Engagement in Particulate Matter Exposure Reduction Behaviors Across Diverse Clinical Cohorts.

Background and

Objectives

We aimed to evaluate differences in PM exposure reduction behaviors among older adults and patients with chronic respiratory diseases, atrial fibrillation, and stroke and to identify associated determinants. Materials and

Methods

This multicenter cross-sectional study included 717 participants from five cohorts: older adults (n = 255), chronic obstructive pulmonary disease (COPD, n = 145), asthma (n = 100), atrial fibrillation (n = 117), and stroke (n = 100). PM exposure reduction behaviors were assessed using a standardized 18-item questionnaire (total score range: 0-126) covering indoor, outdoor, and other behaviors (health-seeking actions, such as checking air quality and using purifiers).

Results

In multivariable linear regression models, COPD (β = 11.09), asthma (β = 15.54), and atrial fibrillation (β = 14.29) were associated with significantly higher total behavior scores compared with the older adult cohort (adjusted mean 69.0), corresponding to an approximately 20% relative increase in the asthma cohort. The stroke cohort did not differ significantly from the primary cohort. Domain-specific analyses showed that indoor and other behavioral scores were consistently higher across all disease cohorts, whereas outdoor scores were significantly elevated only for asthma and atrial fibrillation. In a fully adjusted model that included all covariates simultaneously, the stroke cohort demonstrated a modest increase in the total score (β = 8.79). Increased age and higher educational attainment were independently associated with greater behavioral engagement.

Conclusions

PM exposure reduction behavior scores differed across the clinical cohorts, and sociodemographic factors were independently associated with behavioral engagement. These findings support personalized disease-specific counseling and inform future digital health interventions for vulnerable populations.