Abstract Introduction/Rationale A translational gap exists in how patients with chronic obstructive pulmonary disease (COPD) utilize mitigation strategies (e.g. indoor air cleaners) to limit exposure to wildfire smoke entering their homes. Our study examines patients’ points of view about barriers and facilitators of strategy uptake, informing interventions that could protect patients’ health during periods of poor air quality. Methods We conducted a qualitative study and performed semi-structured, virtual interviews with members of Kaiser Permanente Northern California until reaching thematic saturation. We recruited participants aged 65 and older in the lowest quartile of socioeconomic status because they are disproportionately exposed to environmental exposures with fewer resources to utilize existing mitigation strategies. A codebook was developed, and qualitative analysis was performed using inductive and deductive approaches. Results Of 90,696 adults aged 65 years and older with COPD, we interviewed 31 in January 2025. Participants were racially and ethnically diverse (19% Black, 10% Hispanic, 3% Native American, 68% non-Hispanic White), from 10 counties throughout Northern California. Three major themes were 1) patients tended to get wildfire and air quality information from the internet and smartphone apps, not clinical encounters, but expressed openness to receiving information from clinicians, 2) there appear to be modifiable barriers to uptake of mitigation strategies, such as education and supplying equipment (e.g., masks, air cleaners), and 3) patients prefer real-time alerts sent to their phones from trusted sources, such as healthcare or government entities, to change their behavior during periods of poor air quality. Modifiable barriers were assigned appropriate Capability, Opportunity, and Motivation - Behavior and Behavior Change Wheel (COM-B, BCW) factors from which potential interventions were designed (Figure 1). Conclusions By understanding patients’ perspectives, we are more able to design a successful intervention for protecting patients’ health from wildfire smoke. This abstract is funded by: NIH (National Institutes of Health)
Yao et al. (Fri,) studied this question.