A Prescription for Environmental Health

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Prescriptions for Prevention, an online public education tool, is the result of a partnership between NIEHS’s Community Engagement Cores and several regional Pediatric Environmental Health Specialty Units (PEHSU) across the country. The prescriptions are short, downloadable documents that have two parts: an action plan and a list of additional resources. Each prescription educates both clinicians and families about how environmental exposures impact children’s health. The prescriptions also provide clinicians with an easy method to counsel and refer families to needed community resources. The partnership connects the dots among researchers, clinicians, and community partners by incorporating environmental health into routine pediatric care.
Mount Sinai’s Community Engagement Core, which sits within Mount Sinai’s Transdisciplinary Center on Early Environmental Exposures, spearheads the Prescriptions for Prevention project. The Community Engagement Core is co-led by Maida Galvez, M.D., M.P.H., and Carol Horowitz, M.D., M.P.H., who are both public health researchers at Mount Sinai, and Luz Guel, the community engagement coordinator. To develop the Prescriptions for Prevention, they worked with Lauren Zajac, M.D., M.P.H., the clinical director for the Region 2 PEHSU, which is centered at Mount Sinai.
“Prescriptions for Prevention provide easy-to-use information to parents. They empower parents to take meaningful action on their kids’ environmental heath exposures,” said Zajac. “Working together with an interdisciplinary team, including pediatricians and researchers, across the country has really helped us ensure the tools are maximally relevant to local communities.”
Custom Plans and Resources

