Does Dixon's Integrative Environmental Health Model Inform an Understanding of Rural Parents' Perceptions of Local Environmental Health Risks?


  • Kelly E. Harnish,

    1. B.S., C.H.E.S., is the Montana Project Coordinator for the Environmental Risk Reduction through Nursing Intervention and Education (ERRNIE) study, Montana State University College of Nursing, Bozeman, Montana,
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  • Patricia Butterfield,

    1. Ph.D., R.N., F.A.A.N., is Professor and Chair, Department of Psychosocial and Community Health, University of Washington School of Nursing, Seattle, Washington
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  • Wade G. Hill

    1. Ph.D., A.P.R.N., B.C., is Assistant Professor, Montana State University College of Nursing, Bozeman, Montana
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Kelly E. Harnish, College of Nursing, Montana State University, 206 Sherrick Hall, Bozeman, MT 59717. E-mail:


ABSTRACT A qualitative study of parents' perceptions of local environmental health risks was conducted to assess the fit between concepts from Dixon's Integrative Environmental Health Model (DIEH model) and field-generated data. This research was part of a prospective study addressing environmental exposures of rural low-income children. Home visit data from 11 parents were analyzed (1) thematically and (2) according to DIEH concepts. These complementary analyses allowed the researchers to examine perceptions that were congruent with or diverged from the DIEH model. Findings revealed that participants were concerned about children's exposure to pathogenic molds and cigarette smoke and felt uninformed about risks and prevention strategies. Barriers to preventive actions included families' lack of time and a disinterest in brochures. Participants reported being “stuck” in substandard housing by poverty and family demands. They expressed concern about risks, but were unsure “what to worry about.” Results provided the researchers with confidence that the DIEH model aligned with participants' cognitive constructions of risk. As a result, the DIEH model was incorporated into the conceptualization for the clinical trial phase of the study. This type of check between a theoretical approach and field data can be a helpful intermediate step for researchers involved in multiyear studies.