A person-centered digital intervention program to reduce exposures to endocrine disrupting chemicals in an under-resourced population - ABSTRACT Exposures to endocrine disrupting chemicals (EDCs) are linked to chronic diseases, reproductive and fetal harm, and infertility.1–24 Infertility costs the US $8-18 billion/yr;25–35 most expenses are not covered by insurance.33,34 Lower-cost methods of improving fertility are in demand.29 Further, infertility disparately affects people of African descent (B/AA), due to foundational hurdles, distinct customs, and economic obstacles in accessing prenatal/fertility care. 34,36,37 There are known associations between EDCs and adverse reproductive outcomes in this population.13,37,38 Current tools do not support B/AA individuals in understanding and reducing exposures. There is an urgent need for interventions that improve environmental health literacy (EHL), empower behavioral change, and improve reproductive health in B/AA populations. Million Marker (MM) is a science-driven company that combines biomonitoring, personalized education, and digital health tools to reduce environmental exposures using with EDC urine testing, tailored actionable reports, and EDC EHL education.39 MM services are effective at reducing exposures40 and improving health/wellness parameters, clinical biomarkers, and sperm quality. In Phase I, we developed the first mobile tool providing population- targeted EHL education and personalized recommendations.41 In another pilot, we found EDC report-back/ intervention in 25 B/AA individuals improved EHL attitudes/knowledge, health, stress, exposure reduction, and clinical biomarkers. We also found differences between B/AAs and other populations, indicating the need for tailored report-back and education materials. These results demonstrate feasibility, strong population engagement, and proof-of-concept. Phase II will rigorously evaluate efficacy and clinical outcomes with a focus on fertility health in reproductive-aged B/AA individuals. This focus on fertility augments commercialization potential and impact, as individuals are willing to invest more in their health and lifestyle to achieve their fertility goals, and healthier lifestyle/minimized exposures are linked to better fertility health. We will accomplish our goals through the following aims: 1) Develop and refine a tailored EDC report-back intervention for reproductive-aged B/AA adults, 2) Evaluate the efficacy and clinical parameters of the intervention in a randomized controlled trial, and 3) Evaluate changes in EHL, readiness to change, and fertility-related exposure-reducing practices, as well as intervention acceptability and usability (System Usability Scale). By completing these aims, we will deliver the first population-tailored biomonitoring report-back intervention for reproductive-aged B/AAs, improving the reproductive health of the population. Results will advance population-specific fertility science, inform clinical adoption and scaling, with commercialization potential for integration into clinics, OB/GYN practices, employee wellness programs, and preventive health care. This project will advance MM’s mission to democratize environmental biomonitoring, reduce infertility and health gaps, and improve reproductive and population health.