Top: The Mount Sinai team, including Maida Galvez, M.D., M.P.H. (left) Bottom: Lauren Zajac, M.D., M.P.H., examining a child. (Photo courtesy of Maida Galvez)
Prescriptions for Prevention addresses common concerns such as lead, mold, secondhand smoke, and radon. Although tailored with local resources for New York City, Buffalo, New York State, and the U.S. Virgin Islands and Puerto Rico, they can be readily customized to any geographic region by identifying local community resources.
Each document addresses a different exposure and has an easy-to-follow action plan. For example, there is a Prescription for Prevention for indoor air quality. The action plan suggests reducing indoor sources of pollution with methods like using a stove hood while cooking, letting fresh air in, and testing for radon. The list of additional resources includes links to information about free home visits from the Healthy Neighborhood Program, green cleaning, radon, and carbon monoxide.
Diverse groups collaborated to create the Prescriptions for Prevention, and their focus on community and community engagement makes the Prescriptions for Prevention meaningful to families. Environmental pediatricians, led by Zajac, helped create the tools, ensuring the information is relevant, easy to understand, and aligned with guidance from the American Academy of Pediatrics. Moreover, each prescription is available in both English and Spanish, and select prescriptions are available in Chinese, French, Korean, and Russian.
“The Prescriptions for Prevention is a great example of actionable scientific information that can be tailored to diverse geographic regions,” says Perry Sheffield, M.D., M.P.H., co-director of the Region 2 PEHSU. “We have incorporated Prescriptions for Prevention, including the Spanish versions, into hurricane recovery efforts, working together with federally qualified heath centers and Head Start centers in Puerto Rico and the U.S. Virgin Islands.”
Galvez, a pediatrician and NIEHS grantee, focuses her research on promoting healthy environments for children and improving health outcomes in high poverty communities. In her 2017 co-authored review, Environmental Risks to Children: Prioritizing Health Messages in Pediatric Practice, she urges pediatricians to provide families with evidence about certain environmental exposures and their impact on children’s health so families can make informed decisions. Many of the exposures discussed in the review, including mercury in fish, radon, and secondhand smoke, have a corresponding Prescription for Prevention. Read more about Galvez’s work empowering pediatricians to address children’s environmental health needs in a May 2019 Grantee Highlight.
Timely and Responsive Community Engagement at Mount Sinai
The structure of Mount Sinai’s Community Engagement Core ensures that it is responsive to their communities’ developing needs. The core is informed by a Stakeholder Advisory Board, which identifies community concerns and collaborates on educational, engagement, and research activities. Board representatives come from a variety of disciplines, including family health services, environmental justice and advocacy groups, education, law, architecture and design, and local government.
Using this approach, the Mount Sinai team, with its PEHSU partners, led development of nearly two dozen prescriptions and continues to develop new ones as environmental health issues arise. Their latest, published in April 2020, is about safe disinfecting in homes in the context of COVID-19. Its action plan includes information related to when disinfection is needed and which disinfectants to use. The additional resources link to pages from the American Academy of Pediatrics, local government, and others.
Prescriptions for Prevention is just one of the many ways that the Mount Sinai Community Engagement Core forges community partnerships, translates research for use by the communities it serves, improves the health of families, and advances environmental public health. Read more about the Core’s clinical outreach, community engagement, and education initiatives.
NIH Names New Director of NIEHS
Francis Collins, M.D., Ph.D., appointed Richard Woychik, Ph.D., as director of NIEHS, effective June 7. Woychik had been serving as acting director since October 2019. Woychik will also be the director of the National Toxicology Program, which is composed of NIEHS, the National Center for Toxicological Research, and the National Institute for Occupational Safety and Health.
Woychik’s research has focused on mammalian genetics and environmental epigenetics. His laboratory has several firsts, such as identifying a gene associated with polycystic kidney disease and cloning an obesity-related gene. He says his passion for epigenetics and environmental health started when his research group discovered that obesity in mice was influenced by the epigenome during embryonic development.
Read the full press release.
Now Available: New Walk-through of the Human Subjects & Clinical Trials Information Form
If you work with volunteers in your research and must include the PHS Human Subjects & Clinical Trials Information Form in your NIH grant applications, a new resource may be helpful. The Office of Extramural Research released a short walk-through video of the form to align with the latest application form update, Forms-F, which went into effect for due dates on or after May 25.
The video is six minutes. It covers how to use the form and how to complete both delayed onset and full study records. The video also describes each of the five sections of a study record and goes over which fields are required for human subjects and clinical trial studies. The changes made to the form with the Forms-F release are listed in the Release Notes, and include updates to the form’s organization, updates to the instructions for delayed onset studies regarding the use of a single IRB, and new fields.
National Children’s Study Biological and Environmental Samples Now Available
Biospecimens and environmental sample materials from the National Children’s Study (NCS) Vanguard are now available to approved requesters. Sample materials can be requested through the Eunice Kennedy Shriver National Institute of Child Health and Human Development’s Data and Specimen Hub (DASH). DASH is a centralized resource for researchers to share and access de-identified data for secondary research use. The Vanguard data was made available starting in 2016.
The Vanguard Study was a pilot for a planned cohort study of environmental influences on child health and development. The study, which began in 2009, enrolled over 14,000 participants throughout the United States and followed them through 2014. The study collected nearly 19,000 biological and 5,500 environmental primary samples. Biological samples include blood, urine, saliva, breast milk, and vaginal swabs, while environmental samples include dust, indoor air, infant formula, and water. Additionally, the study collected data records, including questionnaires and interviews, neuro-psychosocial and cognitive assessments, and physical examinations. Study visit data span preconception to 42 months post birth.
For more information, see the notice (NOT-HD-20-018).
NIEHS Updates Environmental Health Topics Webpage on Air Pollution and Health
NIEHS publishes a series of webpages in its Environmental Health Topics series. These pages have information about how chemicals and environmental agents influence a variety of diseases. The pages are geared toward the public and cover a variety of topics, including breast cancer, children’s environmental health, and climate change.
Recently, NIEHS updated a page on Air Pollution and Your Health. The page has information on what air pollution is, and covers various relevant definitions, including traffic-related air pollution, ozone, and particulate matter. There is also a section about areas of health that NIEHS researchers are studying in relation to air pollution, such as respiratory disease, cardiovascular disease, and cancer. The page also describes vulnerable populations, genetic components of respiratory health, NIEHS’s community involvement, and why improving air quality matters.
The Environmental Protection Agency’s Clean Air Excellence Awards Are Open for Applications
The Environmental Protection Agency is now accepting applications for the 2020 Clean Air Excellence Awards Program. This year’s awards will commemorate the 50th anniversary of the Clean Air Act. Applications are due July 31.
The awards recognize individuals and organizations who have helped make progress in achieving cleaner air in the United States. Award recipients are selected for developing innovative, replicable, and sustainable programs; serving as pioneers in their fields; and improving air quality. Awards are made in five main categories, including community action, which applies to community partnership efforts that help achieve cleaner air; and education/outreach, which applies to efforts to educate and/or disseminate information to target audiences about air quality. The three other main categories are clean air technology, state/tribal/local air quality policy innovations, and transportation efficiency innovations.
More information is available on the Clean Air Excellence Awards page.
Environmental Exposure Assessment Services for Researchers: The Human Health Exposure Analysis Resource
To better understand how exposures affect health and lead to disease, NIEHS, in partnership with the National Cancer Institute, the National Heart, Lung, and Blood Institute, and the NIH Environmental Influences on Child Health Outcomes Program, has established a network of exposure analysis services and expertise to support NIH-funded researchers.
The Human Health Exposure Analysis Resource (HHEAR) was established in 2019. It promotes the characterization of human environmental exposures by helping scientists include environmental information in their research. Specifically, researchers can use the HHEAR network of laboratories to analyze biological and environmental samples collected from human health studies. In addition to the analysis laboratories, HHEAR has two other components: a data center that provides statistical services, a data repository, and data standards; and a coordinating center that connects the research community to the exposure resources.
Researchers must apply to the HHEAR program to access to these resources. Applications are due Aug. 28 for the third and final round of 2020.

