χ ² = 0.038; p = .846). Both groups reported being “not at all confident” in refer- ring patients to appropriate resources (56.2% of physicians/physician assistants and 53.8% of nurse practitioners/registered nurses). Last, when asked about their confidence in treating patients for the adverse health effects of nitrate contamination in drinking water, 83.2% of physicians/physician assistants and 74.0% of nurse practitioners/registered nurses reported being “not at all confident” in doing so ( χ ² = 6.073; p = .014). Access to and Preferences for Educational Materials and Training To gauge the current availability of water qual- ity-related resources, participants were asked if they currently had access to resources to learn more about the adverse health effects of nitrate
contamination in drinking water. The majority of physicians/physician assistants (79.2%) and nurse practitioners/registered nurses (80.9%) stated that they did not have access to these educational materials ( χ ² = 0.205; p = .650). Participants were then asked to select their preference for various types of educational materials that they would be interested in using to learn more about the health risks of consuming nitrate-contaminated drink- ing water. Physicians/physician assistants reported that they would be most interested in receiving educational materials and train- ing via a resource website, educational vid- eos, virtual training, and informational fly- ers. Nurse practitioners/registered nurses reported similar preferences, with a resource website, virtual training, educational vid- eos, and brochures being the most preferred. Mean differences between types of educa- tional material varied largely between the two participant groups, suggesting that HCP type should be considered when developing mate- rials and selecting the mode of delivery. Effect of Knowledge and Attitudes on Information-Sharing Behaviors To explore the effect of knowledge and atti- tudes on reported information-sharing behav- iors, a linear regression analysis was con- ducted. Results showed that knowledge was not a strong indicator of information-sharing behaviors ( B = 0.064), nor was it significant
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October 2026 • Journal of Environmental Health
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