Behaviors, Beliefs, and Recommendations to Optimize Promotion of Safe Fish Consumption Before and During Pregnancy: A Physician Survey

Jeanette Y. Ziegenfuss, Jennifer M. Dinh, Patricia McCann, Abigail S. Katz, Meghan M. JaKa, Jacob Haapala, Cresta Jones, Abbey Mello, Jeremy Springer, Thomas E Kottke

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Introduction: Eating fish before and during pregnancy is important but care must be taken to choose fish which maximize developmental outcomes. Physicians, a trusted health information source, could provide this nuanced communication. This cross-sectional survey of a representative sample of 400 family medicine and obstetrics and gynecology (OB-GYN) physicians in Minnesota was designed to understand physician behaviors and beliefs about safe fish consumption, describe barriers to physician-patient conversations about safe fish consumption generally and as part of prenatal care and to identify resources to help facilitate conversations on this topic. Methods: Data was collected January to April 2020. Two hundred nineteen surveys were completed (55% response rate) with 194 reporting seeing patients at least 1 day a week. Descriptive survey results from all were summarized and analyzed overall and by physician specialty. Responses to 3 open-ended questions were thematically coded to enrich the quantitative results. Results: While 62% of these reported discussing nutrition topics, only about one-third reported discussing with patients the benefits and about one-quarter the risks of eating fish. Despite the relative infrequency of fish discussions, almost all (>90%) respondents agreed that it is important to discuss fish consumption with people who are or may become pregnant. The largest reported barrier to these conversations was time (82%), and the most endorsed resource to overcome identified barriers was talking points (72%). Conclusions: Because physicians report limited time, resources that facilitate fish consumption should be succinct while serving to both nudge the message and direct clinicians and their patients to robust information.

Original languageEnglish (US)
JournalJournal of Primary Care and Community Health
StatePublished - 2022

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding from the Environmental Protection Agency’s Great Lakes Restoration Initiative (GL00E01161) awarded to the Minnesota Department of Health was used for this work.

Publisher Copyright:
© The Author(s) 2022.


  • health promotion
  • maternal and infant health
  • nutrition
  • surveys

PubMed: MeSH publication types

  • Journal Article
  • Research Support, U.S. Gov't, Non-P.H.S.


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