Assessing Protective Behaviors and Acceptability of Future Interventions for Reducing Children's Wildfire Smoke Exposure

Abstract

Background: As wildfire activity in the U.S. increases, children are increasingly exposed tounhealthy levels of wildfire smoke. Public health interventions to reduce wildfire smoke impacts are needed, particularly in vulnerable communities who experience barriers to self-protection. More information is needed to understand families’ current engagement in protective behaviors and the acceptability of potential future resources. This study aims to address these gaps in a rural community in Washington State. Methods: We conducted a mixed-methods study using survey and focus group data collectedfrom participants in an existing prospective cohort study. The survey was administered following a regional wildfire smoke event and collected information on protective actions taken, barriers to actions not taken, unmet needs, and interests in future resources. Descriptive summaries were reported. We conducted focus groups to gather information on the acceptability of a draft intervention comprised of education, free durable goods, and wildfire smoke alerts. A thematic analysis guided by the Theoretical Framework of Acceptability revealed key takeaways. Results: Of N=94 survey participants, most identified as Hispanic or Latino (74.5%), most wereborn in the United States (71.3%), and nearly half had attended some college or more (46.8%). The protective action most frequently reported was closing windows and doors, with 88% reporting doing so “often.” Barriers to taking other protective actions included gaps in knowledge and economic limitations. Survey participants were interested in future resources including free durable goods and text alerts about wildfire smoke. Feedback from N=15 focus group participants indicated that the draft intervention is acceptable in this population, especially when suggested improvements are integrated. Conclusions: This study provides novel insights into the experiences of families in vulnerablecommunities during wildfire smoke events. Participant perspectives on potential future resources to mitigate child health impacts should inform the design and implementation of public health interventions.