The Effects of Environmental Health Literacy and Climate Change‐Health Perception on Climate Change‐Health Nursing Practice Among Korean Community Health Practitioners: A Descriptive Correlational Study

BACKGROUND: The climate crisis is among the most pressing public health threats of the 21st century, and the climate-health competencies of primary care nursing personnel serving medically underserved areas are a critical determinant of community resilience. Korean Community Health Practitioners (CHPs), established in 1980 under the Special Measures Act for Public Health and Medical Services in Rural Areas, have provided primary health care (PHC) in medically underserved rural regions for over 40 years; however, their environmental and climate-health competencies have rarely been studied. AIMS: This study examined the effects of Environmental Health Literacy (EHL) and Climate Change-Health Perception on Climate Change-Health Nursing Practice among Korean Community Health Practitioners. DESIGN: A descriptive cross-sectional correlational study. METHODS: Of 1,899 health practice posts nationwide as of 2023, we recruited Community Health Practitioners working in 567 health practice posts located in two administrative regions (J Special Self-Governing Province and J Province). Data were collected via a structured online survey from September 24 to October 31, 2024, yielding a final analytic sample of 144 participants. We administered the Korean Environmental Health Literacy scale (K-EHL, 38 items), the Korean version of the Climate, Health, and Nursing Tool (K-CHANT) Awareness/Concern/Motivation subscales (12 items), and a 32-item Climate Change-Health Nursing Practice checklist developed by Park (2024). Descriptive statistics, independent t-tests, one-way ANOVA with Scheffé's post-hoc test, Pearson correlations, and multiple regression were performed using SPSS 28.0. RESULTS: Mean scores (out of 5) were 3.81 ± 0.34 for EHL, 4.23 ± 0.62 for Climate Change-Health Perception, and 3.51 ± 0.61 for Climate Change-Health Nursing Practice. Climate Change-Health Nursing Practice was significantly correlated with both EHL (r = 0.52, p < 0.001) and Climate Change-Health Perception (r = 0.53, p < 0.001). Multiple regression identified Climate Change-Health Perception (β = 0.33, p < 0.001) and EHL (β = 0.30, p = 0.001) as significant predictors of Climate Change-Health Nursing Practice, jointly explaining 32% of the variance (F = 34.95, p < 0.001). CONCLUSIONS: Climate Change-Health Perception and Environmental Health Literacy are key determinants of climate-health nursing practice among Korean Community Health Practitioners serving medically underserved areas. Educational programs targeting both constructs may strengthen the climate-health practice readiness of primary care nurses and enhance the health resilience of rural and medically underserved populations. IMPLICATIONS FOR PUBLIC HEALTH NURSING PRACTICE: This study provides empirical justification for developing integrated Climate Change-Health Perception + Environmental Health Literacy training programs for primary care nursing personnel in medically underserved areas. Linking such programs with public health centers, civil servant continuing education, and nurse refresher education systems is recommended.