Public health professionals recommend that women of childbearing age (WOCBA) consume 2 meals of fish low in mercury each week to maximize the health benefits of eating fish, while minimizing the harmful effects of exposure to mercury. Despite the many benefits of consuming fish, research suggests that many WOCBA fall short of this recommendation, while some continue to consume high-risk species. The Wisconsin Department of Health Services partnered with community-based clinics in northern Wisconsin to implement a clinic-based intervention aimed at assessing mercury levels in participants and educating WOCBA on how to choose and incorporate low mercury fish into their diets.
METHODS:
Project participants included 255 northern Wisconsin women, ages 18-45, who were recruited through local health clinics and community based outreach. Participation included two forty-five minute clinic visits (separated by six months), completion of detailed dietary questionnaires, hair sample collection, education on Wisconsin’s fish consumption advisories, and personalized results-based education. Education activities included dietary counseling, discussion of fish consumption advisory information, and the distribution of health education materials (example recipes, brochures, cookbooks, etc.). After completing the six-month follow-up visit participants completed a project evaluation questionnaire. Questionnaires were submitted anonymously. Multiple choice responses were summarized with basic frequencies, while open-ended responses were reviewed in multiple phases to allow for identification and coding of themes.
RESULTS:
After participating in this intervention, >90% of women reported increased confidence in their understanding of Wisconsin’s fish consumption advisories. Several participants noted an increase in perceived access to advisory information, including knowing where to look for guidance, having tangible health education resources, and gaining knowledge regarding the advisory components. Many participants also mentioned one-on-one interactions with project staff as a positive experience, noting that their questions were answered during in-person clinic visits and that any previous misconceptions or concerns about fish consumption were addressed. Furthermore, participants felt better equipped to interpret and apply fish consumption guidance to their dietary habits, and the majority of participants indicated increased confidence in their ability to choose locally caught and purchased fish low in contaminants.
CONCLUSIONS:
Individualized dietary counseling appears to be an effective method for communicating complex dietary guidance, such as fish consumption advisories, to an at-risk population. This approach may result in increased confidence to make meaningful health behavior changes and could be further explored as an alternative to traditional passive communication methods.