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Improving the Behavioural Impact of Air Quality Alerts

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03552198
Recruitment Status : Completed
First Posted : June 11, 2018
Last Update Posted : June 11, 2018
Sponsor:
Collaborators:
National Institute for Health Research, United Kingdom
Public Health England
Information provided by (Responsible Party):
King's College London

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.


Condition or disease Intervention/treatment Phase
Pollution; Exposure Health Behavior Behavioral: Alternative health advice Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 225 participants
Allocation: Randomized
Intervention Model: Factorial Assignment
Intervention Model Description: 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.
Masking: Single (Participant)
Masking Description: To avoid bias participants were not told how the wording of the health advice had been changed.
Primary Purpose: Prevention
Official Title: Improving the Behavioural Impact of Air Quality Alerts in London
Actual Study Start Date : July 23, 2017
Actual Primary Completion Date : September 8, 2017
Actual Study Completion Date : September 8, 2017

Arm Intervention/treatment
No Intervention: General public/usual health advice
Healthy participants with a self-reported existing health condition were randomised to receive the usual UK Air Quality Indices health advice.
Experimental: General public/alternative health advice
Generally healthy participants were randomised to receive targeted health advice about the adoption of protective behaviours in an alternative format.
Behavioral: Alternative health advice
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.

No Intervention: At risk group/usual health advice
Participants with a self-reported pre-existing health condition were randomised to receive the usual UK Air Quality Indices health advice.
Experimental: At risk group/alternative health advice
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
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.




Primary Outcome Measures :
  1. Adoption of preventative behaviour at 4 weeks [ Time Frame: Baseline and at 4 weeks ]
    Differences between conditions in actual adoption of protective behaviours at 4 weeks. Outcome measures were collected via self-reports: participants were asked to agree with statements about their behaviours on 9-point scales. Measures at 4 weeks were adjusted for baseline measures collected at the beginning of the study


Secondary Outcome Measures :
  1. Actual behaviour change in response to a real air quality alert [ Time Frame: At 3 weeks ]
    Differences between conditions in self-reported actual behaviour change in response to receiving a real air quality alert. Behavioural outcomes were collected via a questionnaire asking participants to respond 'yes/no/not sure' to questions about actual adoption of protective behaviour

  2. Self-reported reasons for not changing behaviour in response to receiving a real air quality alert [ Time Frame: At 3 weeks ]
    Qualitative data on participants' self-reported reasons for not changing behaviour in case of a real air quality alert

  3. Intentions to adhere to health advice associated with a hypothetical high air pollution scenario [ Time Frame: Baseline and at 4 weeks ]
    Differences between conditions in intentions to adhere to the health advice received in association with a hypothetical high air pollution alert scenario. Intentions were measured by self-report items: participants were asked to agree with statements about their adherence intentions on 9-point scale, where 1=strongly disagree to 9=strongly agree.

  4. Worry about air pollution [ Time Frame: At 4 weeks ]
    Measured by self-report items: participants were asked to agree with statements about their perceived worry on 9-point scale, where 1=strongly disagree to 9=strongly agree.

  5. Perceived susceptibility to air pollution [ Time Frame: At 4 weeks ]
    Measured by self-report items: participants were asked to state how likely they were to suffer from health effects of air pollution, had they not taken protective actions on a 9-point scale, where 1=not likely at all, to 9=extremely likely.

  6. Perceived severity air pollution [ Time Frame: At 4 weeks ]
    Measured by one self-report item: participants were asked to agree with statements about their perception of the severity of air pollution on 9-point scale, where 1=strongly disagree to 9=strongly agree.

  7. Perceived self-efficacy [ Time Frame: At 4 weeks ]
    Measured by self-report items: participants were asked to agree with statements about their perceived ability to follow the health advice received on 9-point scale, where 1=strongly disagree to 9=strongly agree.

  8. Perceived efficacy of the health advice received [ Time Frame: At 4 weeks ]
    Measured by self-report items: participants were asked to agree with statements about the perceived efficacy of the health advice received on 9-point scale, where 1=strongly disagree to 9=strongly agree.

  9. Perceived costs of the health advice received [ Time Frame: At 4 weeks ]
    Measured by self-report items: participants were asked to agree with statements about their beliefs about the negative consequences of adopting the recommended behaviour on 9-point scale, where 1=strongly disagree to 9=strongly agree.

  10. Information credibility [ Time Frame: At 4 weeks ]
    Meyer's credibility index (1988)

  11. Information clarity [ Time Frame: At 4 weeks ]
    Measured on one self-report item on a 9-point scale, where 1=not clear at all; to 9=extremely clear.

  12. Perceived Informed choice [ Time Frame: At 4 weeks ]
    Measured on one self-report item on a 9-point scale, where 1=strongly disagree to 9=strongly agree.


Other Outcome Measures:
  1. Mediating effects of hypothetical mediator variables on behavioural changes at 4 weeks [ Time Frame: at 4 weeks ]
    Using PROCESS Macro (Hayes, 2013) a mediation analysis (model 4) was ran in order to test whether specific variables mediated the effect of the intervention on behavioural changes at 4 weeks. The model aimed to identify the processes underlying the relationship between the independent variable (i.e. the intervention) and the dependent variable (i.e. behaviours) through the simultaneous inclusion of several hypothetical mediator variables (i.e. worry, perceived susceptibility, perceived severity, perceived efficacy of the advice, self-efficacy, perceived costs of the health advice, and message credibility). These variables were measured using self-report items on a 9-point scale as described above. Behavioural changes at 4 weeks were measured via self-reports: participants were asked to agree with statements about their behaviours on 9-point scales.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • 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.

Exclusion Criteria:

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

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03552198


Locations
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United Kingdom
King' College London
London, United Kingdom, SE1 9NH
Sponsors and Collaborators
King's College London
National Institute for Health Research, United Kingdom
Public Health England
Investigators
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Principal Investigator: Donatella D'Antoni King's College London

Publications:
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Responsible Party: King's College London
ClinicalTrials.gov Identifier: NCT03552198    
Other Study ID Numbers: LRS-16/17-4286
First Posted: June 11, 2018    Key Record Dates
Last Update Posted: June 11, 2018
Last Verified: May 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by King's College London:
Air quality alerts
Health behaviour change
Adherence