Assessing the use of the Air Quality Health Index by vulnerable populations in a ‘low-risk’ region: A pilot study

Several studies have shown a relationship between exposure to outdoor air pollution and adverse health effects, and that people with specific chronic diseases appear to be particularly vulnerable. An important opportunity exists for respiratory therapists to inform at-risk clients, especially those with lung disease, about outdoor air pollution and its role in self-management. The Air Quality Health Index (AQHI), a national program led by Health Canada and Environment Canada, is intended to inform individuals about the level of health risk associated with air pollution in Canadian communities, and to provide a tool to manage those risks. The main purpose of the present study was to assess the use of the AQHI by vulnerable populations in a ‘low-risk’ (AQHI ≤3) region. The specific objectives were: to develop and evaluate an AQHI education strategy; to investigate whether awareness of the AQHI impacts self-management in vulnerable populations in low-risk regions; and to identify enabling factors and/or barriers concerning use of the AQHI by both health care professionals and their patients. A pilot study was conducted using a small convenience sample of clients/patients and educators at respiratory clinics across Nova Scotia. A short educational activity on the utility and application of the AQHI was incorporated into their regular disease management plans and surveys were administered pre- and posteducational intervention. Twenty-one clients from three respiratory clinics consented to participate in the study and received the AQHI education program. Using a Wilcoxon signed-rank test with paired data, five of six survey questions had statistically significant changes in response to pre- and posteducation. Some common themes that emerged from qualitative data collected included: limited access to the Internet; lack of its reporting in the media; confusion with other indexes; and relevancy of the AQHI in Nova Scotia, a ‘low-risk’ region. An AQHI educational program improved knowledge and use of the AQHI reported by respiratory clinic patients. Respiratory educators reported the AQHI education program was relatively simple to implement into their chronic disease education plan. A larger-scale study involving participants residing in a moderate- or high-risk region is recommended.