In our latest podcast, Microplastic Pollution and Human Health, hear from Woods Hole Oceanographic Institution scientist, Mark Hahn, Ph.D., about how microplastics impact human health and the ecosystem. Plus, learn how researchers are working to address this issue.
You can find more podcasts on the Environmental Health Chat webpage or subscribe to the series on iTunes. We want your feedback! Send comments and ideas for future podcasts to podcast@niehs.nih.gov.

PEPH Grantee Highlight
Beverly May, Dr.P.H.
Beverly May, Dr.P.H., a nurse practitioner, was inspired to pursue a degree in public health when her community was slated for mountain top removal, a form of coal mining. May is now the program manager for the Mountain Air Project, which aims to reduce respiratory health disparities in Appalachian communities. The project has given May the opportunity to use her expertise as both a nurse and epidemiologist.
May trained residents to be community health workers, an approach which resulted in an 82.1% participation rate. She attributes this success to the personal connections the health workers had to the communities.
Funding Opportunities
Environmental Influences on Aging: Effects of Extreme Weather and Disaster Events on Aging Populations (R01 Clinical Trial Optional)
Supports research to advance our understanding of the impact of extreme weather and disaster events in aging human populations. This FOA (PAR-19-250) and its companion FOA (), which focuses on underlying mechanisms of aging utilizing animal models, will help explicate the behavioral, biological, and socioecological processes that occur during extreme weather or disaster events that affect aging processes. Through the integration of the population studies and the companion mechanistic studies FOA, the goal is to improve the health and well-being of older adults via increased knowledge about extreme weather and disaster preparedness, response, and recovery.
Deadline: July 7, 2020; November 9, 2020; March 8, 2021
Letter of Intent: Due 30 days prior to the application due date
Native American Research Centers for Health (S06 Clinical Trials Optional)
Invites applications from federally recognized Tribes and Tribal organizations for the Native American Research Centers for Health (NARCH) initiative, which supports biomedical research and career enhancement opportunities to meet health needs prioritized by American Indian or Alaska Native communities. The NARCH initiative also supports research capacity building and the development of research infrastructure to enhance the biomedical research capabilities of these communities.
Deadline: July 24, 2020; June 24, 2021
Letter of Intent: Due 30 days prior to the application due date
Emergency Awards: RADx-UP Coordination and Data Collection Center (U24 Clinical Trial Optional)
Provides an expedited funding mechanism as part of the Rapid Acceleration of Diagnostics for Underserved Populations initiative, a consortium of community-engaged research projects to understand factors that have led to disproportionate burden of the pandemic on underserved and/or vulnerable populations so that interventions can be implemented to decrease these disparities. This funding opportunity seeks to fund a single Coordination and Data Collection Center as an integral part of the consortium.
Deadline: August 7, 2020
Emergency Competitive Revisions for Community-Engaged Research on COVID-19 Testing among Underserved and/or Vulnerable Populations
This NOSI will support supplements to individual NIH research awards that include community collaborations or partnerships to support COVID-19 testing (or have the capacity to ramp up quickly) to reach underserved and/or COVID-19 vulnerable populations. The NOSI highlights the urgent need to understand and address COVID-19 morbidity and mortality disparities among underserved and vulnerable populations across the United States. These two-year community-engaged Testing Research Projects will examine SARS-CoV-2 infection patterns and efforts to increase access and effectiveness of diagnostic methods through the Rapid Acceleration of Diagnostics for Underserved Populations (RADx-UP) initiative. The overarching goal is to understand factors that have led to disproportionate burden of the pandemic on these underserved populations so that interventions can be implemented to decrease these disparities. Collectively, projects funded under these notices will serve as one consortium of interlinked community-engaged research projects across the United States to understand COVID-19 health disparities, and to deploy implementation strategies to improve the reach, acceptance, uptake, and sustainability of COVID-19 testing.
Deadline: August 7, 2020 or September 8, 2020
Emergency Competitive Revisions for Social, Ethical, and Behavioral Implications Research on COVID-19 Testing Among Underserved and/or Vulnerable Populations
Highlights the urgent need to understand the social, ethical, and behavioral implications of COVID-19 testing among underserved and/or vulnerable populations across the United States through the Rapid Acceleration of Diagnostics for Underserved Populations (RADx-UP) initiative. The overarching goal is to understand factors that have led to disproportionate burden of the pandemic on these underserved populations so that interventions can be implemented to decrease these disparities. The purpose of this notice is to identify, analyze, and address the social, ethical, and behavioral factors likely to influence access and uptake of COVID-19 testing in underserved and/or vulnerable populations.
Deadline: August 7, 2020 or September 8, 2020
