An e-Learning Course to Train General Practitioners in PlanetaryHealth:Pilot Intervention Study

Background: According to the World Health Organization, climate and ecological emergencies are already major threats tohuman health. Unabated climate change will cause 3.4 million deaths per year by the end of the century, and health-related deathsin the population aged >= 65 years will increase by 1540%. Planetary health (PH) is based on the understanding that human healthand human civilization depend on flourishing natural systems and the wise stewardship of those natural systems. Health caresystems collectively produce global emissions equivalent to those of the fifth largest country on earth, and they should take stepsto reduce their environmental impact. Primary care in France accounts for 23% of greenhouse gas emissions in the health caresector. General practitioners (GPs) have an important role in PH. The course offers first-year GP residents of the Montpellier-N & icirc;mesFaculty of Medicine a blended-learning course on environmental health. An e-learning module on PH, lasting 30 to 45 minutes,has been introduced in this course. Objective: The objective of this study was to assess the impact of the e-learning module on participants'knowledge and behaviorchange. Methods: This was a before-and-after study. The module consisted of 3 parts: introduction, degradation of ecosystems andhealth (based on the Intergovernmental Panel on Climate Change report and planetary limits), and ecoresponsibility (based onthe Shift Project report on the impact of the health care system on the environment). The questionnaire used Likert scales toself-assess 10 points of knowledge and 5 points of PH-related behavior. Results: A total of 95 participants completed the pre- and posttest questionnaires (response rate 55%). The mean scores forparticipants'pretest knowledge and behaviors were 3.88/5 (SD 0.362) and 3.45/5 (SD 0.705), respectively. There was no statisticallysignificant variation in the results according to age or gender. The pretest mean score of participants who had already taken PHtraining was statistically better than those who had not taken the PH training before this course (mean 4.05, SD 0.16 vs mean3.71, SD 0.374; P<.001). Conclusions: The PH module of the Primary Care Environment and Health course significantly improved self-assessmentknowledge scores and positively modified PH behaviors among GP residents. Further work is needed to study whether theseself-declared behaviors are translated into practice