WIC Research, Policy and Practice Hub WIC Research, Policy and Practice Hub

Journal Article

Successfully Changing a State’s Climate to Increase Blood Lead Level Testing

By Gettens G, Drouin B


Childhood lead poisoning continues to be a persistent environmental pediatric health problem in New Hampshire (NH). In 2015, 660 (4.9%) children younger than 6 years had blood lead levels of 5 µg/dL or more, the Centers for Disease Control and Prevention’s recommended level for public health action. Yet, only 16.8% of NH children younger than 6 years were tested. NH’s Healthy Homes and Lead Poisoning Prevention Program (HHLPPP) identified 2 barriers to blood lead testing and the opportunities to resolve them: (1) venous testing had lower compliance and resulted in costly follow-up time for providers and (2) lack of understanding in the medical community about the importance of blood lead testing. Strategies to engage pediatric providers needed to recognize the realities of this rural state. In 2016, a strategy with goals of increasing blood lead screening and testing rates statewide with focus on high-risk communities was developed and implemented. The 5-part integrated strategy included the following: (1) implement a medical education program for pediatric providers; (2) increase provider awareness of point-of-care testing equipment; (3) create and distribute medical reference materials; (4) develop parent reminders for blood lead tests; and (5) increase the availability of point-of-care testing equipment. During 2016, NH’s HHLPPP presented 25 medical education sessions. Blood lead testing rates improved dramatically, especially at medical sites where both face-to-face education and point-of-care testing were implemented. NH’s success serves as a model for other rural areas seeking to improve lead screening rates.

View Resource

Date Added
February 11, 2019

Gettens G, Drouin B (2019) Successfully Changing a State's Climate to Increase Blood Lead Level Testing. Journal of Public Health Management and Practice: Vol. 25, pp S31–S36. Available online: https://journals.lww.com/jphmp/Fulltext/2019/01001/Successfully_Changing_a_State_s_Climate_to.6.aspx