Applying the mental models framework to carbon monoxide risk in northern Mexico.

OBJECTIVES Low-income residents of northern Mexico rely on unvented heaters during the winter, a practice that puts them at elevated risk for carbon monoxide intoxication. The goal of this study is to develop a communication protocol for carbon monoxide intoxication risks among the primarily low socioeconomic status population of Ciudad Juárez, Chihuahua, Mexico. METHODS The mental models risk communication approach was used to identify important gaps in public understanding. This approach consists of step-by-step assessment of information needs and effectiveness of risk communication efforts by using interviews and surveys. RESULTS The mental models process uncovered a key technical misunderstanding, the subject population's belief that carbon monoxide can be seen or smelled, which may result in a risk-prone behavior: failure to use a carbon monoxide detector. A communication protocol was designed to address this and other knowledge gaps, and it produced significant improvements in subjects' knowledge in a pretest/posttest evaluation. CONCLUSIONS The mental models process was successful in developing a communication instrument capable of improving knowledge in the subject population. Future research needs include assessing the extent to which this instrument succeeds in changing behavior and reducing the risk of carbon monoxide intoxication. Future interventional efforts may focus on encouraging people to use carbon monoxide detectors.