Improving the Behavioural Impact of Air Quality Alerts in London
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 225
- 试验地点
- 2
- 主要终点
- Adoption of Protective Behaviour at 4 Weeks
研究概览
简要总结
The evidence shows that adherence to air quality advice to adopt protective behaviours during pollution episodes is suboptimal, and that the traditional strategy of simply informing people about high pollution episodes is not effective. The aim of the present study was to investigate how to improve the behavioural impact of existing air quality alert messages through a systematic manipulation of key communication variables, including perceived susceptibility, self-efficacy, response efficacy, planning, message specificity, etc. Users of an existing air quality alert smartphone application in London, who agreed to take part in the study, were randomly allocated to a control group (i.e. receiving usual health advice associated with the official UK Air Quality Index) or an intervention group receiving health advice associated with air quality alerts in an alternative format (i.e. targeting key variables). Both intended and actual adherence behaviours were investigated. Qualitative data were also collected to understand the reasons for not adopting protective behaviours in response to receiving a real air pollution alert.
Implications of this study include the potential to increase protective behaviours in the general population during air pollution episodes through the development of more effective communication strategies provided via existent air quality alert systems.
详细描述
According to data released in 2014, in 2012 around 3.7 million people died prematurely in the world as a result of exposure to ambient air pollution ((WHO), 2014). Evidence has shown the negative short- and long-term effects of air pollution on both premature mortality and morbidity from cardiopulmonary disease (for an overview, see (Kelly & Fussell, 2015)). This is particularly a problem in London (Samoli et al., 2016), where levels of air pollution are quite worrying. In the UK monitoring networks measure the levels of different air pollutants, and these measurements are provided by the Department for Environment, Food & Rural Affairs (DEFRA) in the form of daily air quality indices (AQIs), together with separate health advice for at-risk groups and the general population. A recently published systematic review (D'Antoni, Smith, Auyeung, & Weinman, 2017) has found suboptimal adherence levels to health advice associated with air quality alerts, and identified several facilitators and barriers of adherence. Some of the facilitators included beliefs that air pollution can have negative health effects (i.e. perceived severity), outcome expectancies (e.g., beliefs that something can be done to reduce smog), beliefs about the health benefits of AQI adoption (i.e. response efficacy), and receiving advice from health care professionals. Barriers to adherence included: lack of understanding of the indices, being exposed to health messages that reduced both concern about air pollution and perceived susceptibility, as well as perceived lack of self-efficacy/locus of control, reliance on sensory cues and lack of time to make behavioural changes. The findings of this systematic review have informed the current research study, which aimed to improve the behavioural impact of existing air quality alerts. In particular, alternative health messages were developed based on the psychosocial factors identified in the systematic review. The purpose of the study was to test whether these theory and evidence-based alternative communication formats, compared to the official messages sent in association with the UK AQIs, maximise the behavioural impact of existing alert systems.
Methods
Design:
This was a randomised control trail using a 2-way factorial design, with target population (2 levels: general population vs. individuals with a pre-existing health condition) and message format (2 levels: usual message format vs. alternative format) as between-factors. Qualitative data were also collected to understand the reasons for actual adherence and non-adherence.
- Theoretical framework and targeted psychosocial predictors:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Prevention
- 盲法
- Single (Participant)
盲法说明
To avoid bias participants were not told how the wording of the health advice had been changed.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •To be eligible to participate, participants had to be members of the general public in the adult age range (>18 years), be fluent in English, working or living in Greater London, and being new or old users of a specific air quality alert smartphone application.
排除标准
- •younger than 18 years
- •not working or living in Greater London
- •no longer users of the air quality alert smartphone application.
结局指标
主要结局
Adoption of Protective Behaviour at 4 Weeks
时间窗: Baseline and at 4 weeks
Differences between conditions in actual adoption of protective behaviours at 4 weeks. Outcome measures were collected via self-reports: The question was: 'In the past 4 weeks, how often have you taken action to reduce exposure to air pollution, in response to hearing or reading an air quality forecast?' Measures: from 1 'Not at all' to 9 'all of the time' (answers 'N/A, I am not aware of any forecast' were excluded from analyses).
次要结局
- Considered Making Permanent Changes(at 4 weeks)
- Actual Behaviour Change in Response to a Real Air Quality Alert(At 3 weeks)
- Intentions to Adhere to Health Advice Associated With a Hypothetical High Air Pollution Scenario(Baseline and at 4 weeks)