Improving the Behavioural Impact of Air Quality Alerts

NCT03552198 | Completed Results

• 1 other identifier: LRS-16/17-4286
• Study Type: interventional
• Target: 225
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Pollution; Exposure; Health Behavior

Keywords

Air quality alerts; Health behaviour change; Adherence

Outcome Measures

Primary Outcomes (1)

• Adoption of Protective Behaviour 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).

  Baseline and at 4 weeks

Secondary Outcomes (3)

• 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

Study Arms (4)

General public/usual health advice

NO INTERVENTION

Healthy participants with a self-reported existing health condition were randomised to receive the usual UK Air Quality Indices health advice.

General public/alternative health advice

EXPERIMENTAL

Generally healthy participants were randomised to receive targeted health advice about the adoption of protective behaviours in an alternative format.

Behavioral: Alternative health advice

At risk group/usual health advice

NO INTERVENTION

Participants with a self-reported pre-existing health condition were randomised to receive the usual UK Air Quality Indices health advice.

At risk group/alternative health advice

EXPERIMENTAL

Participants with a self-reported existing health conditions were randomised to receive targeted health advice (based on their health condition) about the adoption of protective behaviours in an alternative format.

Behavioral: Alternative health advice

Interventions

Alternative health advice BEHAVIORAL

These messages targeted specific beliefs about air pollution and protective actions aimed at reducing exposure to air pollution. In addition, message specificity was targeted, which means that compared to the usual messages, the alternative messages reported more detailed health recommendations.

At risk group/alternative health advice; General public/alternative health advice

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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.

You may not qualify if:

• younger than 18 years
• not working or living in Greater London
• no longer users of the air quality alert smartphone application.

Sponsors & Collaborators

• King's College London: lead
• National Institute for Health Research, United Kingdom: collaborator
• Public Health England: collaborator

Study Sites (1)

King' College London

London, SE1 9NH, United Kingdom

Location

Related Publications (6)

• (WHO), W. H. O. (2014). Burden of disease from air pollution. Retrieved from http://www.who.int/phe/health_topics/outdoorair/databases/FINAL_HAP_AAP_BoD_24March2014.pdf?ua=1.

  BACKGROUND

• D'Antoni D, Smith L, Auyeung V, Weinman J. Psychosocial and demographic predictors of adherence and non-adherence to health advice accompanying air quality warning systems: a systematic review. Environ Health. 2017 Sep 22;16(1):100. doi: 10.1186/s12940-017-0307-4.

  PMID: 28938911 BACKGROUND

• Kelly FJ, Fussell JC. Air pollution and public health: emerging hazards and improved understanding of risk. Environ Geochem Health. 2015 Aug;37(4):631-49. doi: 10.1007/s10653-015-9720-1. Epub 2015 Jun 4.

  PMID: 26040976 BACKGROUND

• Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011 Apr 23;6:42. doi: 10.1186/1748-5908-6-42.

  PMID: 21513547 BACKGROUND

• Daniel J. O'Keefe (1997) Standpoint Explicitness and Persuasive Effect: A Meta-Analytic Review of the Effects of Varying Conclusion Articulation in Persuasive Messages, Argumentation and Advocacy, 34:1, 1-12, DOI: 10.1080/00028533.1997.11978023

  BACKGROUND

• Samoli E, Atkinson RW, Analitis A, Fuller GW, Green DC, Mudway I, Anderson HR, Kelly FJ. Associations of short-term exposure to traffic-related air pollution with cardiovascular and respiratory hospital admissions in London, UK. Occup Environ Med. 2016 May;73(5):300-7. doi: 10.1136/oemed-2015-103136. Epub 2016 Feb 16.

  PMID: 26884048 BACKGROUND

MeSH Terms

Conditions

Health Behavior

Condition Hierarchy (Ancestors)

Behavior

Results Point of Contact

• Title: Dr D D'Antoni
• Organization: KCL

donatella.d'antoni@kcl.ac.uk

NA

Study Officials

• Donatella D'Antoni

  King's College London

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: To avoid bias participants were not told how the wording of the health advice had been changed.
• Purpose: PREVENTION
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: 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.

Study Record Dates

• First Submitted: May 15, 2018
• First Posted: June 11, 2018
• Study Start: July 23, 2017
• Primary Completion: September 8, 2017
• Study Completion: September 8, 2017
• Last Updated: October 22, 2021
• Results First Posted: October 22, 2021

Record last verified: 2018-05

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)