Limited Competition for Emergency Competitive Revisions for Community-Engaged Research on COVID-19 Testing among Underserved and/or Vulnerable Populations
This NOSI will support supplements to NIH grantees that are part of large-scale networks, consortia, centers and other current programs that have adequate capacity, infrastructure, and established community-engaged relationships to support large-scale testing. The NOSI highlights the urgent need to understand and address COVID-19 morbidity and mortality disparities among underserved and vulnerable populations across the United States. These two-year community-engaged Testing Research Projects will examine SARS-CoV-2 infection patterns and efforts to increase access and effectiveness of diagnostic methods through the Rapid Acceleration of Diagnostics for Underserved Populations (RADx-UP) initiative. The overarching goal is to understand factors that have led to disproportionate burden of the pandemic on these underserved populations so that interventions can be implemented to decrease these disparities. Collectively, projects funded under these notices will serve as one consortium of interlinked community-engaged research projects across the United States to understand COVID-19 health disparities, and to deploy implementation strategies to improve the reach, acceptance, uptake, and sustainability of COVID-19 testing.
Deadline: August 7, 2020
U.S. – India Collaborative Environmental Health Research Program (R01 Clinical Trial Optional)
Stimulates and promotes collaborative basic, translational, and clinical research between U.S.-based researchers and Indian researchers to gain a comprehensive understanding of the impacts of environmental insults on children and adults across all organ systems (e.g., pulmonary, cardiovascular, cancer, and neurological disorders). NIEHS and the Indian Council for Medical Research (ICMR) are interested in supporting collaborative research and research training through joint U.S.-India partnerships that address or seek to understand how exposures to toxic environmental insults alter biologic processes and are linked to disease initiation, progression, or morbidity. To promote these collaborative efforts, the partnering U.S. and Indian investigators must work jointly to submit identical applications to NIH and ICMR, respectively.
Deadline: October 15, 2020
Collaborative Centers in Children's Environmental Health Research and Translation (P2C Clinical Trial Optional)
Creates a national network of children's environmental health translation centers. Through external collaboration with the children's environmental health community, centers will protect and improve children’s health by developing and testing new scientific questions and public health interventions/strategies and by mentoring a pipeline of new investigators interested in translational children’s environmental health. These centers will serve as leaders in children’s environmental health translational research and research methodology development, with a focus on creating actionable steps to move evidence-informed biomedical, behavioral, psychosocial, environmental research findings in children's environmental health to the wider community. The collective collaborative center program will also serve as a national research resource to support response efforts to emerging environmental exposures affecting children.
Deadline: November 23, 2020
Letter of Intent: Due October 23, 2020
Research to Action: Assessing and Addressing Community Exposures to Environmental Contaminants (R01 Clinical Trial Optional)
Encourages multidisciplinary projects to investigate the potential health risks of environmental exposures of concern to a community and to implement an environmental public health action plan based on research findings. Projects supported under this program are expected to employ community-engaged research methods to not only conduct research but also to seamlessly translate research findings into public health action.
Deadline: December 4, 2020
Check out the Research to Action Currently Funded Grantees webpage for a sense of the types of projects supported through this FOA.
Competitive and Administrative Supplements for Community Interventions to Reduce the Impact of COVID-19 on Health Disparity and Other Vulnerable Populations
Supports research to test community interventions focused on the prevention (or slowing) of COVID-19 transmission, evaluate local and state policies and programs intended to mitigate COVID-19 exposure and improve adherence, and reduce the negative impact of the multifaceted consequences on the health of populations who experience health disparities and other vulnerable groups. This may include leveraging and scaling existing resources (e.g., health education materials, technology, social media, mass media, social support networks, social services). In domains and populations in which the evidence base is limited, the development, testing, and implementation of novel or adapted interventions to address the negative health consequences of the COVID-19 pandemic may also be needed to address the unique needs of populations.
Deadline: On a rolling basis through December 15, 2020
PEPH-related News

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David Berube, an NTP adviser, discussed pandemic communications research. Others presented studies using zebrafish as physiological models.

Five teams won honors from the Department of Health and Human Services, marking the institute’s tenth year of recognition.

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