Understanding the Knowledge, Attitudes, and Practices of Healthcare Professionals toward Climate Change and Health in Minnesota

Round 1

Reviewer 1 Report

This is an important subject and although the proportion of elligible respondents is low, the numbers are still sufficient for analysis and interpretation.

The main disadvantage is that it is a convenience sample with a relatively low uptake  (probably less than 5%).  Therefore, we cannot assume that the responses are represntative of the target group and may be over-represented by those with a previous interest or kowledge of the impact of climate change on health.  Nurses seemed more likely to respond than doctors.

Having said that it is ulikely to detract from the main conclusion which is that many nurses would like to be able to discuss the impact of climate change on health but often do not do so.  The main reasons seem to be a lack of confidence in their knowledge, a shortage of time and a concern that patients will not be interested.  Their suggested remedies include specific training modules and access to relevant research.

If this sort of survey is repeated, I would like to see some inclusion of questions on how individual action to improve health can also help reduce climate change.  There are many examples of this including active transport (more walking and cycling), healthier nutrition (less processed foods, especially meat and more fresh vegetables), improved insulation of housing  and increasing access to urban green space.  These subjects could legitimately be raised when encouraging healthier lifestyles but the opportunity is rarely taken.

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

The present work discusses how important is that healthcare professionals have knowledge about CC effects (direct and indirect) impacts on patients’ health. This can be challenging both in terms of (i) awareness and acquiring knowledge by those technicians and (ii) how to have a conversation with patients, mostly with patients that have a “lower belief” in CC.

Somehow, the field of the paper is related with the following important questions to society:

1.Can a conversation by a healthcare professional transfer knowledge or spark interest on patients to search more knowledge about preventive and corrective measures about CC and health? Can it impact patients’ attitude towards a better health?

2. How could agencies develop better skills on their employees (healthcare professionals)? Are these workers interested in this issue? How they see their (actual and potential) capacities and fragilities on this theme.

Despite the open complexities of this issue, the paper addresses the problem with bibliographical studies and with anonymous surveys to both nurses and physicians.

Chapter 2.2 do carefully explain the survey methodology performed in April and May 2021.

Results chapter explores statistically the survey data.

Some suggestions:

It would be interesting if the paper could address the possible influence of survey questions on answers: Are the questions clearly objective or they leave some subjectivity depending on the pre-positioning on CC by respondents?

Conclusions chapter can include more numerical data such as that of lines 205 -210, in figure 3 and other quantified statistics

Author Response

Please see the attachment.

Author Response File: Author Response.docx