Impact of Air Quality Index awareness on outdoor activity levels

The Air Quality Index (AQI) is reported daily by the U.S. Environmental Protection Agency (USEPA) to inform the public when air quality is bad. It is unknown if these messages are reaching target populations leading to behavior change and ultimately protecting the public's health. This project examined AQI awareness and its impact on outdoor activity levels. A four question state-added module was added to the 2005 Behavioral Risk Factor Surveillance Survey (BFRSS) in eight states. Multivariate logistic regression examined the relationship between AQI and changes in outdoor activity level. Modifying factors included: demographics, chronic diseases, disabilities, and advice from a health professional. Individuals aware of the AQI were 2 times as likely to change their behavior compared to those not aware (OR=1.95, 95%CI 1.72, 2.20). Asthmatics were 18% (OR=1.18, 95%CI 1.04-1.34) more likely to be aware of the AQI and 66% (OR=1.66, 95%CI 1.41-1.96) more likely to reduce/change their outdoor activity level compared to non-asthmatics. Individuals receiving advice from a physician were 4 times as likely to change their behavior when compared to those not receiving advice (OR=4.02, 95%CI 3.30-4.90). Significant risk factors for not being aware of the AQI included, lower income, less education, younger age, minority status, and being in poor or fair health. The results showed that sensitive populations are acknowledging the AQI and are modifying behavior to some extent. Physician advice yielded increased awareness and behavior change. Intervention strategies by federal, state, and local governments to improve AQI awareness should target high risk populations.